title: Online Sex-Seeking Among Men who have Sex with Men in Nigeria: Implications for Online Intervention.
abstract: The TRUST/RV368 project was undertaken to apply innovative strategies to engage Nigerian MSM into HIV care. In this analysis we evaluate characteristics of online sex-seekers from the TRUST/RV368 cohort of 1370 MSM in Abuja and Lagos. Logistic regression and generalized estimating equation models were used to assess associations with online sex-seeking. Online sex-seeking (n = 843, 61.5 %) was associated with participation in MSM community activities, larger social and sexual networks, and higher levels of sexual behavior stigma. In addition, online sex-seeking was associated with testing positive for HIV at a follow-up visit [adjusted odds ratio (aOR) = 2.02, 95 % confidence interval (CI) = 1.37, 2.98)] among those who were unaware of or not living with HIV at baseline. Across visits, online sex-seekers were marginally more likely to test positive for chlamydia/gonorrhea (aOR 1.28, 95 % CI 0.99, 1.64). Online sex-seekers in Nigeria are at increased risk for HIV/STIs but may not be benefiting from Internet-based risk reduction opportunities.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Center for Public Health and Human Rights, Johns Hopkins University, E7133, 615 N. Wolfe St., Baltimore, MD, 21205, USA. sstahlm1@jhu.edu.
authors.forename: Shauna
authors.initials: S
authors.lastname: Stahlman
authors.affiliation: Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Baltimore, USA.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Nowak
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, USA.
authors.forename: Hongjie
authors.initials: H
authors.lastname: Liu
authors.affiliation: U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA.|Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA.
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Crowell
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Center for Public Health and Human Rights, Johns Hopkins University, E7133, 615 N. Wolfe St., Baltimore, MD, 21205, USA.
authors.forename: Sosthenes
authors.initials: S
authors.lastname: Ketende
authors.affiliation: Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Baltimore, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Blattner
authors.affiliation: Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, Baltimore, USA.
authors.forename: Manhattan E
authors.initials: ME
authors.lastname: Charurat
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Center for Public Health and Human Rights, Johns Hopkins University, E7133, 615 N. Wolfe St., Baltimore, MD, 21205, USA.
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Baral
mesh_terms: D000328:Adult; D015331:Cohort Studies; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D057545:Social Stigma
keywords: Africa; HIV; Internet sex partners; MSM; STIs