TY - JOUR
T1 - Oral sex practices among men who have sex with men and transgender women at risk for and living with HIV in Nigeria
AU - Robbins, Sarah J.
AU - Dauda, Wuese
AU - Kokogho, Afoke
AU - Ndembi, Nicaise
AU - Mitchell, Andrew
AU - Adebajo, Sylvia
AU - Gaydos, Charlotte A.
AU - Peel, Sheila
AU - Ramadhani, Habib O.
AU - Robb, Merlin L.
AU - Baral, Stefan D.
AU - Ake, Julie A.
AU - Charurat, Man E.
AU - Crowell, Trevor A.
AU - Nowak, Rebecca G.
AU - Charurat, Manhattan
AU - Ake, Julie
AU - Abayomi, Aka
AU - Adebajo, Sylvia
AU - Crowell, Trevor
AU - Gaydos, Charlotte
AU - Kokogho, Afoke
AU - Malia, Jennifer
AU - Makanjuola, Olumide
AU - Michael, Nelson
AU - Ndembi, Nicaise
AU - Nowak, Rebecca
AU - Olawore, Oluwasolape
AU - Parker, Zahra
AU - Jackson, Henry M.
AU - Peel, Sheila
AU - Ramadhani, Habib
AU - Robb, Merlin
AU - Rodriguez-Hart, Cristina
AU - Sanders-Buell, Eric
AU - Shoyemi, Elizabeth
AU - Tovanabutra, Sodsai
AU - Vasan, Sandhya
N1 - Publisher Copyright:
© 2020 Robbins et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/9
Y1 - 2020/9
N2 - Background Men who have sex with men (MSM) and transgender women (TGW) are at risk for sexually transmitted infections (STIs), including those of the oropharynx. We estimated the prevalence and factors associated with oral sex practices and characterized oropharyngeal STIs among a cohort of MSM and TGW in Nigeria. Methods From 2013 to 2018, TRUST/RV368 recruited MSM and TGW into HIV/STI diagnosis and treatment at community-based clinics in Nigeria. Participants who completed HIV testing and oral sex questions at enrollment were selected. Cross-sectional analyses with bivariate and multivariable logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs). Oropharyngeal swab testing for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) began in 2014 and for those with diagnostic results at enrollment, the unadjusted association of oral sex practices with oropharyngeal STIs was conducted. Results A total of 1342 participants had a median age of 25 years (interquartile range: 22-29), 58% were living with HIV, and 69% reported oral sex practices. Factors associated with increased odds of engaging in oral sex included living with HIV (adjusted [a]OR: 1.4, 95% CI: 1.1-1.8), self-identifying as a woman (aOR:1.8, 95% CI: 1.1-2.8), mobile phone ownership (aOR:2.3, 95% CI: 1.3-3.9), receptive anal sex (aOR:1.7, 95% CI:1.3-2.3) and multiple male sexual partners (2 to 4 vs. <1, aOR:1.5, 95% CI: 1.0-2.2; 5+ vs <1, aOR:2.9, 95% CI:1.9-4.3). Oropharyngeal STI prevalence was 7% (52/752) and higher among those who engaged in oral sex compared to those who did not (unadjusted OR: 2.5, 95% CI:1.2-5.3). Conclusions Oral sex was common and associated with an increased odds of oropharyngeal STIs among MSM and TGW from Nigeria. In the absence of screening and treatment guidelines, condoms continue to be the mainstay for oral STI prevention. A pre-exposure prophylaxis for bacterial STIs would complement current prevention strategies to curb transmission.
AB - Background Men who have sex with men (MSM) and transgender women (TGW) are at risk for sexually transmitted infections (STIs), including those of the oropharynx. We estimated the prevalence and factors associated with oral sex practices and characterized oropharyngeal STIs among a cohort of MSM and TGW in Nigeria. Methods From 2013 to 2018, TRUST/RV368 recruited MSM and TGW into HIV/STI diagnosis and treatment at community-based clinics in Nigeria. Participants who completed HIV testing and oral sex questions at enrollment were selected. Cross-sectional analyses with bivariate and multivariable logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs). Oropharyngeal swab testing for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) began in 2014 and for those with diagnostic results at enrollment, the unadjusted association of oral sex practices with oropharyngeal STIs was conducted. Results A total of 1342 participants had a median age of 25 years (interquartile range: 22-29), 58% were living with HIV, and 69% reported oral sex practices. Factors associated with increased odds of engaging in oral sex included living with HIV (adjusted [a]OR: 1.4, 95% CI: 1.1-1.8), self-identifying as a woman (aOR:1.8, 95% CI: 1.1-2.8), mobile phone ownership (aOR:2.3, 95% CI: 1.3-3.9), receptive anal sex (aOR:1.7, 95% CI:1.3-2.3) and multiple male sexual partners (2 to 4 vs. <1, aOR:1.5, 95% CI: 1.0-2.2; 5+ vs <1, aOR:2.9, 95% CI:1.9-4.3). Oropharyngeal STI prevalence was 7% (52/752) and higher among those who engaged in oral sex compared to those who did not (unadjusted OR: 2.5, 95% CI:1.2-5.3). Conclusions Oral sex was common and associated with an increased odds of oropharyngeal STIs among MSM and TGW from Nigeria. In the absence of screening and treatment guidelines, condoms continue to be the mainstay for oral STI prevention. A pre-exposure prophylaxis for bacterial STIs would complement current prevention strategies to curb transmission.
UR - http://www.scopus.com/inward/record.url?scp=85090510053&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0238745
DO - 10.1371/journal.pone.0238745
M3 - Article
C2 - 32886722
AN - SCOPUS:85090510053
SN - 1932-6203
VL - 15
JO - PLoS ONE
JF - PLoS ONE
IS - 9
M1 - e0238745
ER -