title: Access to HIV Services at Non-Governmental and Community-Based Organizations among Men Who Have Sex with Men (MSM) in Cameroon: An Integrated Biological and Behavioral Surveillance Analysis.
abstract: BACKGROUND
  Men who have sex with men (MSM) are more likely to be living with HIV than other adult men in low- and middle-income countries. MSM experience barriers to accessing HIV services including a lack of available specialized care, and community-level stigma and discrimination. This study aims to examine the uptake of HIV services at non-governmental and community-based organizations (NGOs/CBOs) to identify ways to improve coverage of HIV prevention and treatment among MSM.
  
  
  METHODS
  An Integrated Biological and Behavioral Surveillance (IBBS) survey was conducted in Yaoundé and Douala, Cameroon in 2011 using the respondent driven sampling (RDS) method to recruit and interview 239 MSM in Yaoundé and 272 MSM in Douala.
  
  
  RESULTS
  MSM in Yaoundé were statistically significantly more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they had any STI symptoms (aOR 2.17 CI 1.02-4.59. p=0.04), or if they had a larger MSM social network (aOR 1.02 CI 1.01-1.04. p<0.01). MSM in Douala were more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they were living with HIV (aOR 3.60 CI 1.35-9.60. p=0.01), or if they reported higher numbers of male sexual partners (aOR 1.17 CI 1.00-1.36. p=0.046). Compared to men in Douala, MSM in Yaoundé were significantly less likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months (aOR 0.22 CI 0 .14-0.34. p=<0.01).
  
  
  CONCLUSIONS
  With appropriate funding and resources, community-based organizations that provide care specifically for MSM can improve access to HIV prevention, treatment, and care services. Additionally, using social networks to reach MSM can connect greater numbers of the population to effective HIV interventions, which will improve health outcomes and decrease onward transmission of HIV.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, 21205, United States of America.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Holland
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, 21205, United States of America.
authors.forename: Erin
authors.initials: E
authors.lastname: Papworth
authors.affiliation: Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon.
authors.forename: Serge C
authors.initials: SC
authors.lastname: Billong
authors.affiliation: Population Services International, Cotonou, Benin.
authors.forename: Sethson
authors.initials: S
authors.lastname: Kassegne
authors.affiliation: CARE International in Cameroon, Yaoundé, Cameroon.
authors.forename: Fanny
authors.initials: F
authors.lastname: Petitbon
authors.affiliation: Cameroon National Association for Family Welfare (CAMNAFAW), Yaoundé, Cameroon.
authors.forename: Valentin
authors.initials: V
authors.lastname: Mondoleba
authors.affiliation: Association Camerounaise pour le Marketing Sociale (ACMS), Yaoundé, Cameroon.
authors.forename: Laure Vartan
authors.initials: LV
authors.lastname: Moukam
authors.affiliation: CARE International in Cameroon, Yaoundé, Cameroon.
authors.forename: Isaac
authors.initials: I
authors.lastname: Macauley
authors.affiliation: Cameroon National Association for Family Welfare (CAMNAFAW), Yaoundé, Cameroon.
authors.forename: Simon Pierre
authors.initials: SP
authors.lastname: Eyene Ntsama
authors.affiliation: Alternatives-Cameroun, Douala, Cameroon.
authors.forename: Yves Roger
authors.initials: YR
authors.lastname: Yomb
authors.affiliation: Humanity First, Yaoundé, Cameroon.
authors.forename: Jules
authors.initials: J
authors.lastname: Eloundou
authors.affiliation: Alternatives-Cameroun, Douala, Cameroon.
authors.forename: Franz
authors.initials: F
authors.lastname: Mananga
authors.affiliation: Global Viral Cameroon, Yaoundé, Cameroon.
authors.forename: Ubald
authors.initials: U
authors.lastname: Tamoufe
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, 21205, United States of America.
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Baral
mesh_terms: D000293:Adolescent; D000328:Adult; D002163:Cameroon; D017280:Condoms; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000517:prevention & control*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D021841:Safe Sex; D012747:Sexual Partners; D057545:Social Stigma; D011795:Surveys and Questionnaires; D055815:Young Adult