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Alessi EJ, Lee YG, Chikalogwe VP, Tarusarira W, Raymond H, Lynn M, Kahn S. Pilot study of an arts- and theatre-based HIV prevention intervention for men who have sex with men and transgender women migrants in South Africa: acceptability, feasibility and preliminary efficacy. HEALTH EDUCATION RESEARCH 2023; 38:392-411. [PMID: 37229526 DOI: 10.1093/her/cyad021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/27/2023]
Abstract
Innovative approaches addressing the elevated human immunodeficiency virus (HIV) risk among men who have sex with men (MSM) or transgender women (TGW) migrants in South Africa are urgently needed. We sought to present the acceptability, feasibility and preliminary efficacy of 'Externalize and Mobilize!', a multi-session arts- and theatre-based HIV prevention group intervention for MSM and TGW migrants in South Africa. Fourteen participants-MSM (n = 7; 50%), genderqueer/nonbinary persons (n = 4; 29%) and TGW (n = 3; 21%)-in Cape Town were recruited and enrolled in the intervention and administered pre- and post-intervention assessments of HIV knowledge, HIV risk-reduction self-efficacy, stigma and resilience. The intervention, delivered over 4 days, was completed by all 14 participants. Scores on HIV knowledge and HIV risk-reduction self-efficacy were statistically significantly higher at post-intervention compared with pre-intervention. Additionally, participants responded affirmatively (i.e. 'Agree' or 'Strongly agree') on all items assessing intervention acceptability. Findings demonstrate the high acceptability, feasibility and preliminary efficacy of an arts- and theatre-based intervention for increasing HIV knowledge and HIV risk-reduction self-efficacy among MSM and TGW migrants in South Africa. This study provides further support for the use of creative and innovative interventions to address entrenched HIV disparities in South Africa.
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Affiliation(s)
- E J Alessi
- Rutgers University School of Social Work, New Brunswick, NJ 08901, USA
| | - Y G Lee
- Rutgers University School of Social Work, New Brunswick, NJ 08901, USA
| | | | - W Tarusarira
- PASSOP, Cape Town, Western Cape 8001, South Africa
| | - H Raymond
- Rutgers University School of Public Health, Piscataway, NJ 08854, USA
| | - M Lynn
- Rutgers University School of Social Work, New Brunswick, NJ 08901, USA
| | - S Kahn
- McGill University School of Social Work, Montreal, Quebec H3A 1B9, Canada
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Gebrehiwet K, Biranu E, Nigatu W, Gebreegziabher A, Desta K. Prevalence of Hepatitis B Virus, Human Immune Deficiency Virus and Associated Risk Factors Among Individuals with Presumptive Pulmonary Tuberculosis Attending at Saint Peter's Specialized Hospital, Addis Ababa, Ethiopia. Infect Drug Resist 2023; 16:3965-3979. [PMID: 37366503 PMCID: PMC10290864 DOI: 10.2147/idr.s410260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023] Open
Abstract
Background Hepatitis B virus (HBV), human immunodeficiency virus (HIV) and tuberculosis are the causes of widely spread infectious disease, especially in resource-limited countries. The extent of HBV infection and its contributing factors among people with suspected pulmonary tuberculosis (PTB) were not adequately addressed. Objective To assess the prevalence of HBV, HIV & their associated risk factors and the magnitude of TB among individuals with presumptive pulmonary tuberculosis attending at St. Peter's Specialized Hospital, Addis Ababa, Ethiopia. Methods A cross-sectional study was conducted among 387 individuals with presumptive PTB from October to December 2020. A standard questionnaire was used to collect socio-demographic data and associated risk factors. Sputum samples were analyzed by GeneXpert, Florescent Microscopy and Ziehl-Nelson staining technique. HBsAg test was carried out using Murex Version 3 ELISA test kit from serum/Plasma samples, HIV testing was performed by rapid HIV test kits and data were analyzed using SPSS version 23. Results The mean age of study participants was 44.2 years. Overall, 14 (3.6%), 28 (7.2%) and 37 (9.6%) of them were positive for HBV, HIV & TB, respectively. Only single patient was HBV-HIV co-infected (0.3%). The TB-HIV co-infection was identified in 6 (1.6%). In multivariate analysis, being partner separated, alcohol consumption, body piercing and having multiple sexual partners were significantly associated with HBV infection. Having a spouse, who is divorced, widowed, sharing scissors, alcohol consumption and contact with multiple sexual partners also significantly associated with HIV infection. Conclusion This study showed that HBV, HIV and TB are still public health issues that need awareness and health education on the risky behaviors and transmission of HBV, HIV & TB among individuals with presumptive TB suspects. Further large-scale study is necessary.
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Affiliation(s)
- Kahasit Gebrehiwet
- Addis Ababa University College of Health Sciences, Department of Medical Laboratory Sciences, Addis Ababa, Ethiopia
- St. Peter’s Specialized Hospital, Addis Ababa, Ethiopia
| | | | - Wondatir Nigatu
- Ethiopian Public Health Institute, Tuberculosis /HIV Research Directorate, Addis Ababa, Ethiopia
| | | | - Kassu Desta
- Addis Ababa University College of Health Sciences, Department of Medical Laboratory Sciences, Addis Ababa, Ethiopia
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Mackesy-Amiti ME, Levy JA, Bahromov M, Jonbekov J, Luc CM. HIV and Hepatitis C Risk among Tajik Migrant Workers Who Inject Drugs in Moscow. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5937. [PMID: 37297541 PMCID: PMC10252367 DOI: 10.3390/ijerph20115937] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/05/2023] [Accepted: 05/20/2023] [Indexed: 06/12/2023]
Abstract
The human immunodeficiency virus (HIV) epidemic in Eastern Europe and Central Asia continues to grow with most infections occurring in high-risk groups including people who inject drugs and their sexual partners. Labor migrants from this region who inject drugs while in Russia are at especially high HIV risk. Male Tajik migrant workers who inject drugs in Moscow (N = 420) were interviewed prior to a randomized trial of the Migrants' Approached Self-Learning Intervention in HIV/AIDS (MASLIHAT) peer-education HIV-prevention intervention. Participants were interviewed about their sex and drug use behavior and tested for HIV and hepatitis C (HCV) prior to the intervention. Only 17% had ever been tested for HIV. Over half of the men reported injecting with a previously used syringe in the past month, and substantial proportions reported risky sexual behavior. Prevalence rates of HIV (6.8%) and HCV (2.9%) were elevated, although lower than expected when compared to estimates of prevalence among people who inject drugs at the national level in Tajikistan. Risk behavior in diaspora varied across the men's regional area of origin in Tajikistan and occupation in Moscow, with HIV prevalence rates highest among those working at the bazaars. Evidence-based prevention approaches and messaging that specifically address the drug- and sex-related risk behavior of migrants with varying backgrounds are needed.
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Affiliation(s)
| | - Judith A. Levy
- School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA
| | | | | | - Casey M. Luc
- School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA
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Mackesy-Amiti ME, Levy JA, Bahromov M, Jonbekov J, Luc CM. HIV and hepatitis C risk among Tajik migrant workers who inject drugs in Moscow. RESEARCH SQUARE 2023:rs.3.rs-2622346. [PMID: 36909589 PMCID: PMC10002823 DOI: 10.21203/rs.3.rs-2622346/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Background . The HIV epidemic in Eastern Europe and Central Asia continues to grow with most infections occurring in high-risk groups including people who inject drugs and their sexual partners. Labor migrants from this region who inject drugs while in Russia are at especially high HIV risk. Methods . We recruited 420 male Tajik migrant workers who inject drugs in Moscow for a peer-education HIV prevention intervention trial. Participants were interviewed about their sex and drug use behavior and tested for HIV and hepatitis C prior to the intervention. Results . Over half of the men reported injecting with a previously used syringe in the past month. Many men reported condomless sex (42%), multiple sex partners (30%), and sex with sex workers (42%). Only 17% had ever been tested for HIV. Despite substantial risk behavior, prevalence rates of HIV (6.8%) and HCV (2.9%) although elevated were lower than expected when compared to estimates of prevalence among PWID at the national level in Tajikistan. Risk behavior in diaspora varied across the men’s regional area of origin in Tajikistan and occupation in Moscow with HIV prevalence rates highest among those working at the bazaars. Conclusion . Tajik male migrants who inject drugs in Moscow are at heightened risk for HIV and hepatitis C. Evidence-based prevention approaches and messaging that specifically address the drug- and sex-related risk behavior of migrants from different parts of Tajikistan, employment sectors within the destination city, and socio-demographic background are needed.
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Durojaiye I, Obisie-Nmehielle N, Ibisomi L. Transactional sex and HIV infection among commercial farm workers in South Africa. J Public Health Afr 2020; 11:1229. [PMID: 33623652 PMCID: PMC7893317 DOI: 10.4081/jphia.2020.1229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 01/18/2021] [Indexed: 11/23/2022] Open
Abstract
Background High prevalence of HIV infection has been reported among commercial farm workers in South Africa, but studies of the role of transactional sex in this epidemic is limited. Objective This study seeks to examine the association between transactional sex and HIV infection among commercial farm workers in South Africa. Methods This is a cross-sectional secondary data analysis of the Integrated Biological and Behavioural Surveillance Survey by the International Organization of Migration among farm workers in Mpumalanga and Limpopo Provinces, South Africa in 2010. The study included 2,758 sexually active farm workers. The outcome variable was HIV infection while the main explanatory variable was engagement in transactional sex. Other explanatory variables were sex, age, marital status, number of sex partners, food security, recent history of sexually transmitted infection, condom use at last sex with non-regular partner, history of sexual violence and migration status. Bivariate and multivariable logistic regression analyses were done to obtain unadjusted and adjusted odds ratios of the association between transactional sex and HIV infection. Results Engagement in transactional sex was common (19%) but not significantly associated with HIV infection (OR 1.1; CI 0.57-2.44). Female sex (1.93; 1.60-2.32), age 25 to 44 years, recent STI (OR 1.37; CI 1.18-1.58) and sexual violence (OR 1.39; CI 1.19-1.63) were significant risk factors for HIV infection. Conclusion Risky sexual behaviours were common among the farmworker population. HIV prevention interventions should include behavioural change communication and improved access to healthcare for STI and HIV treatment.
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Affiliation(s)
- Idris Durojaiye
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Latifat Ibisomi
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Nigerian Institute of Medical Research, Lagos, Nigeria
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Wulandari LPL, Guy R, Kaldor J. The burden of HIV infection among men who purchase sex in low- and middle-income countries - a systematic review and meta-analysis. PLoS One 2020; 15:e0238639. [PMID: 32886695 PMCID: PMC7473528 DOI: 10.1371/journal.pone.0238639] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/20/2020] [Indexed: 12/03/2022] Open
Abstract
Background Since the start of the HIV epidemic, transactional sexual relationships have been considered to present a high risk of HIV transmission to both the client and the person offering the sexual service. However, prevention research and programs have focused predominantly on sex workers rather than on their clients, who are generally men. To support effective and targeted interventions, we undertook a systematic review and meta-analysis of the evidence of the prevalence of HIV infection among men who purchase sex (MWPS) in low- and middle-income countries (LMICs), and the association between HIV infection and purchase of sex. Methods We included articles that reported from LMICs on the prevalence of HIV in MWPS and those that reported on HIV prevalence among both MWPS and non-MWPS in the same study, or any information which allowed calculation of the prevalence. We defined MWPS as heterosexual males (not men who purchase sex or individuals of other sexual orientation) who purchased sex mostly from women (and not men), or who have had sexual contact with female sex workers (FSWs). We searched Medline, Global Health, Scopus, Embase and Cinahl for articles published up until 1 March 2020. Meta-analysis was conducted using a random effects model to estimate the pooled HIV prevalence and the relative risk (RR) of HIV infection associated with purchasing sex. Results Of 34862 studies screened, we included 44 studies (59515 men, 47753 MWPS) from 21 countries. The pooled HIV prevalence among MWPS was 5% (95%CI: 4%-6%; I2 = 95.9%, p < 0.001). The pooled HIV prevalence calculated from studies that reported data collected pre-2001 was highest, i.e. 10% (95% CI: 6%-14%; I2 = 91.2%, p < 0.001), compared to studies whose data was collected between 2001–2010, i.e. 4% (95%CI: 2%-6%; I2 = 96.6%, p < 0.001), and from 2011 and beyond, i.e. 3% (95% CI: 2%-5%; I2 = 94.3%, p < 0.001). For studies which included comparisons of HIV infection among MWPS and non-MWPS, the relative risk of HIV infection was consistently higher among MWPS than among non-MWPS within the same study, with the overall pooled relative risk of 1.95 (95%CI: 1.56–2.44; I2 = 84.3%, p < 0.001), and 2.85 (95%CI: 1.04–7.76; I2 = 86.5%, p < 0.001) for more recent studies. Conclusions This review represents the first comprehensive assessment of the burden of HIV among MWPS in LMICs. We found that HIV prevalence was elevated compared to the population as a whole, and that there was a strong association between purchasing sex and HIV prevalence. Despite a reduction over time in prevalence, these data highlight that MWPS need better access to HIV preventive interventions.
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Affiliation(s)
- Luh Putu Lila Wulandari
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Bali, Indonesia
- * E-mail: ,
| | - Rebecca Guy
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - John Kaldor
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Hamdiui N, Buskens V, van Steenbergen JE, Kretzschmar MEE, Rocha LEC, Thorson AE, Timen A, Wong A, van den Muijsenbergh M, Stein ML. Clustering of chronic hepatitis B screening intentions in social networks of Moroccan immigrants in the Netherlands. BMC Public Health 2020; 20:344. [PMID: 32183757 PMCID: PMC7077096 DOI: 10.1186/s12889-020-8438-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 02/28/2020] [Indexed: 12/05/2022] Open
Abstract
Background Early detection, identification, and treatment of chronic hepatitis B through screening is vital for those at increased risk, e.g. born in hepatitis B endemic countries. In the Netherlands, Moroccan immigrants show low participation rates in health-related screening programmes. Since social networks influence health behaviour, we investigated whether similar screening intentions for chronic hepatitis B cluster within social networks of Moroccan immigrants. Methods We used respondent-driven sampling (RDS) where each participant (“recruiter”) was asked to complete a questionnaire and to recruit three Moroccans (“recruitees”) from their social network. Logistic regression analyses were used to analyse whether the recruiters’ intention to request a screening test was similar to the intention of their recruitees. Results We sampled 354 recruiter-recruitee pairs: for 154 pairs both participants had a positive screening intention, for 68 pairs both had a negative screening intention, and the remaining 132 pairs had a discordant intention to request a screening test. A tie between a recruiter and recruitee was associated with having the same screening intention, after correction for sociodemographic variables (OR 1.70 [1.15–2.51]). Conclusions The findings of our pilot study show clustering of screening intention among individuals in the same network. This provides opportunities for social network interventions to encourage participation in hepatitis B screening initiatives.
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Affiliation(s)
- Nora Hamdiui
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, RIVM/LCI, Postbus 1 (Postbak 13), 3720, BA, Bilthoven, The Netherlands. .,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. .,Radboud University Medical Center, Radboud Institute for Health Sciences , Department of Primary and Community Care, Nijmegen, The Netherlands.
| | - Vincent Buskens
- Department of Sociology/ICS, Utrecht University, Utrecht, The Netherlands
| | - Jim E van Steenbergen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, RIVM/LCI, Postbus 1 (Postbak 13), 3720, BA, Bilthoven, The Netherlands.,Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mirjam E E Kretzschmar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Luis E C Rocha
- Department of Economics & Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Anna E Thorson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Aura Timen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, RIVM/LCI, Postbus 1 (Postbak 13), 3720, BA, Bilthoven, The Netherlands.,Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Albert Wong
- Department of Statistics, Informatics and Modeling, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Maria van den Muijsenbergh
- Pharos: Dutch Centre of Expertise on Health Disparities, Program Prevention and Care, Utrecht, The Netherlands.,Radboud University Medical Center, Radboud Institute for Health Sciences , Department of Primary and Community Care, Nijmegen, The Netherlands
| | - Mart L Stein
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, RIVM/LCI, Postbus 1 (Postbak 13), 3720, BA, Bilthoven, The Netherlands
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Effects of Migration on Risky Sexual Behavior and HIV Acquisition in South Africa: A Systematic Review and Meta-analysis, 2000-2017. AIDS Behav 2019; 23:1396-1430. [PMID: 30547333 DOI: 10.1007/s10461-018-2367-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
While human mobility has been implicated in fueling the HIV epidemic in South Africa, the link between migration and HIV has not been systematically reviewed and quantified. We conducted a systematic review of the role of migration in HIV risk acquisition and sexual behaviour based on 29 studies published between 2000 and 2017. Furthermore, we performed a meta-analysis of the association between migration and HIV risk acquisition in four of the studies that used HIV incidence as an outcome measure. The systematic review results show that HIV acquisition and risky sexual behavior were more prevalent among both male and female migrants compared to their non-migrant counterparts. The meta-analysis results demonstrate that migration was significantly associated with increased HIV acquisition risk (aOR = 1.69, 95% CI 1.33-2.14; I2 = 35.0%). There is an urgent need for effective combination HIV prevention strategies (comprising biomedical, behavioral and structural interventions) that target migrant populations.
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Dai W, Luo Z, Xu R, Zhao G, Tu D, Yang L, Wang F, Cai Y, Lan L, Hong F, Yang T, Feng T. Prevalence of HIV and syphilis co-infection and associated factors among non-commercial men who have sex with men attending a sexually transmitted disease clinic in Shenzhen, China. BMC Infect Dis 2017; 17:86. [PMID: 28100187 PMCID: PMC5241916 DOI: 10.1186/s12879-017-2187-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/05/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although HIV and syphilis co-infection has been frequently observed in men who have sex with men (MSM), only few studies have focused on it. Different subgroups of MSM might exhibit heterogeneous HIV and syphilis risk profiles, indicating that interventions for HIV and HIV-related co-infections may vary with different subgroups of MSM. However, no previous study has investigated HIV and syphilis co-infection among non-commercial MSM (ncMSM) attending a sexually transmitted disease (STD) clinic. Therefore, this study aimed to explore the prevalence of HIV and syphilis co-infection and associated factors among ncMSM attending an STD clinic in Shenzhen, China. METHODS NcMSM attending the STD clinic of Shenzhen Center for Chronic Disease Control were recruited in this cross-sectional study every Monday between March 2013 and August 2015 using a site based convenience sampling method. An anonymous questionnaire was used to collect data regarding socio-demographic characteristics, risky sexual behaviors and HIV-related knowledge. Blood samples were collected to perform HIV and syphilis tests. RESULTS Totally 533 participants were enrolled in this study and the prevalence of HIV and syphilis co-infection among them was 13.13%. Multivariable analyses indicated that having lived in Shenzhen for less than one year (aOR = 2.80, 95% CI = 1.30-6.05), having first anal sexual intercourse before the age of 18 (aOR = 2.78, 95% CI = 1.29-5.89), having 3 to 5 anal sexual partners in the past six months (aOR = 2.54, 95% CI = 1.19-5.40), playing exclusively receptive (aOR = 6.87, 95% CI = 3.02-15.61) or both insertive and receptive (aOR = 3.65, 95% CI = 1.64-8.09) roles in anal sexual intercourse and not always using condom in anal sexual intercourse (aOR = 2.13, 95% CI = 1.08-4.19) were associated risk factors for HIV and syphilis co-infection, relative to the non-infected ncMSM. Compared with the mono-infected ncMSM, associated risk factors for the co-infection were being unmarried (aOR = 2.47, 95% CI = 1.03-5.89) and playing exclusively receptive role (aOR = 2.44, 95% CI = 1.04-5.73) in anal sexual intercourse. CONCLUSIONS HIV and syphilis co-infection is quite prevalent among the study participants in Shenzhen. Integrated and intensified intervention strategies, specifically targeting at the non-infected and mono-infected ncMSM attending the STD clinic, are needed to reduce HIV and syphilis co-infection. Most importantly, non-infected and mono-infected ncMSM attending the STD clinic with the aforementioned associated risk factors should be given special concern.
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Affiliation(s)
- Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Zhenzhou Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Ruiwei Xu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Guanglu Zhao
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Dan Tu
- Graduate School, Shenzhen University, Shenzhen, Guangdong China
| | - Lin Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Feng Wang
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Yumao Cai
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Lina Lan
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Fuchang Hong
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Tubao Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Tiejian Feng
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
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