MSM populations in low and middle-income countries: assessing magnitude, sexual behaviour and HIV prevalence
Background: While men who have sex with men (MSM) still play a central role in most concentrated HIV epidemics, better evidence of this role is missing. We sought to bring together surveillance and research data on the prevalence of male-male sex among adults, and on the prevalence of HIV, consistent condom use, and lifetime heterosexual sex, among MSM in lower/middle-income countries.
Methods: Literature searches were conducted and regional informants provided unpublished information. Quality of information was assessed. The best data available per region were identified and confidence intervals for indicator estimates were used to propose regional estimate ranges.
Results: 561 studies were identified, with significantly different numbers per region and virtually no information for all of Africa, the Middle-East, and the English-speaking Caribbean. Lifetime prevalence of sex with men (among males) was 3-5% for East Asia, 6-12% for South/South East Asia, 6-15% for Eastern Europe and 6-20% for Latin America. Prevalence of high-risk sex among MSM last year was 20-30% of the previous figures. Among MSM, HIV prevalence was 2% or less (MENA region), 10-20% (Latin America), 1-4% (China), and variable in South Asia (highest in India, 5-15%), South East Asia (highest in Cambodia, Thailand and Myanmar, 10-15%), and Eastern Europe (highest in Poland/Czech Republic, 6-10%). 33%-50% of MSM reported consistent condom use, and 30-50% of these men had sex with women at least once in all regions except East Asia where this rose to 60-70%.
Conclusions: Lifetime prevalence of sex with men among males was found to be 6-20%. HIV prevalence was 5-15% in parts of Latin America, South/South East Asia and Eastern Europe, with consistent condom use below 50%. Sex with women was frequent in MSM, particularly in East Asia. More valid data on MSM and HIV across regions is needed, which ensures comparability, allows for projections and supports programmatic action.
AIDS 2006 - XVI International AIDS Conference
"C.F.Caceres, et al.
MSM populations in low and middle-income countries: assessing magnitude, sexual behaviour and HIV prevalence.
AIDS 2006 - XVI International AIDS Conference: