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Scott Geibel, Stanley Luchters, Nzioki Kingola,
Agnes Rinyiru,
Eka Esu-Williams, and
Waimar Tun. "Informing HIV and STI prevention programs
for men who sell sex to men in Mombasa, Kenya."
ABSTRACT
Background
Despite anecdotal information regarding the existence of men who
sell sex to men (MSSM) in Mombasa, Kenya, there has been no
systematic data collected on this vulnerable population. Better
understanding of MSSM sexual risk behaviors is needed to inform HIV
and STI prevention programs, so that the specific needs of MSSM may be
addressed.
Methods
In 2006, a cross-sectional survey of 425 MSSM in Mombasa
District was conducted, utilizing a time-location sampling design.
Using a structured questionnaire administered through handheld
computers, data were collected on sociodemographic characteristics,
sexual behaviors, prevention knowledge and practices,
discrimination, and health service utilization. The survey was
supplemented with ten in-depth interviews and three focus group
discussions.
Results
While 58 percent of respondents reported using a condom during anal sex
with their last male client, only 36 percent reported consistent condom
use. Only 15 percent reported using a water-based lubricant with their last
male client. Of those who have ever used condoms, those who reported
using water-based lubrication with their last male client were
significantly less likely than those who used other
lubrications—such as Vaseline—to have ever experienced condom
breakage (46 percent vs. 61 percent, p=0.033). Thirty-five percent of respondents did not know
that HIV
can be transmitted via anal sex.
Recommendations
Existing HIV/STI prevention and care programs are failing to reach
many MSSM. An HIV prevention program is currently being implemented
by ICRH in Mombasa to address this gap via the opening of an MSM-friendly
drop-in center, condom and lubricant distribution, and prevention
education through peer educators.
Learning objectives
- Analyze the population characteristics and sexual risk
behaviors of men who sell sex to men in Mombasa, Kenya.
- Discuss how sexual behaviors described in the objective
above are not accounted for by existing prevention and treatment
programs in Kenya.
- Describe a pilot prevention program that aims to address the
gaps discussed in the second objective listed above.
Oral Session 4037.0—Prevention Strategies and HIV Risk Sexual
Behaviors in Africa
Tuesday, 6 November 2007,
8:30–10:00
am
APHA 2007 Conference Web site
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