title: Decline in HIV prevalence among young men in the general population of Cotonou, Benin, 1998-2008.
abstract: OBJECTIVE
  To assess changes in the prevalence of HIV and other sexually transmitted infections, as well as in different proximal and distal factors related to HIV infection, in the general population of Cotonou between 1998 and 2008, while an intensive preventive intervention targeting the sex work milieu was ongoing.
  
  
  METHODS
  A two-stage cluster sampling procedure was used to select the participants in each study. Subjects aged 15-49 who agreed to participate were interviewed and tested for HIV, syphilis, HSV-2, gonorrhoea and chlamydia. We used the Roa-Scott Chi-square test (proportions) and the Student's t test (means) for bivariate comparisons, and adjusted logistic regression models taking into account the cluster effect for multivariate analyses.
  
  
  RESULTS
  HIV prevalence decreased significantly in men (3.4% in 1998 versus 2.0% in 2008, p = 0.048), especially in those aged 15-29 (3.0% to 0.5%, p = 0.002). Among men, the prevalence of gonorrhoea decreased significantly (1.1% to 0.3%, p = 0.046) while HSV-2 prevalence increased from 12.0% to 18.1% (p = 0.0003). The proportion of men who reported condom use at least once (29.3% to 61.0%, p<0.0001) and of those having attained a secondary educational level or more (17.1% to 61.3%, p<0.0001) also increased significantly. There was an overall decrease in the prevalence of syphilis (1.5% to 0.6%, p = 0.0003).
  
  
  CONCLUSIONS
  This is the first population-based study reporting a significant decline in HIV prevalence among young men in an African setting where overall prevalence has never reached 5%. The decline occurred while preventive interventions targeting the sex work milieu were ongoing and the educational level was increasing.
authors.affiliation: Unite de recherche en santé des populations, Centre de recherche FRSQ du CHA universitaire de Québec, Québec Canada.
authors.forename: Luc
authors.initials: L
authors.lastname: Béhanzin
authors.forename: Souleymane
authors.initials: S
authors.lastname: Diabaté
authors.forename: Isaac
authors.initials: I
authors.lastname: Minani
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Lowndes
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Boily
authors.forename: Annie-Claude
authors.initials: AC
authors.lastname: Labbé
authors.forename: Séverin
authors.initials: S
authors.lastname: Anagonou
authors.forename: Djimon Marcel
authors.initials: DM
authors.lastname: Zannou
authors.forename: Anne
authors.initials: A
authors.lastname: Buvé
authors.forename: Michel
authors.initials: M
authors.lastname: Alary
mesh_terms: D000293:Adolescent; D000328:Adult; D001541:Benin / Q000453:epidemiology; D003710:Demography / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D055815:Young Adult