Sexual health, HIV testing and health seeking behaviour of men who have sex with men (MSM) in Nigeria

Published: August 1, 2008

Sexual health, HIV testing and health seeking behaviour of men who have sex with men (MSM) in Nigeria

Background: While Nigeria has private and public health services available, little is known about access, health care needs and the sexual health status of MSM. We present results of a study of the sexual health status and use of health care services for HIV testing and treatment of MSM in Nigeria.

Methods: Between April and July 2006, a survey including an interviewer-administered questionnaire, physical examination and HIV/STI testing were carried out among self-identified MSM. Men were recruited through Respondent Driven Sampling from two cities in South West Nigeria. Participation and testing were voluntary and anonymous.

Results: 1125 MSM were recruited. Only 25.4% of the study population had been previously tested for HIV. Although most (96.4%) provided blood samples for this study, only (10.3%) returned for their test results. Of 145 (13.4%) who tested HIV positive, only 9 (6.2%) knew they were infected. Ninety-six (8.5%) reported either anal or genital discharge in the previous 12 months, of which only 18.8% sought treatment from an accredited health care facility. Only 84 (7.5%) had ever disclosed their sexual identity to their health care providers. Among the 695 who consented to a physical examination, the prevalence of genital discharge, ulcer and warts was 1.9%, 3.7% and 1.9% respectively. The reasons given for low health care use included high costs (77.6%), homophobic attitudes of health care providers (17.0%), and fear of being ‘outed’ (6.1%).

Conclusions: MSM in our study were highly vulnerable to HIV and STIs yet, their health seeking behaviors were poor. There are few opportunities for MSM to access preventive programmes. It is a matter of urgency to recognize the sexual and health risks confronting MSM in Nigeria and the substantial benefits cost-effective targeted intervention programmes could deliver. To reduce the spread of HIV/STI, health care services need to address treatment costs and homophobia.

-Abstract available at link below-

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