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    Oral sex practices among men who have sex with men and transgender women at risk for and living with HIV in Nigeria

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    Author
    Robbins, Sarah J
    Dauda, Wuese
    Kokogho, Afoke
    Ndembi, Nicaise
    Mitchell, Andrew
    Adebajo, Sylvia
    Gaydos, Charlotte A
    Peel, Sheila
    Ramadhani, Habib O
    Robb, Merlin L
    Baral, Stefan D
    Ake, Julie A
    Charurat, Man E
    Crowell, Trevor A
    Nowak, Rebecca G
    Show allShow less

    Date
    2020-09-04
    Journal
    PLoS ONE
    Publisher
    Public Library of Science
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1371/journal.pone.0238745
    Abstract
    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.
    Keyword
    Oral sex
    Homosexuality, Male
    Oropharynx
    Sexually Transmitted Diseases
    Nigeria
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/13691
    ae974a485f413a2113503eed53cd6c53
    10.1371/journal.pone.0238745
    Scopus Count
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    UMB Open Access Articles 2020

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