title: Exploring risk behaviors and vulnerability for HIV among men who have sex with men in Abidjan, Cote d'Ivoire: poor knowledge, homophobia and sexual violence.
abstract: Men who have sex with men (MSM) are at high risk of HIV. Few data are available on MSM and HIV-related risk behaviors in West Africa. We aimed to describe risk behaviors and vulnerability among MSM in Abidjan, Cote d'Ivoire. We conducted a cross-sectional respondent-driven sampling survey with 601 MSM in 2011-2012. Sociodemographic and behavioural data as well as data related to emotional state and stigma were collected. Population estimates with 95% confidence intervals were produced. Survey weighted logistic regression was used to assess factors associated with inconsistent condom use in the prior 12 months. Most MSM were 24 years of age or younger (63.9%) and had attained at least primary education (84.4%). HIV risk behaviors such as low condom and water-based lubricant use, high numbers of male and female sex partners, and sex work were frequently reported as well as verbal, physical and sexual abuse. Inconsistent condom use during anal sex with a male partner in the prior 12 months was reported by 66.0% of the MSM and was positively associated with history of forced sex, alcohol consumption, having a regular partner and a casual partner, having bought sex, and self-perception of low HIV risk. MSM in Abidjan exhibit multiple and frequent HIV-related risk behaviors. To address those behaviours, a combination of individual but also structural interventions will be needed given the context of stigma, homophobia and violence.
authors: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors: Josephine
authors: J
authors: Aho
authors: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors: Avi
authors: A
authors: Hakim
authors: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors: Bea
authors: B
authors: Vuylsteke
authors: Family Health International 360, Kinshasa, Democratic Republic of Congo.
authors: Gisèle
authors: G
authors: Semde
authors: Family Health International 360, Abidjan, Cote d'Ivoire.
authors: Honorat G
authors: HG
authors: Gbais
authors: Centers for Disease Control and Prevention, Abidjan, Cote d'Ivoire.
authors: Mamadou
authors: M
authors: Diarrassouba
authors: Program for Highly Vulnerable Populations, Ministry of Health and Fight against AIDS, Abidjan, Cote d'Ivoire.
authors: Marguerite
authors: M
authors: Thiam
authors: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors: Marie
authors: M
authors: Laga
mesh_terms: D000293:Adolescent; D000328:Adult; D007560:Cote d'Ivoire / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D063509:Homophobia / Q000523:psychology* / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology* / Q000706:statistics & numerical data; D012747:Sexual Partners / Q000523:psychology*; D055815:Young Adult