title: An Assessment of Health Interventions Required to Prevent the Transmission of HIV Infection Among Men Having Sex with Men in Bujumbura, Burundi.
abstract: Data regarding HIV among men having sex with men (MSM) in Burundi are scarce. In a context where same-sex practices are illegal, national recommendations including MSM have been issued in 2012. However, no study has been conducted to evaluate MSM's health needs, which would be useful to adapt recommendations and implement evidence-based interventions. This study aimed at identifying health needs expressed by MSM. A cross-sectional study was conducted in Bujumbura in 2014, in collaboration with the National Association for HIV positive people and AIDS patients. Fifty-one MSM, recruited during HIV prevention activities, self-completed a questionnaire. A descriptive analysis was conducted. Participants had a median age of 23 years, over 60 % declared being a member of an LGBT organisation and 76 % lived their homosexuality secretly or discretely. Over the last month, 67 % declared having had sex with a man and 32 % with a woman. In the previous 6 months, 40 % declared having systematically used a condom during sexual intercourse. In terms of health needs, 22 % did not use the services offered by HIV providers. Participants expressed needs in terms of prevention (access to rapid HIV tests, in a confidential setting, with counselling) and care (listening centre, free treatment, confidentiality). Medical expertise and being a good listener were the predominant healthcare staff qualities desired by participants. Results suggest that Burundian MSM represent an at-risk population, with low access to HIV services, in need of a comprehensive approach for HIV prevention, with community-based activities (HIV testing, counselling, prevention tools), psychological and social support.
authors.affiliation: INSERM, UMR_S 912, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), 13385, Marseille, France. pierre-julien.coulaud@inserm.fr.|UMR_S 912, IRD, Aix Marseille Université, 13385, Marseille, France. pierre-julien.coulaud@inserm.fr.
authors.forename: Pierre-Julien
authors.initials: PJ
authors.lastname: Coulaud
authors.affiliation: Association Nationale de Soutien aux Séropositifs et malades du Sida, Centre Tuhiro, Quartier Kigobe Nord, 88 Avenue des Etats-Unis, 4152, Bujumbura, Burundi.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Mujimbere
authors.affiliation: Association Nationale de Soutien aux Séropositifs et malades du Sida, Centre Tuhiro, Quartier Kigobe Nord, 88 Avenue des Etats-Unis, 4152, Bujumbura, Burundi.
authors.forename: Arsène
authors.initials: A
authors.lastname: Nitunga
authors.affiliation: Association Nationale de Soutien aux Séropositifs et malades du Sida, Centre Tuhiro, Quartier Kigobe Nord, 88 Avenue des Etats-Unis, 4152, Bujumbura, Burundi.
authors.forename: Candide
authors.initials: C
authors.lastname: Kayonde
authors.affiliation: Coalition Internationale Sida, Tour Essor, 14 rue Scandicci, 93500, Pantin, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Trenado
authors.affiliation: INSERM, UMR_S 912, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), 13385, Marseille, France.|UMR_S 912, IRD, Aix Marseille Université, 13385, Marseille, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.affiliation: Coalition Internationale Sida, Tour Essor, 14 rue Scandicci, 93500, Pantin, France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Bernier
mesh_terms: D000293:Adolescent; D000328:Adult; D002063:Burundi; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006293:Health Promotion / Q000379:methods*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D040242:Risk Reduction Behavior; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Burundi; Comprehensive care; HIV; Health needs; Men who have sex with men (MSM)