Population Council Research that makes a difference

Kenya National AIDS Control Council
First National Biennial HIV and AIDS Research Conference
17–20 May 2011

Abstract

"HIV and STI prevalence among men who have sex with men in Nairobi: Results from a respondent-driven sampling study"
Scott Geibel, Waimar Tun, Meredith Sheehy, D. Broz, H. Mutua, N. Muraguri, H.F. Raymond, B. Mundia, A. Kim, R. Kaiser, S. Dadabhai, J. Kimani, and Jerry Okal

Background
Men who have sex with men (MSM) in Africa are at high risk of HIV infection. Probability sample surveys to determine HIV and STI prevalence and behavioral risk factors among MSM in Kenya are urgently needed to inform prevention and care services.

Methods
In 2010, we conducted a cross-sectional survey with MSM aged 18 and older, using respondent-driven sampling (RDS) in Nairobi. Consenting MSM completed a behavioral questionnaire and were tested for HIV (fingerstick rapid test); syphilis (venous blood); and chlamydia and gonorrhea (urine and rectal swabs). Population-based prevalence rates and 95% confidence intervals (CI) were estimated using RDS Analysis Tool (RDSAT).

Results
Among 563 MSM, the median age was 28 years (inter-quartile range: 24–35). MSM not involved in selling sex comprised 60.4%; while 12.2% of MSM reported sex work as their "main occupation" and another 27.4% reported selling sex in the past two months (but not as their main occupation). Overall HIV prevalence was 18.2% (CI: 13.1–23.6%), syphilis 0.7% (CI: 0–1.8%), genital gonorrhea 3.4% (CI: 1.6–5.8%), rectal gonorrhea 3.5% (CI: 1.8–5.4%), genital chlamydia 2.2% (CI: 0.4–4.3%), and rectal chlamydia 3.5% (CI: 1.8–5.4%). HIV prevalence was higher among MSM who reported sex work as their main occupation (27.3%, CI: 14.1–44.3%) or selling sex in the past two months (26.6%, CI: 16.1–37.7%), than among MSM who did not sell sex (12.7%, CI: 8.0–18.1%). STI prevalence rates and risk behaviors showed similar associations with sex work status.

Conclusions
HIV prevalence rates among MSM were higher than among Nairobi’s general population aged 15–64 years (8.8%; 2007 KAIS) and highest in male sex workers. Health programs need to address concerns and modify services to meet needs of diverse subgroups of MSM. We recommend continued, periodic surveillance to monitor HIV and STI prevalence and behavioral risks among MSM in Nairobi, and expansion to other areas in Kenya.

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