MSM access to VCT in a conservative environment, case of Egypt
I. Abdel Rahman1, C. Soliman2, T. Bahaa1, M. Moustafa3, S. Shawky4, I. Kabore5, S. Elkamhawi2
1Ministry of Health, National AIDS Program, Cairo, Egypt, 2Family Health International, Cairo, Egypt, 3United Nations Population Fund, Cairo, Egypt, 4The American University in Cairo, Cairo, Egypt, 5Family Health International, Washington DC, United States
Issues: Although HIV prevalence in Egypt is low (< 0.1%), available evidence from the 2006 Biological Behavioral Surveillance Survey indicates relatively higher rates of infection among most-at-risk-populations (MARPs). However, little is known about the MSM population and there is a lack of targeted interventions due to high stigma. VCT services are widely available in Egypt. However to which extent MSM access these services is to be explored.
Description: The Egyptian network of VCT services provides a standardized approach to anonymous, confidential and free of charge services mainly targeting MARPs. It provides care and support for all detected HIV cases. From 2004 to 2008, 5,913 men visited 13 National VCT centers. This paper describes the access of MSM to these centers, using existing routine VCT data.
Lessons learned: Despite the high stigma toward MSM in Egypt, VCT services still attract them; Out of all male clients, 229 reported MSM activity (3.5%). Almost half of them learned about the services from their peers and sexual partners.
Reasons for seeking VCT services were diverse: 74.2% reported personal risky behaviors and 17.9% for having a new sexual partner. Furthermore, 19.5% of them had a previous HIV test.MSM appear to be an important sub-population to target for interventions; HIV prevalence in MSM VCT clients was 11.5% with 72.8% not intending to share results with their partners About one third were bisexual, 58.1% had more than one sex partner and 72.7% did not use condoms in the previous six months. Furthermore, there were an overlap of other risk behaviors including injecting drugs (6.3%) and exchanging sex for drugs (2.2%).
Next steps: Targeted VCT promotion through peers may be the best way to provide HIV testing and prevention services for MSM. A combined approach of harm reduction should include promotion of safe sex and safe injection.