Merrigan et al. (2010) reported results that are similar MSM in three states in Nigeria 52. Another present research in Nigeria among MSM whom engaged in transactional intercourse, revealed that MSM aged 25 years and above had been four times very likely to be HIV good compared to those aged 15–19 years 53. Nevertheless, our findings are as opposed to those reported by Beyrer et al. (2012) and (2016) which indicated that more youthful MSM had greater burden of HIV 1, 54. A plausible description for the choosing is the fact that the older MSM have experienced prolonged experience of HIV through greater amount of intimate lovers, participating in transactional intercourse and greater contact with unprotected rectal intercourse. Also, MSM sampled this season and 2014 had been almost certainly going to be HIV good in comparison to those in 2007 and also this further supports our argument that the extended experience of higher danger behaviours will be the reason for higher HIV prevalence among older MSM. Young MSM aged 16–19 years will likely still have parental help and hence, there’s less socioeconomic force to take part in risky sexual methods such as for example transactional intercourse. In addition, their sexual sites revolve around their peers in place of intergenerational intimate lovers and also this limits their experience of older HIV contaminated MSM.
There is a significant rise in the proportion of MSM who reported making love with feminine lovers between 2007 and 2014. This takes its bridge that is potential MSM additionally the basic populace and so merits conversation given that gains in reduced amount of HIV prevalence one of the basic populace could be eroded by bisexual sex among MSM. The rise in bisexuality may mirror the increasing hostility, stigma and criminalization of MSM in Nigeria. Schwartz et al. (2015) evaluated the instant aftereffects of the same-sex wedding prohibition work in Nigeria and reported a statistically significant boost in percentage of MSM that has feminine lovers following the legislation ended up being passed away in comparison to the pre-law period 13. This coping device into the high stigma and criminalization of MSM could also adversely influence their usage of key populace friendly clinics while they continue steadily to conceal their identification also to medical care employees.
This research has many limits. The lack of a prospective research team therefore the utilization of cross-sectional studies from unmatched cohort limitations the strength of our research and so calls for caution into the interpretation for the information. There might be possible dependence between information from various rounds of IBBSS which might overestimate HIV prevalence if an important quantity of positives from previous rounds had been recruited into subsequent rounds or an underestimation of HIV prevalence is a substantial quantity of HIV negative MSM were targeted and recruited in subsequent rounds. Future studies will include a adjustable to greatly help recognize those in past rounds and their HIV status at that round to permit an even more estimation that is robust of among MSM. Information on HIV prevention programs and therapy protection within the research states had not been available and therefore could never be taken into account within our research to separately assess the effects of the programs within the research outcome. In addition, information on therapy protection may help give an explanation for increase that is observed therapy protection had been examined become low. Another limitation is the fact that of social desirability bias on intimate danger behaviours as information had been self-reported, nevertheless the greater escalation in constant condom usage during transactional intercourse when compared with non-transactional is related to that seen among female intercourse employees 54 and shows that risks behaviors captured during these studies was under-reported because of the enhance of STIs and HIV observed. Also, studies on biological validation of non-safe sex among feminine intercourse employees have indicated significant over-reporting of protected sex 55 and future studies should think about biological validation of protected intercourse among MSM to higher characterize risk behaviours medication use especially usage of methamphetamine 1 happens to be related to HIV among MSM, but, there clearly was no information on medication usage among MSM in most three rounds associated with study. Further research is needed to figure out the association of medication use and HIV among MSM in Nigeria. Finally, only a few customers plumped for an HIV make sure the percentage of refusal ranged from 10 to 16percent. Even though the status of these whom rejected an HIV test may not be thought, individuals who declined to choose for an HIV test could have done this as a result of past knowledge of HIV infection and thus prevalence of HIV might have been underestimated within the present study and afterwards biases the noticed trend in HIV prevalence.
In summary, this the very first research to assess the trend of HIV prevalence among MSM in Nigeria and we also report lots of key findings. Such as other climes, HIV prevalence among MSM in Nigeria is for an alarming progression with a general enhance of 10% point each year over 7 years. No state is spared, and avoidance packages must certanly be holistic and include the utilization of techniques aided by the strongest proof of greatest effectiveness in preventing HIV transmission; very very early remedy for partners, 2, 56 condoms 32, 57 and oral preexposure prophylaxis 58. Finally, the HIV epidemic among MSM in Nigeria is serious and obviously, is amongst the defining challenges ahead, and perhaps the absolute most gap that is critical the nationwide HIV avoidance system to manage the HIV epidemic in Nigeria.
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