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Journal Articles AIDS. Official journal of the international AIDS Society Year : 2024

Sexual behaviours and risk with women in MSM in sub-Saharan Africa

Abstract

In sub-Saharan Africa (SSA), MSM – a high HIV prevalence group – experience strong social stigma and pressure to have female partners. Accordingly, they could constitute a bridging group for HIV transmission to cisgender women. We developed a multilevel summary of MSM sexual behaviors and risk with women in various SSA regions. Following PRISMA guidelines, we conducted a mixed-method systematic review of data of sex with women in MSM in SSA. We performed meta-analyses on quantitative data (i.e. percent of recent sex and condomless sex with women) for each SSA region (when proportions reported in ≥4 studies). Pooled proportions were calculated using random-effects models. Qualitative data were analyzed using the three-step thematic synthesis methodology. The pooled proportion of MSM who had sex with women was 58% (33–83%) in East Africa (in the previous 3 months), and 27% (13–48%) in Southern Africa and 50% (95% CI 39–62%) in West Africa (in the previous 6 months); 23% (16–32%) of MSM in West Africa had condomless sex with a woman (during the most recent encounter). Approximately one quarter of MSM had recent multiple female partners. MSM reported having sex with women because of heteronormative pressure, erotic/romantic attraction, or financial needs leading to transactional sex. MSM may act as a bridging population to women in SSA, as they commonly practice sex with women and risky sexual behaviors with them. HIV programmes and community-based support for MSM should be adapted to this population to reduce this risk.
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hal-04600790 , version 1 (04-06-2024)

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Marion Fiorentino, Nathan Yanwou, Robinson Gravier-Dumonceau Mazelier, August Eubanks, Perrine Roux, et al.. Sexual behaviours and risk with women in MSM in sub-Saharan Africa. AIDS. Official journal of the international AIDS Society, 2024, 38 (3), pp.273-287. ⟨10.1097/qad.0000000000003787⟩. ⟨hal-04600790⟩

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