HIV prevalence and associated risk factors among young tertiary student men who have sex with men (MSM) in Nairobi, Kenya: a respondent-driven sampling survey

摘要

Young men who have sex with men (MSM), are a key population at higher risk of HIV infection yet they are underrepresented in research. We conducted a bio-behavioral survey to estimate HIV prevalence and associated risk factors among tertiary student MSM (TSMSM) in Nairobi, Kenya. Between February and March 2021, 248 TSMSM aged ≥ 18 years who reported sex with another man in the past year participated in a respondent-driven sampling (RDS) based cross-sectional survey. Participants completed an electronically self-administered behavioral survey and provided a blood sample for HIV antibody testing, alongside urine, anorectal and oropharyngeal swabs for pooled testing of sexually transmitted infections using a multiplex nucleic acid amplification test. RDS-Analyst v.0.72 and Stata v.15 software were used for data analysis. Differences in proportions were examined using chi-square (χ2) test, and unweighted multivariate logistic regression was used to assess factors associated with HIV infection. HIV prevalence among study participants was 8.3, whereas the weighted prevalence was 3.6 (95 CI: 1.3–6.0). Median ages of participants, and at self-reported first anal sex with a man were 21(interquartile range IQR 20-22) and 18 (IQR 17-19) years, respectively. A majority (89.3) of TSMSM owned a smart phone, 46.5 had ever used a geosocial networking app for MSM such as Grindr ® to find a sex partner, and a third (33.6) met their last sex partner online. Almost three-quarters (71.3) had > 1 male sex partner in the year before the survey. A third (34.3) did not use condoms with their last sex partner, 21.2 received money from their last sex partner and 40.9 had taken alcohol/another drug during their last sexual encounter. HIV infection was associated with studying in private institutions (adjusted odds ratioAOR = 6.0; 95 confidence intervals CI : 1.2–30.0, p = 0.027), preferring a sex partner of any age—younger, same or older (AOR = 5.2; 95 CI: 1.1–25.2, p = 0.041), last sex partner being > 25 years (AOR = 6.4; 95 CI: 1.2–34.6, p = 0.030), meeting the last sex partner online (AOR = 4.2; 95 CI; 1.1–17.0, p = 0.043) and testing positive for Neisseria gonorrhea (AOR = 7.8; 95 CI: 2.0–29.9, p = 0.003). HIV prevalence among TSMSM in Nairobi is alarmingly high, demonstrating a need for tailored prevention and control interventions for this young key population.