Assessing the burden of HIV/AIDS among Men who have Sex with Men (MSM) in Abuja, Nigeria

Background

Health authorities and institutions had always believed that HIV transmission was mainly through heterosexual transmission. Their main focus has always been on prevention of HIV virus through heterosexual relationships and MSM are usually ignored when it comes to AIDS awareness campaigns and educational programme. Consequently, many do not have adequate knowledge about the risks involved in unprotected anal intercourse and how to protect themselves from HIV infection resulting in them being at high risk for HIV infection. The fact that homosexuality is widely ignored in Nigeria is having a negative impact on the spread of AIDS in the country. This necessitated the urgent need to address all aspects of the HIV/AIDS pandemic without prejudice of social groups. The main problem contributing to this was the fact that not much was known about MSM in Nigeria. This project embarked on a base line study of MSM in Abuja with a view to unearth the challenges faced MSM in Abuja.

Methods

A quantitative interviewer administered questionnaire was used in the project. This included question on demographic characteristics, knowledge of HIV/AIDS, sexual behavior of MSM, use of drugs, and health & social consequences. In-depth interview was carried out with ten participants from the MSM community on key areas such as identification of viable collection sites, health and legal challenges faced, accessibility to condoms and lubricants. Other issues discussed were security issues, care and support of HIV positive MSM; new key terms used and proffer solutions to issues. Provision of condoms and lubricants, HIV Counseling and Testing were made available. Several parties were conducted for questionnaire administration.

Results

The quantitative study of this research is in the analytical phase and thus shows results from the qualitative assessment. Results showed that the MSM community lacked information on sexual reproductive health and access to HIV integrated services. This consequences and implications serve as a likely component of the HIV epidemic among MSM which plays a key role in the dynamics of the epidemic (bridging population). Several face health and legal challenges and have been harassed by police authorities. Condoms are accessible unlike lubricants which are expensive and inaccessible.

Discussion

This information shows that the MSM community has contributed to the national prevalence of HIV/AIDS in Nigeria among the general population. The size of the MSM population and the percentage of adult men practicing male-to-male sex in Abuja and Nigeria are unknown. The project revealed that the MSM population is a hidden population; the easiest way to provide information to the MSM community is through parties hosted by a popular MSM celebrant. Many MSMs denied their sexuality when confronted for fear of being stigmatized and discriminated against which resulted in physical attack and criminal offence. Majority of the respondents have sex without condoms and don’t feel the need to use such. More than half of the respondents have lost a partner/friend as a result of HIV/AIDS. A dire need for services providing MSM specific information on HIV transmission & prevention and health care services aimed at impact mitigation is thus urgently required. MSM influence and popular leaders can be used as peer educators to reach out to other MSM on HIV/AIDS/STI information and need to go for HIV Counseling and Testing (HCT). On health issues, many have faced discrimination from health care providers once they discover an anal tear associated with physical behavior. Thus, this has resulted many to self medication in curing STIs, and anal tear. In that process, they have continuously suffered from recurring STIs and partner re-infection. Depending on usage and cost, lubricants can be used effectively with water. When unavailable, alternatives such as engine oil, vegetable oil, olive oil, saliva, water and soap could be used. Presently, there are no support groups specifically for HIV positive MSM in Abuja except in Calabar and Kaduna. HIV positive MSM have found it difficult to integrate in other support groups to obtain care and support services. MSM have long been ignored in HIV research and intervention strategies in Nigeria and Africa as a whole. There is a strong denial of the MSM behavior in many African countries as this is not attuned with the cultural norms and values of the African society. These studies also show that when respectful and considerate approaches are used to ensure their safety, dignity and anonymity, MSM will come forward to work with public health authorities and others to help improve their sexual health thereby stemming down the prevalence of HIV/AIDS.

CONCLUSION

This Project provided an overview on the magnitude of HIV in MSM in Abuja, highlighting the issues facing men having sex with men and the urgency to reduce HIV/AIDS transmission among MSM. Public education on HIV/AIDS in MSM community should be integrated into public health programs. Access to health care intervention to treat STIs which predisposes MSM to HIV/AIDS should be addressed. Thus, reaching out to these MSM and educating them about HIV/AIDS and safer sex becomes crucial. Providing HIV/AIDS education and distribution of condoms alone may not be sufficient unless an enabling environment is created.

ACKNOWLEDGEMENT

The findings and conclusions in this report are those of CRH. This research received funding support from The Foundation for AIDS Research (amfAR).

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