Merrigan et al. (2010) reported results that are similar MSM in three states in Nigeria 52. Another study that is recent Nigeria among MSM whom involved in transactional intercourse, revealed that MSM aged 25 years and above had been four times more prone 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 extended experience of HIV through greater amount of intimate partners, doing transactional intercourse and greater contact with anal sex that is unprotected. Also, MSM sampled this season and 2014 had been more prone to be HIV good in comparison to those in 2007 and also this further supports our argument that the exposure that is prolonged higher danger behaviours will be the cause of higher HIV prevalence among older MSM. Young MSM aged 16–19 years will probably continue to have parental help and therefore, there’s less socioeconomic force to take part in high-risk intimate techniques such as for example transactional intercourse. In addition, their networks that are sexual around their peers in the place of intergenerational intimate lovers and also this limits their contact with older HIV contaminated MSM.
There is an increase that is significant the percentage of MSM whom reported sex with feminine lovers between 2007 and 2014. This takes its possible connection between MSM as well as the general populace and therefore merits conversation due to the fact gains in reduced amount of HIV prevalence on the list of basic population could be eroded by bisexual sex among MSM. The rise in bisexuality may reflect the hostility that is increasing stigma and criminalization of MSM in Nigeria. Schwartz et al. (2015) evaluated the instant outcomes 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 had been passed away when comparing to the pre-law period 13. This coping process towards the high stigma and criminalization of MSM could also adversely influence their utilization of key populace friendly clinics while they continue steadily to conceal their identification also to medical care employees.
This research has some limits. The lack of a study that is prospective while the utilization of cross-sectional studies from unmatched cohort limitations the energy of our study and so calls for care within the interpretation regarding the information. There could be possible dependence between information from various rounds of IBBSS that may overestimate HIV prevalence if an important quantity of positives from past rounds had been recruited into subsequent rounds or an underestimation of HIV prevalence is an important quantity of HIV negative MSM were targeted and recruited in subsequent rounds. Future studies ought to include a variable to simply help recognize those in past rounds and their HIV status at that round to permit a far more estimation that is robust of among MSM. Information on HIV prevention programs and therapy protection into the research states wasn’t available and therefore could never be accounted for in our research to measure the impacts independently of the programs into the research result. In addition, information on therapy protection may help give an explanation for observed enhance if therapy protection ended up being examined become low. Another limitation is of social desirability bias on sexual 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 within these scholarly studies might have been under-reported offered the enhance of STIs and HIV observed. Additionally, studies on biological validation of unsafe sex among feminine intercourse employees have indicated significant over-reporting of protected sex 55 and future studies should think about biological validation of protected sex among MSM to raised characterize risk behaviours medication use especially utilization of methamphetamine 1 happens to be related to HIV among MSM, but, there is no information on medication usage among MSM in every three rounds associated with the study. Further research is needed to figure out the relationship of medication usage and HIV among MSM in Nigeria. Finally, only a few consumers plumped for an HIV make sure the percentage of refusal ranged from 10 to 16per cent. Even though the status of these whom rejected an HIV test is not thought, individuals whom declined to decide for an HIV test might have done this as a result of past knowledge of HIV infection and thus prevalence of HIV might have been underestimated into the current study and later biases the noticed trend in HIV prevalence.
Conclusions
In conclusion, this the first research to measure the trend of HIV prevalence among MSM in Nigeria and now we report lots of key findings. As with other climes, HIV prevalence among MSM in Nigeria is for a progression that is alarming a general enhance of 10% point each year over 7 years. No state is spared, and avoidance packages needs to be holistic and include making use of techniques using the evidence that is strongest of greatest efficacy in preventing HIV transmission; 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 demonstrably, is amongst the defining challenges ahead, and perhaps the absolute most critical space in the nationwide HIV avoidance program to regulate the HIV epidemic in Nigeria.
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