title: HIV infection and sexually transmitted infections among men who have sex with men in Senegal.
abstract: BACKGROUND
  No epidemiological study has been conducted on HIV and vulnerability to sexually transmitted diseases (STI) among men who have sex with men (MSM) in sub-Saharan Africa.
  
  
  METHODS
  A survey including questionnaire, physical examination and detection of HIV and STI was carried out among 463 MSM, aged 18-52 years, recruited through the snowball technique in five urban sites throughout Senegal.
  
  
  RESULTS
  A total of 21.5% of men were found to be infected with HIV [95% confidence interval (CI), 17.8-25.6]. Active syphilis, positive serology for herpes simplex virus (HSV)-2, and polymerase chain reaction detection in urine of Chlamydia and gonorrhea infections were recorded in 4.8, 22.3, 4.1 and 5.4% of participants, respectively. Most respondents reported sex with women (94.1%). In the month preceding the interview, 24% reported at least one unprotected insertive anal intercourse with a male partner, 20% at least one unprotected receptive anal intercourse, and 18% at least one unprotected intercourse with a female partner. Genital examination showed that 5% of participants had at least one clinical sign of STI. Factors associated with HIV infection were age group, the reporting of more than nine lifetime male partners [odds ratio (OR), 3.76; 95% CI, 1.61-8.79], being a waiter or bartender (OR, 3.33; 95% CI, 1.41-7.84), and living in Dakar (OR, 3.33; 95% CI, 1.07-3.43).
  
  
  CONCLUSIONS
  Men who have sex with men in Senegal are highly infected with HIV and other STI. Intervention programs targeting this population are urgently needed, given their particular vulnerability and because infections are likely to disseminate into the general population given the high proportion of bisexual activity in this community.
authors.affiliation: Programme National de Lutte contre le SIDA, Dakar, Sénégal.
authors.forename: Abdoulaye Sidibe
authors.initials: AS
authors.lastname: Wade
authors.forename: Coumba Toure
authors.initials: CT
authors.lastname: Kane
authors.forename: Pape Amadou Niang
authors.initials: PA
authors.lastname: Diallo
authors.forename: Abdou Khoudia
authors.initials: AK
authors.lastname: Diop
authors.forename: Khady
authors.initials: K
authors.lastname: Gueye
authors.forename: Souleymane
authors.initials: S
authors.lastname: Mboup
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Ndoye
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Lagarde
mesh_terms: D000293:Adolescent; D000328:Adult; D001727:Bisexuality / Q000706:statistics & numerical data; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012675:Senegal / Q000453:epidemiology; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D011795:Surveys and Questionnaires