Male same-sex behaviour and associated sexual health indicators in low and middle-income countries: 2003-2007 estimates

Published: August 1, 2008

Male same-sex behaviour and associated sexual health indicators in low and middle-income countries: 2003-2007 estimates

Background: We sought to review published and unpublished data from research and public health information systems on the prevalence of male-to-male sex in the total male population; as well as, among men who have sex with men (MSM), data on prevalence of heterosexual activity; prevalence of condom use with male and female partners; and HIV/STI prevalence.

Methods: Key indicators were defined (a) among men in the general population: prevalence of sex with a man [ever/last year]; (b) among

MSM: prevalence of heterosexual experiences; proportion of male-female transgenders; proportion of sex workers; prevalence of HIV/STIs, and condom use in last sexual encounter; among others. Study searches were conducted in academic and other databases. Methodology/quality of information were assessed, and the best data available for 2003-2007 were selected. Indicator estimates from each study were used to propose regional estimate ranges.
Results: 643 studies were identified. Of these, 107 showing 2003-2007 data were selected. Many new studies came from Sub-Saharan Africa, portraying hidden HIV epidemics among MSM. The most frequently reported estimate was HIV infection, with high estimate ranges in most of the regions, except for MENA and Eastern Europe. The next most frequently reported was lifetime frequency of heterosexual sex, showing that roughly 50% of MSM ever had sex with a woman.

Conclusions: Many new studies with relevant estimates were identified, with substantial new data from Sub-Saharan Africa. However, limitations in the quality, utility and comparability of available information persist. Three measures could be promoted for use in surveillance and academic studies: Standardized indicators for MSM studies; standardized operational definitions of variables; and standardized research designs and data gathering strategies. A prerequisite for this all is intense advocacy to ensure a social climate in which research into such matters is prioritized, resources are made available, and the human rights of MSM are respected.

-Abstract available at link below-

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