Abstract
Background: Men who have sex with men (MSM) are disproportionately impacted by HIV in
sub-Saharan Africa (SSA), where condomless anal intercourse (CAI) is a major driver of HIV
transmission among this hidden subpopulation.
Objectives: To determine CAI drivers and prevalence among HIV-positive and HIV-negative
MSM.
Method: Data from 1538 MSM who participated in a biobehavioural survey in Zimbabwe
were used. Secondary statistical data analysis methods were used to determine prevalences
and drivers of CAI.
Results: A high prevalence of CAI, of at least 30%, among HIV-positive and HIV-negative
MSM was found. Factors that led to a statistically significant higher CAI among HIV-positives
compared to HIV-negatives included drunkenness (35% vs. 25%, P = 0.01), fear of partner
(13% vs. 9%, P = 0.017), trusting the partner (10% vs. 6%, P = 0.008), and being offered more
money (10% vs. 6%, P = 0.003).
Conclusion: Our findings indicate that economic, socio-behavioural and perceptual
dimensions increase men’s likelihood to engage in risky sexual behaviour, suggesting the
need for HIV prevention efforts that provide tailored education regarding HIV risk among
MSM in SSA. This is the first large biobehavioural survey that generated valuable information
useful for analysing condomless anal sex among MSM in Zimbabwe.
sub-Saharan Africa (SSA), where condomless anal intercourse (CAI) is a major driver of HIV
transmission among this hidden subpopulation.
Objectives: To determine CAI drivers and prevalence among HIV-positive and HIV-negative
MSM.
Method: Data from 1538 MSM who participated in a biobehavioural survey in Zimbabwe
were used. Secondary statistical data analysis methods were used to determine prevalences
and drivers of CAI.
Results: A high prevalence of CAI, of at least 30%, among HIV-positive and HIV-negative
MSM was found. Factors that led to a statistically significant higher CAI among HIV-positives
compared to HIV-negatives included drunkenness (35% vs. 25%, P = 0.01), fear of partner
(13% vs. 9%, P = 0.017), trusting the partner (10% vs. 6%, P = 0.008), and being offered more
money (10% vs. 6%, P = 0.003).
Conclusion: Our findings indicate that economic, socio-behavioural and perceptual
dimensions increase men’s likelihood to engage in risky sexual behaviour, suggesting the
need for HIV prevention efforts that provide tailored education regarding HIV risk among
MSM in SSA. This is the first large biobehavioural survey that generated valuable information
useful for analysing condomless anal sex among MSM in Zimbabwe.
| Original language | English |
|---|---|
| Article number | a1583 |
| Number of pages | 6 |
| Journal | Southern African Journal of HIV Medicine |
| Volume | 25 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 30 Sept 2024 |
Keywords
- HIV
- MSM
- condomless anal intercourse
- sexual behaviour
- condom use
- biobehavioural survey