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      Factors associated with HIV testing among young men who have sex with men in Myanmar: a cross‐sectional study

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          Abstract

          Introduction

          In Myanmar, men who have sex with men ( MSM) experience high risk of HIV infection. However, access to HIV testing and prevention services remains a challenge among this marginalized population. The objective of this study was to estimate population prevalence and correlates of prior HIV testing among young MSM ( YMSM) and informs the development of HIV testing and intervention programmes that respond to the specific needs of this population.

          Methods

          Five hundred and eighty‐five YMSM aged 18 to 24 years were recruited using respondent‐driven sampling ( RDS) in a cross‐sectional survey conducted in six townships of Myanmar. RDS‐adjusted population estimates were calculated to estimate prevalence of HIV testing; RDS‐weighted logistic regression was used to examine correlates of HIV testing in the past 6 months and in a lifetime.

          Results

          There were 12 participants who reported receiving a HIV‐positive test; of those, five were tested in the past 6 months. The RDS‐weighted prevalence estimates of lifetime (any prior) HIV testing was 60.6% (95% CI: 53.3% to 66.4%) and of recent (≤ 6 months) HIV testing was 50.1% (95% CI: 44.1% to 55.5%). In multivariable analysis, sexual identity was associated with lifetime but not recent HIV testing. Lifetime and recent HIV testing were associated with having three or more male sexual partners in the past 12 months (adjusted ORs ( aORs) = 2.28, 95% CIs: 1.21 to 4.32 and 2.69, 95% CI: 1.59 to 4.56), having good HIV‐related knowledge ( aORs = 1.96, 95% CIs: 1.11 to 3.44 and 1.77, 95% CI: 1.08 to 2.89), reporting high HIV testing self‐efficacy ( aORs = 13.5, 95% CIs: 6.0 to 30.1 and 9.81, 95% CI: 4.27 to 22.6) and having access to and use of non‐ HIV health‐related services in the past 12 months ( aORs = 13.2, 95% CIs: 6.85 to 25.6 and 7.15, 95% CI: 4.08 to 12.5) respectively.

          Conclusions

          HIV testing coverage among YMSM aged 18 to 24 years old in Myanmar is still suboptimal. Integrated HIV testing and prevention services in existing health service provision systems with tailored HIV information and education programmes targeting YMSM to improve HIV‐related knowledge and self‐efficacy may help to promote regular HIV testing behaviour and contribute to sustainable control of the HIV epidemic among this marginalized population in Myanmar.

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          Most cited references60

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          Sampling and Estimation in Hidden Populations Using Respondent-Driven Sampling

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            Sampling Weights and Regression Analysis

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              The increase in global HIV epidemics in MSM.

              Epidemics of HIV in MSM continue to expand in most low, middle, and upper income countries in 2013 and rates of new infection have been consistently high among young MSM. Current prevention and treatment strategies are insufficient for this next wave of HIV spread. We conducted a series of comprehensive reviews of HIV prevalence and incidence, risks for HIV, prevention and care, stigma and discrimination, and policy and advocacy options. The high per act transmission probability of receptive anal intercourse, sex role versatility among MSM, network level effects, and social and structural determinants play central roles in disproportionate disease burdens. HIV can be transmitted through large MSM networks at great speed. Molecular epidemiologic data show marked clustering of HIV in MSM networks, and high proportions of infections due to transmission from recent infections. Prevention strategies that lower biological risks, including those using antiretrovirals, offer promise for epidemic control, but are limited by structural factors including, discrimination, criminalization, and barriers to healthcare. Subepidemics, including among racial and ethnic minority MSM in the United States and UK, are particularly severe and will require culturally tailored efforts. For the promise of new and combined bio-behavioral interventions to be realized, clinically competent healthcare is necessary and community leadership, engagement, and empowerment are likely to be key. Addressing the expanding epidemics of HIV in MSM will require continued research, increased resources, political will, policy change, structural reform, community engagement, and strategic planning and programming, but it can and must be done.
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                Author and article information

                Contributors
                stanley.luchters@burnet.edu.au
                Journal
                J Int AIDS Soc
                J Int AIDS Soc
                10.1002/(ISSN)1758-2652
                JIA2
                Journal of the International AIDS Society
                John Wiley and Sons Inc. (Hoboken )
                1758-2652
                06 November 2017
                November 2017
                : 20
                : 3 ( doiID: 10.1002/jia2.2017.20.issue-3 )
                : e25026
                Affiliations
                [ 1 ] Burnet Institute Melbourne Vic. Australia
                [ 2 ] Department of Epidemiology and Preventive Medicine Faculty of Medicine Nursing and Health Science Monash University Melbourne Australia
                [ 3 ] Institute for Global Health Yangon Myanmar
                [ 4 ] University of Maryland Baltimore MD USA
                [ 5 ] Burnet Institute Yangon Myanmar
                [ 6 ] Population Council Washington DC USA
                [ 7 ] Population Council Phnom Penh Cambodia
                [ 8 ] International Centre for Reproductive Health Department of Obstetrics and Gynecology Faculty of Medicine and Health Sciences Ghent University Ghent Belgium
                Author notes
                [*] [* ] Corresponding author: Stanley Luchters, Burnet Institute, 85 Commercial Road, Melbourne, Victoria, Australia 3004. Tel: +61 0423 066185. ( stanley.luchters@ 123456burnet.edu.au )
                Author information
                http://orcid.org/0000-0002-5932-3491
                Article
                JIA225026
                10.1002/jia2.25026
                5810319
                29105323
                6922ae18-3d30-4b2d-ad2f-247e66b1aa93
                © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 24 April 2017
                : 12 October 2017
                Page count
                Figures: 0, Tables: 4, Pages: 12, Words: 11969
                Funding
                Funded by: Government of the Netherlands' Ministry of Foreign Affairs
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                jia225026
                November 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.2.2 mode:remove_FC converted:13.02.2018

                Infectious disease & Microbiology
                hiv testing,young people,men who have sex with men,respondent‐driven sampling,myanmar

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