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      Men Who Have Sex with Men in Mozambique: Identifying a Hidden Population at High-risk for HIV

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          Abstract

          The population of men who have sex with men (MSM) has been largely ignored in HIV-related policies and programming in Mozambique and there is little information about the contribution of MSM to the HIV epidemic. An integrated biological and behavioral study among MSM using respondent-driven sampling was conducted in 2011 in Maputo, Beira and Nampula/Nacala. Men who reported engaging in oral or anal sex with other men in the last 12 months answered a questionnaire and provided a blood sample for HIV testing. The prevalence of HIV was 8.2 % (Maputo, n = 496), 9.1 % (Beira, n = 584) and 3.1 % (Nampula/Nacala, n = 353). Prevalence was higher among MSM ≥ 25 vs. 18–24 years: 33.8 % vs. 2.4 % ( p < 0.001), 32.1 vs. 2.8 % ( p < 0.001), and 10.3 vs. 2.7 % ( p < 0.06), in each city respectively. The difference in prevalence demonstrates the need to increase prevention for younger MSM at risk for HIV and ensure care and treatment for older HIV-infected MSM.

          Resumen

          Por lo general, la población de hombres que tienen sexo con hombres (HSH) ha sido ignorada en las normas y programas relacionados con el VIH en Mozambique, y escasea información sobre la contribución de los HSH a la epidemia. Se realizó un estudio biológico y conductual integrado entre HSH usando el muestreo dirigido por los participantes en el 2011 en Maputo, Beira y Nampula/Nacala. Los hombres que informaron haber tenido sexo oral o anal con otros hombres durante los últimos 12 meses contestaron una encuesta y proporcionaron una muestra de sangre para detectar el VIH. La prevalencia del VIH fue del 8.2 % (Maputo, n = 496), 9.1 % (Beira, n = 584) y 3.1 % (Nampula/Nacala, n = 353). La prevalencia era mayor entre los HSH ≥ 25 años de edad vs. 18-24 años de edad: del 33.8 % vs. el 2.4 % (p < 0.001), del 32.1 % vs. el 2.8 % (p < 0.001) y del 10.3 % vs. el 2.7 % (p < 0.06), en cada ciudad respectivamente. La diferencia de prevalencia demuestra la necesidad de aumentar los esfuerzos de prevención dirigidos a hombres jóvenes en riesgo del VIH y de asegurar que los HSH mayores infectados por el VIH reciban cuidados y tratamiento.

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          Most cited references11

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          Assessing respondent-driven sampling.

          Respondent-driven sampling (RDS) is a network-based technique for estimating traits in hard-to-reach populations, for example, the prevalence of HIV among drug injectors. In recent years RDS has been used in more than 120 studies in more than 20 countries and by leading public health organizations, including the Centers for Disease Control and Prevention in the United States. Despite the widespread use and growing popularity of RDS, there has been little empirical validation of the methodology. Here we investigate the performance of RDS by simulating sampling from 85 known, network populations. Across a variety of traits we find that RDS is substantially less accurate than generally acknowledged and that reported RDS confidence intervals are misleadingly narrow. Moreover, because we model a best-case scenario in which the theoretical RDS sampling assumptions hold exactly, it is unlikely that RDS performs any better in practice than in our simulations. Notably, the poor performance of RDS is driven not by the bias but by the high variance of estimates, a possibility that had been largely overlooked in the RDS literature. Given the consistency of our results across networks and our generous sampling conditions, we conclude that RDS as currently practiced may not be suitable for key aspects of public health surveillance where it is now extensively applied.
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            EXTENSIONS OF RESPONDENT-DRIVEN SAMPLING: ANALYZING CONTINUOUS VARIABLES AND CONTROLLING FOR DIFFERENTIAL RECRUITMENT

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              Global Report: UNAIDS Report On The Global AIDS Epidemic,

              (2010)
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                Author and article information

                Contributors
                +258 823054660 , Rassuln@hotmail.com , Rnala@misau.gov.mz
                Journal
                AIDS Behav
                AIDS Behav
                AIDS and Behavior
                Springer US (Boston )
                1090-7165
                1573-3254
                19 September 2014
                19 September 2014
                2015
                : 19
                : 2
                : 393-404
                Affiliations
                [ ]Ministério da Saúde, Instituto Nacional de Saúde, Av. Eduardo Mondlane/Salvador Allende nº1008, Maputo, Mozambique
                [ ]Division of Global HIV/AIDS, Centers for Disease Control and Prevention (CDC), Maputo, Mozambique
                [ ]University of California San Francisco (UCSF), San Francisco, CA USA
                [ ]International Training and Education Center for Health (I-TECH), Maputo, Mozambique
                [ ]Pathfinder International, Maputo, Mozambique
                [ ]Population Services International (PSI), Maputo, Mozambique
                [ ]Associação Moçambicana de Defesa das Minorias Sexuais (LAMBDA), Maputo, Mozambique
                Article
                895
                10.1007/s10461-014-0895-8
                4341016
                25234252
                7d30a085-4884-4e37-bff5-2948784526d7
                © The Author(s) 2014

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

                History
                Categories
                Behavioral Surveillance
                Custom metadata
                © Springer Science+Business Media New York 2015

                Infectious disease & Microbiology
                msm,hiv,rds,seroprevalence,mozambique
                Infectious disease & Microbiology
                msm, hiv, rds, seroprevalence, mozambique

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