HIV and STI prevalence among MSM in Kathmandu, Nepal
Background: In Nepal, high HIV prevalence has been demonstrated in previous studies in Kathmandu especially among injecting drug users (IDUs) – e.g., in 2005, about 52% of male IDUs were HIV-positive. Experts have suggested that MSM might also contribute to local transmission but no studies had been conducted to confirm or reject this possibility. To address this need, Family Health International (FHI) in collaboration with the Center for Research on Environmental Health and Population Activities (CREHPA) and Blue Diamond Society (BDS) conducted an integrated biological and behavioral survey among MSM in Kathmandu.
Methods: Using Respondent-Driven Sampling (RDS), 358 MSM were enrolled in the study. Respondents were males who had had anal and/or oral sex with another male in the past year. Respondents were interviewed and underwent routine genital examination. Urine specimens and rectal swabs were tested for N. gonorrhoeae and C. trachomatis using Polymerase Chain Reaction. Blood was also tested for HIV, HSV-2 and syphilis serology. Weighted analysis was performed with Respondent Driven Sampling Analysis tool V.5.0.1 (Cornell University, 2003).
Results: HIV and other STI prevalence was found among MSM in Kathmandu city as follows: HIV: 4.7% (CI 95%, 1.3–7.5); urethral gonorrhea: 1.7% (95% CI, 0.5–3.4); rectal gonorrhea: 4.3% (95%, CI, 2.3–7.2); urethral chlamydia: 2.1 (95% CI, 0.4–4.4); rectal chlamydia: 1.4 (95% CI, 0.5–2); current syphilis: 2.1% (95% CI, 0.5–4.3); HSV-2: 11.8% (95% CI, 7.2–16.1). Condom use during anal sex was low during both commercial and casual sex.
Conclusions: Given these findings, HIV is clearly established in Kathmandu MSM sexual networks. In addition, the observed prevalence of HIV and STIs confirms the high-risk behaviors of MSM populations reported. Local interventions, particularly improved access to MSM-friendly STI and HIV care and support, and treatment services, should be strengthened and a scaling-up process should be implemented.
AIDS 2006 - XVI International AIDS Conference
"L.B.Acharya, et al.
HIV and STI prevalence among MSM in Kathmandu, Nepal.
AIDS 2006 - XVI International AIDS Conference: