title: Sexually transmitted infections associated with alcohol use and HIV infection among men who have sex with men in Kampala, Uganda.
abstract: OBJECTIVE
  Few studies have been conducted in Africa to assess prevalence of sexually transmitted infections (STIs) and risk factors among men who have sex with men (MSM). We report findings from the first behavioural survey to include STI testing among MSM in Kampala, Uganda.
  
  
  METHODS
  Respondent-driven sampling (RDS) was used to recruit MSM for a biobehavioural survey. Eligible participants were men who reported anal sex with another man in the previous 3 months, were 18 years or older, and resided in Kampala. Information was collected on demographics, sexual behaviour, alcohol and drug use, and STI symptoms. Blood, urine and rectal specimens were tested for syphilis, HIV, rectal and urethral gonorrhoea, and chlamydia. Analyses weighted for RDS were conducted to assess associations with STI diagnosis.
  
  
  RESULTS
  A total of 295 MSM participated in the survey. Almost half (weighted percentage: 47.3%) reported STI symptoms in the last 6 months and 12.9% tested HIV-positive. Prevalence of non-HIV STI was 13.5%; syphilis prevalence was 9.0%. Adjusting for age and education, STI was associated with HIV (adjusted OR (AOR)=3.46, 95% CI 1.03 to 11.64), alcohol use before sex (AOR=4.99, 95% CI 1.86 to 13.38) and having sold sex in the last 3 months (AOR=3.17, 95% CI 1.25 to 8.07), and inversely associated with having anonymous sex partners (AOR=0.20, 95% CI 0.07 to 0.61).
  
  
  CONCLUSIONS
  We observed high levels of self-reported STI symptoms and STI prevalence associated with alcohol use and HIV among MSM in Kampala. Public health interventions supporting MSM are needed to address STI risk and facilitate access to diagnosis and treatment services.
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hladik
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Barker
authors.affiliation: School of Public Health, Makerere University, Kampala, Uganda.
authors.forename: George
authors.initials: G
authors.lastname: Lubwama
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Entebbe, Uganda.
authors.forename: Samuel
authors.initials: S
authors.lastname: Sendagala
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention (CDC), Entebbe, Uganda.
authors.forename: John M
authors.initials: JM
authors.lastname: Ssenkusu
authors.affiliation: Ministry of Health, Kampala, Uganda.
authors.forename: Alex
authors.initials: A
authors.lastname: Opio
authors.affiliation: School of Public Health, Makerere University, Kampala, Uganda.
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology*; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012747:Sexual Partners / Q000145:classification; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
keywords: AFRICA; HIV; MEN