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dc.contributor.authorRamadhani, Habib O
dc.contributor.authorCrowell, Trevor A
dc.contributor.authorNowak, Rebecca G
dc.contributor.authorNdembi, Nicaise
dc.contributor.authorKayode, Blessing O
dc.contributor.authorKokogho, Afoke
dc.contributor.authorOnonaku, Uchenna
dc.contributor.authorShoyemi, Elizabeth
dc.contributor.authorEkeh, Charles
dc.contributor.authorAdebajo, Sylvia
dc.contributor.authorBaral, Stefan D
dc.contributor.authorCharurat, Manhattan E
dc.date.accessioned2020-10-09T15:32:38Z
dc.date.available2020-10-09T15:32:38Z
dc.date.issued2020-10-01
dc.identifier.urihttp://hdl.handle.net/10713/13845
dc.description.abstractIntroduction: Young men who have sex with men (MSM) and transgender women (TGW) face stigmas that hinder access to healthcare. The aim of the study was to understand age-related determinants of healthcare needs and engagement among MSM and TGW. Methods: The TRUST/RV368 cohort provides integrated prevention and treatment services for HIV and other sexually transmitted infections (STIs) tailored to the needs of sexual and gender minorities. MSM and TGW aged ≥16 years in Abuja and ≥18 years Lagos, Nigeria, completed standardized behavioural questionnaires and were tested for HIV, Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) every three months for up to 18 months. Logistic regression was used to estimate adjusted odds ratios (aORs) for associations of age and other factors with outcomes of interest upon enrolment, including HIV care continuum steps – HIV testing, ART initiation and viral suppression <1000 copies/mL. Cox proportional hazards models were used to calculate adjusted hazard ratios (aHRs) for associations with incident infections. Results: Between March 2013 and February 2019, 2123 participants were enrolled with median age 23 (interquartile range 21 to 27) years. Of 1745 tested, 865 (49.6%) were living with HIV. HIV incidence was 11.6/100 person-years [PY], including 23.1/100PY (95% CI 15.5 to 33.1) among participants aged 16 to 19 years and 23.8/100 PY (95% CI 13.6 to 39.1) among TGW. Compared to participants aged ≥25 years, those aged 16 to 19 years had decreased odds of prior HIV testing (aOR 0.40 [95% CI 0.11 to 0.92]), disclosing same-sex sexual practices to healthcare workers (aOR 0.53 [95% CI 0.36 to 0.77]) and receiving HIV prevention information (aOR 0.60 [95% CI 0.41 to 0.87]). They had increased odds of avoiding healthcare (aOR 1.94 [95% CI 1.3 to 2.83]) and engaging in transactional sex (aOR 2.76 [95% CI 1.92 to 3.71]). Age 16 to 19 years was independently associated with increased incidence of HIV (aHR 4.09 [95% CI 2.33 to 7.49]), NG (aHR 3.91 [95% CI 1.90 to 8.11]) and CT (aHR 2.74 [95% CI 1.48 to 5.81]). Conclusions: Young MSM and TGW demonstrated decreased healthcare engagement and higher incidence of HIV and other STIs as compared to older participants in this Nigerian cohort. Interventions to address unique obstacles to healthcare engagement by adolescents and young adults are needed to curb the spread of HIV and other STIs among MSM and TGW in Nigeria.en_US
dc.description.urihttps://doi.org/10.1002/jia2.25599en_US
dc.language.isoenen_US
dc.publisherWiley-Blackwellen_US
dc.relation.ispartofJournal of the International AIDS Societyen_US
dc.rights© 2020 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.en_US
dc.subjectAfrica South of the Saharaen_US
dc.subjectDelivery of Health Careen_US
dc.subjectHIV care continuumen_US
dc.subjectSTIen_US
dc.subjectmen who have sex with menen_US
dc.subjectsexual and gender minoritiesen_US
dc.subjecttransgender peopleen_US
dc.titleAssociation of age with healthcare needs and engagement among Nigerian men who have sex with men and transgender women: cross-sectional and longitudinal analyses from an observational cohort.en_US
dc.typeArticleen_US
dc.identifier.doi10.1002/jia2.25599
dc.identifier.pmid33000907
dc.source.volume23 Suppl 6
dc.source.beginpagee25599
dc.source.endpage
dc.source.countryUnited States
dc.source.countryUnited States
dc.source.countryUnited States
dc.source.countryUnited States
dc.source.countrySwitzerland


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