Discussion of HIV and Other Sexually Transmitted Infections With Sex Partners of Nigerian Men Who Have Sex With Men and Transgender Women: Implications for Interventions to Promote Safer Sex Practices.

Discussion of HIV and other sexually transmitted infections among sex partners facilitates risk reduction. We evaluated HIV/STI-related communications, including broad assessment of any self-reported discussion of the topic and specific discussion of each partner's HIV status, among a historically marginalized and presently criminalized community of sexual and gender minorities (SGM) in Nigeria. From 2013 to 2018, we enrolled SGM aged 18+ years in Lagos or 16+ years in Abuja who reported anal sex with men. At enrollment and 3-, 9-, and 15-month follow-up visits, participants were asked about their sexual behaviors and communications with main sexual partners (MSP) and casual sexual partners (CSP). Questions included "have you talked with your [MSP/CSP] about sexually transmitted infections and HIV?" Multivariable robust Poisson regression with generalized estimating equations was used to estimate adjusted relative risks (aRRs) and 95% confidence intervals (CIs) for factors potentially associated with HIV/STI-related communications with some or all of each type of sexual partner. Among 2795 SGM enrolled with median age 23 years (interquartile range 20-27), questions about HIV/STI-related communications with MSP were answered by 2436 (87.2%) and with CSP by 2398 (85.9%) SGM. Communication with MSP was reported by 68.1% (1659/2436), of whom 897 (54.1%) discussed their own HIV status and 925 (55.8%) discussed their partner's status. Communication with CSP was reported by 43.9% (1052/2398), of whom 389 (37.0%) discussed their own HIV status and 385 (36.6%) discussed their partner's status. Among participants with both MSP and CSP, HIV/STI-related communication with MSP was more common among participants with higher than secondary education [aRR 1.40 (95% CI: 1.24 to 1.58)], who were divorced/separated/widowed [aRR 1.19 (95% CI: 1.06 to 1.33)], who discussed their HIV status with CSP [aRR 1.18 (95% CI: 1.10 to 1.25)], discussed CSP's HIV status [aRR 1.20 (95% CI: 1.13 to 1.27)], and used a condom at last sex with CSP [aRR 1.16 (95% CI: 1.08 to 1.25)]. HIV/STI-related communication with CSP was more common among participants with higher than secondary education [aRR 1.36 (95% CI: 1.12 to 1.66)], who were divorced/separated/widowed [aRR 1.38 (95% CI: 1.13 to 1.69)], who discussed their HIV status with MSP [aRR 1.47 (95% CI: 1.27 to 1.69)], who discussed CSP's HIV status [aRR 1.22 (95% CI: 1.06 to 1.40)], and used a condom at last sex with CSP [aRR 1.22 (95% CI: 1.08 to 1.38)]. HIV/STI-related communications with main and casual sex partners were both associated with safer sex with CSP. HIV prevention and treatment programs for SGM should promote open communications in sexual relationships and consider deployment of modern strategies to facilitate disclosure, especially in settings with criminalizing legislation.

Tiamiyu AB ，Hu F ，Kokogho A ，Charurat ME ，Ekeh C ，Adebajo S ，Shoyemi E ，Iroezindu M ，Ake JA ，Baral SD ，Nowak RG ，Crowell TA ，TRUST/RV368 Study Group ... -  《-》

Individual and partnership characteristics associated with consistent condom use in a cohort of cisgender men who have sex with men and transgender women in Nigeria.

Olawore O ，Crowell TA ，Ketende SC ，Ramadhani HO ，Liu H ，Ake JA ，Kokogho A ，Adebajo S ，Charurat ME ，Nowak RG ，Baral SD ，TRUST/RV368 Study Group ... -  《BMC PUBLIC HEALTH》

Factors Associated With Condom Failure in a Longitudinal Cohort of Men Who Have Sex With Men and Transgender Women in Abuja and Lagos, Nigeria.

Effective condom use is a critical intervention to limit the spread of HIV and other sexually transmitted infections, particularly among individuals in high-risk networks who practice anal sex. We characterized condom failures in cisgender men who have sex with men and transgender women in Nigeria. The TRUST/RV368 cohort provided condoms, compatible lubricants, and safer sex education to men who have sex with men and transgender women at community-engaged health centers in Abuja and Lagos, Nigeria. Participants completed structured interview questions about condom usage and failure every 3-6 months. Robust Poisson regression models with generalized estimating equations were used to estimate relative risks and 95% confidence intervals for prespecified factors potentially associated with condom failure in the previous month. From September 2013 to September 2019, 2221 of 2737 participants (81.1%) reported condom use for anal sex with a male partner in the last month, and 305 (13.7%) reported condom failure during this time. Multivariate analyses demonstrated an increased risk of condom failure at postenrollment visits, as well as in participants who reported frequent Internet use, 2 or more casual sexual partners, and 2-4 main sexual partners. Those who cohabited with a woman had reduced risk. Condom failure was common in this population despite freely available condoms, compatible lubrication, and education. Increased risk of condom failure over time could reflect message fatigue a ceiling for effective condom use, or new uptake of condoms by inexperienced users.

Hamill MM ，Hu F ，Kokogho A ，Shoyemi E ，Ekeh C ，Charurat ME ，Robb ML ，Adebajo S ，Baral SD ，Nowak RG ，Crowell TA ，TRUST/RV368 Study Group ... -  《-》

Factors associated with testing for HIV and other sexually transmitted infections in men who have sex with men and transgender women in Bangkok, Thailand.

Routine screening for HIV and other sexually transmitted infections (STIs) facilitates early diagnosis and treatment, thereby preventing morbidity and onward transmission. We estimated the prevalence of prior HIV/STI testing among men who have sex with men (MSM) and transgender women (TGW) in Bangkok, Thailand, and identified factors associated with prior testing. Cross-sectional analyses were performed using data collected at enrollment into an HIV incidence cohort. From April to October 2017, MSM and TGW were enrolled if they were aged 18-35 years, reported anal intercourse with a male or TGW partner, and reported behavioral vulnerability to HIV. Participants answered questions about demographics, sexual behaviors, and lifetime HIV/STI testing history. Multivariable robust Poisson regression was used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for factors potentially associated with prior testing. Among 1,014 participants, 348 (34.3%) were TGW and the median age was 21.6 (interquartile range 20.0-24.8) years. Prior testing for HIV was reported by 421 (41.5%) and for other STIs by 268 (26.4%). HIV testing was more common among participants aged ≥ 22 years (RR 1.37 [95% CI 1.13-1.67]), with college education as compared to secondary or less (RR 1.37 [95% CI 1.08-1.72]), and who met male sexual partners online (RR 1.52 [95% CI 1.24-1.85]), but lower among participants attracted to both men and women as compared to men only (RR 0.64 [95% CI 0.51-0.81]) and who met male sexual partners in bars (RR 0.83 [95% CI 0.72-0.97]). Similar associations were observed with prior testing for other STIs, including increased testing among participants with college education (RR 1.52 [95% CI 1.11-2.09]) and who met male sexual partners online (RR 1.73 [95% CI 1.30-2.31]), but lower among participants attracted to both men and women (RR 0.70 [95% CI 0.51-0.96]) and who met male sexual partners in bars (RR 0.67 [95% CI 0.54-0.83]). Despite behavioral vulnerability, prior testing for HIV and other STIs was uncommon. Online engagement strategies may be effectively reaching Thai MSM and TGW who meet sexual partners online, but new interventions are needed to encourage testing among younger, less educated, and bisexual MSM and TGW.

Crowell TA ，Nitayaphan S ，Sirisopana N ，Wansom T ，Kitsiripornchai S ，Francisco L ，Li Q ，Dear N ，O'Connell RJ ，Pitisuttithum P ，Vasan S ，RV348B Study Group ... -  《-》

HIV status disclosure by Nigerian men who have sex with men and transgender women living with HIV: a cross-sectional analysis at enrollment into an observational cohort.

Tiamiyu AB ，Lawlor J ，Hu F ，Kokogho A ，Charurat ME ，Ekeh C ，Robb ML ，Adebajo S ，Eluwa G ，Ake JA ，Baral SD ，Nowak RG ，Crowell TA ，TRUST/RV368 Study Group ... -  《-》