Discussion of HIV and Other Sexually Transmitted Infections with Sex Partners of Nigerian Men who have Sex with Men and Transgender Women: Implications for Interventions to Promote Safer Sex Practices

Abdulwasiu B Tiamiyu; Fengming Hu; Afoke Kokogho; Manhattan E Charurat; Charles Ekeh; Sylvia Adebajo; Elizabeth Shoyemi; Michael Iroezindu; Julie A Ake; Stefan D Baral; Rebecca G Nowak; Trevor A Crowell; TRUST/RV368 Study Group

doi:10.1097/QAI.0000000000003552

Discussion of HIV and Other Sexually Transmitted Infections with Sex Partners of Nigerian Men who have Sex with Men and Transgender Women: Implications for Interventions to Promote Safer Sex Practices

J Acquir Immune Defic Syndr. 2024 Oct 24. doi: 10.1097/QAI.0000000000003552. Online ahead of print.

Authors

Abdulwasiu B Tiamiyu^{1

2

3}, Fengming Hu^{3

4}, Afoke Kokogho^{1

2

3}, Manhattan E Charurat⁵, Charles Ekeh⁶, Sylvia Adebajo⁷, Elizabeth Shoyemi⁶, Michael Iroezindu^{1

2

3}, Julie A Ake³, Stefan D Baral⁸, Rebecca G Nowak⁵, Trevor A Crowell^{3

4}; TRUST/RV368 Study Group

Affiliations

¹ HJF Medical Research International, Abuja, Nigeria.
² U.S. Military HIV Research Program, Walter Reed Army Institute of Research - Africa, Abuja, Nigeria.
³ U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
⁴ Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
⁵ Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
⁶ Population Council Nigeria, Abuja, Nigeria.
⁷ Maryland Global Initiatives Corporation, University of Maryland, Baltimore, MD, USA.
⁸ Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

PMID: 39446488
DOI: 10.1097/QAI.0000000000003552

Abstract

Background: Discussion of HIV and other sexually transmitted infections (STIs) among sex partners facilitates risk reduction. We evaluated HIV/STI-related communications, including broad assessment of any self-reported discussion of the topic and specific discussion of each partners' HIV status, among a historically marginalized and presently criminalized community of sexual and gender minorities (SGM) in Nigeria.

Methods: From 2013-2018, we enrolled SGM aged 18+ in Lagos or 16+ in Abuja who reported anal sex with men. At enrollment and 3-, 9-, and 15-month follow-up visits, participants were asked about their sexual behaviors and communications with main sexual partners (MSP) and casual sexual partners (CSP). Questions included "have you talked with your [MSP/CSP] about sexually transmitted infections and HIV?" Multivariable robust Poisson regression with generalized estimating equations was used to estimate adjusted relative risks (aRRs) and 95% confidence intervals (CIs) for factors potentially associated with HIV/STI-related communications with some or all of each type of sexual partner.

Results: Among 2795 SGM enrolled with median age 23 years (interquartile range 20-27), questions about HIV/STI-related communications with MSP were answered by 2436 (87.2%) and with CSP by 2398 (85.9%). Communication with MSP was reported by 68.1% (1659/2436), of whom 897 (54.1%) discussed their own HIV status and 925 (55.8%) discussed their partner's status. Communication with CSP was reported by 43.9% (1052/2398), of whom 389 (37.0%) discussed their own HIV status and 385 (36.6%) discussed their partner's status. Among participants with both MSP and CSP, HIV/STI-related communication with MSP was more common among participants with higher than secondary education (aRR 1.40 [95%CI 1.24-1.58)], who were divorced/separated/widowed (aRR 1.19 [95% CI 1.06-1.33]), who discussed their HIV status with CSP (aRR 1.18 [95%CI 1.10-1.25]), discussed CSP's HIV status (aRR 1.20 [95%CI 1.13-1.27]), and used a condom at last sex with CSP (aRR 1.16 [95%CI 1.08-1.25]). HIV/STI-related communication with CSP was more common among participants with higher than secondary education (aRR 1.36 [95%CI 1.12-1.66]); who were divorced/separated/widowed (aRR 1.38 [95%CI 1.13-1.69]), who discussed their HIV status with MSP (aRR 1.47 [95%CI 1.27-1.69]), who discussed CSP's HIV status (aRR 1.22 [95%CI 1.06-1.40]) and used a condom at last sex with CSP (aRR 1.22 (95%CI 1.08-1.38]).

Conclusion: HIV/STI-related communications with main and casual sex partners were both associated with safer sex with CSP. HIV prevention and treatment programs for SGM should promote open communications in sexual relationships and consider deployment of modern strategies to facilitate disclosure, especially in settings with criminalizing legislation.

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