Sexual risk behaviours and HIV-1 prevalence among urban men who have sex with men in Cape Town, South Africa.
BACKGROUND
Distinct homosexual and heterosexual HIV epidemics have previously been recognised in South Africa. However, linked HIV prevalence and self-reported sexual risk behaviour data have not been reported for men who have sex with men (MSM) in Cape Town since 1986.


METHODS
We conducted a cross-sectional, anonymous, venue-based HIV risk behaviour and prevalence study of 542 self-identified MSM in greater Cape Town using a self-administered risk questionnaire and the OraSure testing device to asses HIV-1 prevalence.


RESULTS
This sample had an overall HIV prevalence of 10.4% (56/539). We found that self-identifying as gay, homosexual or queer (adjusted odds ratio (AOR) 4.5, 95% confidence interval (CI) 1.0-20.0) and reporting ever having had a sexually transmissible infection diagnosis (AOR 4.3, 95% CI: 2.3-8.3) were significantly predictive of testing HIV-1 positive, while reporting unprotected anal intercourse with a known HIV-negative partner (AOR 0.4, 95% CI: 0.2-0.9) was significantly protective.


CONCLUSIONS
These data suggest a mature epidemic with consistent high-risk taking among MSM in Cape Town, and significant associations of select self-reported risk behaviours and HIV-1 serostatus. There is a need for continued and robust HIV surveillance along with detailed risk behaviour trends over time to inform the development of targeted risk-reduction interventions for this population.
Burrell
Earl
E
Desmond Tutu HIV Centre, University of Cape Town, Cape Town 7705, South Africa. earl.burrell@ucla.edu
Mark
Daniella
D
Grant
Robert
R
Wood
Robin
R
Bekker
Linda-Gail
LG
D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D015658:HIV Infections / Q000453:epidemiology*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D021841:Safe Sex / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult