Background:Studies on the effectiveness of HIV prevention intervention among men who have sex with men (MSM) are limited. We evaluated the short term effect of HIV prevention intervention on sexual risk behavior among MSM in Nigeria.
Methods:Between May and December 2013, baseline and follow up sexual risk behavior data were collected using structured risk assessment forms. Prevention intervention followed a structured curriculum implemented over three months. Logistic regression was used to identify the effect of the intervention.
Results:A total of 1,526 MSM were recruited at baseline and 1,282 MSM completed the 3 month curriculum, indicating a retention rate of 84%. Median age of participants was 25 years (interquartile range 22-28 years). About 50% had completed secondary level education. Reported condom use at last transactional sex with a female increased significantly (67%vs.77%;p<0.0001) but was unchanged among non-paying partners (74%) at baseline and follow-up. Condom use at last anal sex with a non-paying partner increased from 53% to 73% (p<0.0001) but decreased with paying partners (82%vs.77%;p=0.007). Comprehensive HIV knowledge increased from 45% to 90% (p<0.0001). When controlled for age, education, employment status and state, at follow-up, participants were more likely to use a condom during anal sex with non-paying partners [AOR:7.7;95%CI:5.40-11.04] but less likely with paying partners [AOR:0.79;95%CI:0.64-0.97]. They were also more likely to use a condom with female sex workers [AOR2.12;95%CI:1.75-2.57] but less likely with casual female sex partners [AOR:0.72;95%CI:0.53-0.98]. They were more likely to have tested for HIV [AOR:19.3;95%CI:13.2-28.1] and have comprehensive HIV knowledge [AOR:13.7;95%CI:10.9-17.4].
Conclusions:There were significant reductions in sexual risk behaviors with non-paying sexual partners but an increase with paying sex partners. Safer negotiating skills are urgently required with paying partners in order to consolidate on gains achieved with non-paying partners. Cost-effectiveness studies are urgently needed to identify best modalities for taking this intervention to scale.