HIV Prevalence and Sexual Risk Behaviours Among Men Who Have Sex with Men in Nigeria

Background: Men who have sex with men have a higher burden of HIV, yet they remain understudied in Nigeria. We evaluated the prevalence and correlates of HIV among men who have sex with men (MSM).

Methods: Cross-sectional study using respondent-driven sampling was conducted in six states in Nigeria in 2010. MSMs underwent interviewer-administered surveys and HIV tests. Weighted HIV prevalence was calculated using RDS analytic tool. Logistic regression was used to determine correlates of HIV infection, stratified by state.

Results: Total number of MSM recruited ranged from 199 in Federal Capital Territory (FCT) to 313 in Cross River State (CR). Median age ranged from 22 years in Cross River to 26 years in Kano state. HIV prevalence was highest in the FCT at 37.6% and lowest in CR (2.4%). It was 8.2% in Kano, 16.2% in Kaduna, 3.3% in Oyo and 15.8% in Lagos state. Overall 36% of all respondents had engaged in male sex work (MSW) in the last 12 months. Overall consistent condom use during transactional and non-transactional sex was 34%. By state, it was lowest in Kano (12%) and highest in CR (52%,p≤0.001) while it was lowest in Kano (8%) and highest in the FCT (57%, p≤0.001) during non-transactional sex. Factors associated with HIV varied by state; this includes being older than 25 years in Kaduna [AOR:3.8; 95%CI:1.28-11.00] and Oyo state [AOR:6.7; 95%CI:1.80-24.25] being the insertive partner in Kano state [AOR:0.17;95%CI:0.05-0.67] and being the receptive partner in Lagos state [AOR:4.11; 95%CI:1.21-14.00].

Conclusions: MSM in Nigeria have a high burden of HIV with considerable heterogeneity across states. Engaging in male sex work and low consistent condom use sustains a potent HIV transmission bridge between MSM network and between MSM and the general population. Further research is needed to understand the divergent factors associated with HIV at state level.