Sexually transmitted infections associated with alcohol use and HIV infection among men who have sex with men in Kampala, Uganda

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Sexually transmitted infections associated with alcohol use and HIV infection among men who have sex with men in Kampala, Uganda

E. Kim1, W. Hladik2,3, J. Barker1, J. Ssenkusu2, A. Opio4, D. Serwadda5, Crane Survey Group

1Centers for Disease Control and Prevention, Global AIDS Program, Atlanta, United States, 2Centers for Disease Control and Prevention, Global AIDS Program, Kampala, Uganda, 3University of Amsterdam, Clinical Epidemiology, Amsterdam, Netherlands, 4Ministry of Health, Kampala, Uganda, 5Makerere University, Kampala, Uganda

Background: Despite the significant global morbidity and mortality associated with sexually transmitted infections (STIs), few studies have been conducted in Africa to assess prevalence of STIs and associated risk factors among populations at increased risk for HIV, such as men who have sex with men (MSM). We report findings from the first behavioral survey to include STI testing among MSM in Kampala, Uganda.

Methods: From May 2008 to April 2009, respondent driven sampling (RDS) was used to recruit MSM in Kampala for a bio-behavioral survey. Eligible participants were men who reported having anal sex with another man in the previous 3 months, aged 18 years or older, and resided in Kampala. Information was collected on demographics, sexual behavior by partner type, alcohol and drug use, and STI symptoms. Blood, urine, and rectal specimens were collected to test for syphilis, rectal and urethral gonorrhea, Chlamydia trachomatis, and HIV. Focusing on any non-HIV STI diagnosis, univariate and bivariate analyses were conducted in RDS Analysis Tool (RDSAT); additional bivariate and multivariate analyses were conducted in SAS using weights exported from RDSAT.

Results: A total of 295 MSM participated in the survey; 53.3% reported any STI symptoms in the last 6 months and 13.7% tested positive for HIV. Prevalence of non-HIV STI was 13.1%; syphilis prevalence was 9.1%. Adjusting for age and education, STI was positively associated with HIV (adjusted odds ratio [AOR]=3.5, CI: 1.0-11.6), alcohol use before sex (AOR=5.0, CI: 1.9-13.4), and having sold sex in the last three months (AOR=3.2, CI: 1.2-8.1), and inversely associated with having anonymous sex partners (AOR=0.2, CI: 0.1-0.6).

Conclusions: We observed high levels of self-reported STI symptoms and STI prevalence associated with alcohol use and HIV among MSM in Kampala. Public health interventions targeting this stigmatized population are needed to address STI risk and facilitate access to STI diagnosis and treatment.

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Posted on July 23, 2012, in Uncategorized. Bookmark the permalink. Comments Off on Sexually transmitted infections associated with alcohol use and HIV infection among men who have sex with men in Kampala, Uganda.

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