Men Who Have Sex with Both Men and Women in West Africa: Factors Associated with a High Behavioral Risk of Acquiring HIV from Male Partners and Transmission to Women (CohMSM ANRS 12324—Expertise France) - Archive ouverte HAL Access content directly
Journal Articles Archives of Sexual Behavior Year : 2024

Men Who Have Sex with Both Men and Women in West Africa: Factors Associated with a High Behavioral Risk of Acquiring HIV from Male Partners and Transmission to Women (CohMSM ANRS 12324—Expertise France)

Marion Fiorentino
Bakary Coulibaly
  • Function : Author
Bintou Dembélé Keita
  • Function : Author
Camille Anoma
  • Function : Author
Elias Dah
  • Function : Author
Ephrem Mensah
  • Function : Author
Thomas Niamkey Aka
  • Function : Author
Juste Rodrigue Touré
  • Function : Author
Drissa Camara
  • Function : Author
Anouwarsadat Rodolphe Kokouba
  • Function : Author
Gwenaëlle Maradan
  • Function : Author
Marion Mora
  • Function : Author
Michel Bourrelly
  • Function : Author
Lucas Riegel
  • Function : Author
Daniela Rojas-Castro
  • Function : Author
Bruno Spire
  • Function : Author
Luis Sagaon-Teyssier
  • Function : Author
Véronique Boyer
  • Function : Author
Eric Delaporte
  • Function : Author
Bruno Granouillac
  • Function : Author
Suzanne Izard
  • Function : Author
Laura March
  • Function : Author
Martine Peeters
  • Function : Author
Laetitia Serrano
  • Function : Author
Cyril Berenger
  • Function : Author
Pierre-Julien Coulaud
  • Function : Author
Bakri M'Madi Mrenda
  • Function : Author
Enzo Parisi
  • Function : Author
Adeline Bernier
  • Function : Author
Emmanuel Trenado
  • Function : Author
Oumar Cisse
  • Function : Author
Alou Coulibaly
  • Function : Author
Bintou Dembele Keita
  • Function : Author
Fodié Diallo
  • Function : Author
Mahamadou Diarra
  • Function : Author
Mady Gadjigo
  • Function : Author
Abdoul Aziz Keita
  • Function : Author
Kader Maiga
  • Function : Author
Fodé Traore
  • Function : Author
Niamkey Thomas Aka
  • Function : Author
Malan Jean-Baptiste Kouame
  • Function : Author
Frédéric Dibi N'Guessan
  • Function : Author
Xavier Anglaret
  • Function : Author
Stéphane-Alain Babo Yoro
  • Function : Author
Jean-Marie Masumbuko
  • Function : Author
Maxime Oga
  • Function : Author
Christian Coulibaly
  • Function : Author
ter Tiero Elias Dah
  • Function : Author
Ousseni Ilboudo
  • Function : Author
Joseph Ouedraogo
  • Function : Author
Elisabeth Thio
  • Function : Author
Abdoulazziz Traore
  • Function : Author
Nicolas Meda
  • Function : Author
Aléda Mawuli Badjassim
  • Function : Author
Agbégnigan Lorette Ekon
  • Function : Author
Kossi Jeff Yaka
  • Function : Author
Claver Anoumou Yaotsè Dagnra
  • Function : Author

Abstract

HIV is highly prevalent in men who have sex with men (MSM) in West Africa. Many MSM in the region also have sex with women (MSMW). Accordingly, they are a potential bridge subpopulation for HIV transmission to women. We aimed to evaluate the proportions and characteristics of West African MSMW at high behavioral risk of acquiring HIV from male partners and transmitting it to female partners (HBRMF). The cohort ANRS-12324 CohMSM Study included 630 HIV-negative MSM in Burkina Faso, Cote d'Ivoire, Mali, and Togo. Among MSMW (i.e., with ≥ 1 female partner) in the cohort, HBRMF was identified using trajectory models based on seven at-risk sexual practices with male and female partners, including inconsistent condom use, multiple partnerships, and receptive same-sex anal intercourse. To assess the relevance of using trajectory models, we compared the proportions of participants who seroconverted during the cohort follow-up among those at HBRMF and those not at HBRMF. Factors associated with HBRMF were identified using a generalized estimation equation logistic regression model accounting for longitudinal data. Approximately half (47%) of the 304 MSMW (22% of all CohMSM study participants) were at HBRMF. This group accounted for 75% of the 28 HIV seroconversions observed during follow-up (p = 0.001). HBRMF was positively associated with being aged < 25 years (aOR 95% CI 1.67 [1.23-2.27]), being sexually attracted only to men (1.97 [1.38-2.78]), feelings of loneliness (1.92 [1.38-2.65]), and homonegative violence score (1.22 [1.05-1.41]). HBRMF was negatively associated with having had both stable and casual female partners in the previous 6 months (0.34 [0.20-0.60] vs. only a stable female partner). HBRMF tended to be negatively associated with having ≥ 4 sexual intercourses with female partners in the previous four weeks (0.54 [0.27-1.06] vs. no intercourse). Establishing official relationships with women might be a strategy for young and/or stigmatized MSMW to comply with social pressure to display a heterosexual lifestyle. However, this seems to increase the risk of HIV transmission to female partners. In the present study, almost half of MSMW were at HBRMF. This result stresses the need to adapt HIV research and prevention to MSMW and their female partners. © 2023. The Author(s).
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hal-04601189 , version 1 (04-06-2024)

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Marion Fiorentino, Bakary Coulibaly, Clotilde Couderc, Bintou Dembélé Keita, Camille Anoma, et al.. Men Who Have Sex with Both Men and Women in West Africa: Factors Associated with a High Behavioral Risk of Acquiring HIV from Male Partners and Transmission to Women (CohMSM ANRS 12324—Expertise France). Archives of Sexual Behavior, 2024, 53 (2), ⟨10.1007/s10508-023-02715-2⟩. ⟨hal-04601189⟩

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