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Article Reference Troff document (with manpage macros)Seizing opportunities for intervention: Changing HIV-related knowledge among men who have sex with men and transgender women attending trusted community centers in Nigeria
Background Knowledge of HIV risk factors and reduction strategies is essential for prevention in key populations such as men who have sex with men (MSM) and transgender women (TGW). We evaluated factors associated with HIV-related knowledge among MSM and TGW and the impact of engagement in care at trusted community health centers in Nigeria. Methods The TRUST/RV368 cohort recruited MSM and TGW in Lagos and Abuja, Nigeria via respondent driven sampling. During study visits every three months, participants underwent structured interviews to collect behavioral data, received HIV education, and were provided free condoms and condom compatible lubricants. Five HIV-related knowledge questions were asked at enrollment and repeated after 9 and 15 months. The mean number of correct responses was calculated for each visit with 95% confidence intervals (CIs). Multivariable Poisson regression was used to calculate adjusted risk ratios and CIs for factors associated with answering more knowledge questions correctly. Results From March 2013 to April 2018, 2122 persons assigned male sex at birth were enrolled, including 234 TGW (11.2%). The mean number of correct responses at enrollment was 2.36 (95% CI: 2.31–2.41) and increased to 2.95 (95% CI: 2.86–3.04) and 3.06 (95% CI: 2.97–3.16) after 9 and 15 months in the study, respectively. Among 534 participants who completed all three HIV-related knowledge assessments, mean number of correct responses rose from 2.70 (95% CI: 2.60–2.80) to 3.02 (95% CI: 2.93–3.13) and then 3.06 (95% CI: 2.96–3.16). Factors associated with increased overall HIV-related knowledge included longer duration of study participation, HIV seropositivity, higher education level, and more frequent internet use. Conclusions There was suboptimal HIV-related knowledge among Nigerian MSM and TGW at that improved modestly with engagement in care. These data demonstrate unmet HIV education needs among Nigerian MSM and TGW and provide insights into modalities that could be used to address these needs.
Located in MPRC People / Hongjie Liu, Ph.D. / Hongjie Liu Publications
Methods Workshop: Hongjie Liu, Epidemiology and Biostatistics
How to Sample Hard to Reach Populations?
Located in Coming Up
Article ReferenceGenetic Clustering Analysis for HIV Infection among Men Who Have Sex with Men in Nigeria
Background:  The  HIV  epidemic continues to grow among  MSM  in countries across sub-Saharan Africa including  Nigeria . To inform prevention efforts, we used a  phylogenetic cluster  method to characterize  HIV  genetic clusters and factors associated with cluster formation among  MSM  living with  HIV  in  Nigeria . Methods:  We analyzed  HIV -1 pol sequences from 417  MSM  living with  HIV  enrolled in the TRUST/RV368 cohort between 2013 and 2017 in Abuja and Lagos,  Nigeria . A genetically linked cluster was defined among participants whose sequences had pairwise genetic distance of 1.5% or less. Binary and multinomial logistic regressions were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors associated with  HIV  genetic cluster membership and size. Results:  Among 417  MSM  living with  HIV , 153 (36.7%) were genetically linked. Participants with higher viral load (AOR = 1.72 95% CI: 1.04–2.86), no female partners (AOR = 3.66; 95% CI: 1.97–6.08), and self-identified as male sex (compared with self-identified as bigender) (AOR = 3.42; 95% CI: 1.08–10.78) had higher odds of being in a genetic cluster. Compared with unlinked participants,  MSM  who had high school education (AOR = 23.84; 95% CI: 2.66–213.49), were employed (AOR = 3.41; 95% CI: 1.89–10.70), had bacterial sexually transmitted infections (AOR = 3.98; 95% CI: 0.89–17.22) and were not taking antiretroviral therapy (AOR = 6.61; 95% CI: 2.25–19.37) had higher odds of being in a large cluster (size > 4). Conclusion:  Comprehensive  HIV  prevention packages should include behavioral and biological components, including early diagnosis and treatment of both  HIV  and bacterial sexually transmitted infections to optimally reduce the risk of  HIV  transmission and acquisition.
Located in MPRC People / Hongjie Liu, Ph.D. / Hongjie Liu Publications