HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa

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dc.contributor.authorBaral, Stefanen_ZA
dc.contributor.authorBurrell, Earlen_ZA
dc.contributor.authorScheibe, Andrewen_ZA
dc.contributor.authorBrown, Benen_ZA
dc.contributor.authorBeyrer, Chrisen_ZA
dc.contributor.authorBekker, Linda-Gailen_ZA
dc.date.accessioned2015-10-28T07:01:19Z
dc.date.available2015-10-28T07:01:19Z
dc.date.issued2011en_ZA
dc.description.abstractBACKGROUND:The HIV epidemic in Sub Saharan Africa has been traditionally assumed to be driven by high risk heterosexual and vertical transmission. However, there is an increasing body of data highlighting the disproportionate burden of HIV infection among MSM in the generalized HIV epidemics across of Southern Africa. In South Africa specifically, there has been an increase in attention focused on the risk status and preventive needs of MSM both in urban centers and peri-urban townships. The study presented here represents the first evaluation of HIV prevalence and associations of HIV infection among MSM in the peri-urban townships of Cape Town. METHODS: The study consisted of an anonymous probe of 200 men, reporting ever having had sex with another man, recruited through venue-base sampling from January to February, 2009. RESULTS: Overall, HIV prevalence was 25.5% (n = 51/200). Of these prevalent HIV infections, only 6% of HIV-1 infected MSM were aware of their HIV status (3/50). 0% of men reported always having safe sex as defined by always wearing condoms during sex and using water-based lubricants. Independent associations with HIV infection included inconsistent condom use with male partners (aOR 2.3, 95% CI 1.0-5.4), having been blackmailed (aOR 4.4, 95% CI 1.6-20.2), age over 26 years (aOR 4.2, 95% CI 1.6-10.6), being unemployed (aOR 3.7, 95% CI 1.5-9.3), and rural origin (aOR 6.0, 95% CI 2.2-16.7). Bisexual activity was reported by 17.1% (34/199), and a total of 8% (16/200) reported having a regular female partner. Human rights violations were common with 10.5% (n = 21/200) reporting having been blackmailed and 21.0% (n = 42/200) reporting being afraid to seek health care. CONCLUSIONS: The conclusions from this study include that a there is a high risk and underserved population of MSM in the townships surrounding Cape Town. The high HIV prevalence and high risk sexual practices suggest that prevalence will continue to increase among these men in the context of an otherwise slowing epidemic. These data further highlight the need to better characterize risk factors for HIV prevention and appropriate targeted combination packages of HIV interventions including biomedical, behavioural, and structural approaches to mitigate HIV risk among these men.en_ZA
dc.identifier.apacitationBaral, S., Burrell, E., Scheibe, A., Brown, B., Beyrer, C., & Bekker, L. (2011). HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa. <i>BMC Public Health</i>, http://hdl.handle.net/11427/14458en_ZA
dc.identifier.chicagocitationBaral, Stefan, Earl Burrell, Andrew Scheibe, Ben Brown, Chris Beyrer, and Linda-Gail Bekker "HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa." <i>BMC Public Health</i> (2011) http://hdl.handle.net/11427/14458en_ZA
dc.identifier.citationBaral, S., Burrell, E., Scheibe, A., Brown, B., Beyrer, C., & Bekker, L. G. (2011). HIV risk and associations of HIV infection among men who have sex with men in peri-urban Cape Town, South Africa. BMC Public health, 11(1), 766.en_ZA
dc.identifier.ris TY - Journal Article AU - Baral, Stefan AU - Burrell, Earl AU - Scheibe, Andrew AU - Brown, Ben AU - Beyrer, Chris AU - Bekker, Linda-Gail AB - BACKGROUND:The HIV epidemic in Sub Saharan Africa has been traditionally assumed to be driven by high risk heterosexual and vertical transmission. However, there is an increasing body of data highlighting the disproportionate burden of HIV infection among MSM in the generalized HIV epidemics across of Southern Africa. In South Africa specifically, there has been an increase in attention focused on the risk status and preventive needs of MSM both in urban centers and peri-urban townships. The study presented here represents the first evaluation of HIV prevalence and associations of HIV infection among MSM in the peri-urban townships of Cape Town. METHODS: The study consisted of an anonymous probe of 200 men, reporting ever having had sex with another man, recruited through venue-base sampling from January to February, 2009. RESULTS: Overall, HIV prevalence was 25.5% (n = 51/200). Of these prevalent HIV infections, only 6% of HIV-1 infected MSM were aware of their HIV status (3/50). 0% of men reported always having safe sex as defined by always wearing condoms during sex and using water-based lubricants. Independent associations with HIV infection included inconsistent condom use with male partners (aOR 2.3, 95% CI 1.0-5.4), having been blackmailed (aOR 4.4, 95% CI 1.6-20.2), age over 26 years (aOR 4.2, 95% CI 1.6-10.6), being unemployed (aOR 3.7, 95% CI 1.5-9.3), and rural origin (aOR 6.0, 95% CI 2.2-16.7). Bisexual activity was reported by 17.1% (34/199), and a total of 8% (16/200) reported having a regular female partner. Human rights violations were common with 10.5% (n = 21/200) reporting having been blackmailed and 21.0% (n = 42/200) reporting being afraid to seek health care. CONCLUSIONS: The conclusions from this study include that a there is a high risk and underserved population of MSM in the townships surrounding Cape Town. The high HIV prevalence and high risk sexual practices suggest that prevalence will continue to increase among these men in the context of an otherwise slowing epidemic. These data further highlight the need to better characterize risk factors for HIV prevention and appropriate targeted combination packages of HIV interventions including biomedical, behavioural, and structural approaches to mitigate HIV risk among these men. DA - 2011 DB - OpenUCT DO - 10.1186/1471-2458-11-766 DP - University of Cape Town J1 - BMC Public Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa TI - HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa UR - http://hdl.handle.net/11427/14458 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14458
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2458-11-766
dc.identifier.vancouvercitationBaral S, Burrell E, Scheibe A, Brown B, Beyrer C, Bekker L. HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa. BMC Public Health. 2011; http://hdl.handle.net/11427/14458.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2011 Baral et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Public Healthen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcpublichealth/en_ZA
dc.subject.otherHIV Infectionsen_ZA
dc.subject.otherHomosexuality, Maleen_ZA
dc.subject.otherRisk Assessmenten_ZA
dc.titleHIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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