Men who have sex with men (MSM) and factors associated with not using a condom at last sexual intercourse with a man and with a woman in Senegal

BACKGROUND: Men who have sex with other men (MSM) are a vulnerable population in Africa that has been insufficiently explored. Given the high rate of bisexuality among MSM (73% in the past year), it is important to understand their risk-taking behaviors regarding both men and women. METHODOLOGY/PRINCIPAL FINDINGS: A socio-behavioral survey was carried out in 2007 among 501 MSM recruited using the snowball sampling method. We explore in this article why a condom was not used during last sexual intercourse with a man and with a woman, taking into account the respondent's characteristics, type of relationship and the context of the sexual act. In the survey, 489 men reported that they had had sexual intercourse at least once with another man during the previous year, and 358 with a man and with a woman. The main risk factors for not using a condom at last sexual intercourse with another man were having sex in a public place (aOR = 6.26 [95%CI: 2.71–14.46]), non-participation in an MSM prevention program (aOR = 3.47 [95%CI: 2.12–5.69]), a 19 years old or younger partner (aOR = 2.6 [95%CI: 1.23–4.53]), being 24 years or younger (aOR = 2.07 [95%CI: 1.20–3.58]) or being 35 years or over (aOR = 3.08 [95%CI:1.11–8.53]) and being unemployed (aOR = 0.36 [95%CI: 0.10–1.25]). The last sexual intercourse with the respondent's wife was hardly ever protected (2%). With women, the other factors were a 15 years or younger partner (aOR = 6.45 [95%CI: 2.56–16.28]), being educated (primary: aOR = 0.45 [95%CI: 0.21–0.95], secondary or higher: aOR = 0.26 [95%CI: 0.11–0.62]), being a student (aOR = 2.20 [95%CI: 1.07–4.54]) or unemployed (aOR = 3.72 [95%CI: 1.31–10.61]) and having participated in a MSM prevention program (aOR = 0.57 [95%CI: 0.34–0.93]). CONCLUSION: Having participated in a prevention program specifically targeting MSM constitutes a major prevention factor. However, these programs targeting MSM must address their heterosexual practices and the specific risks involved

Men who have sex with men (MSM) and risk factors associated with last sexual intercourse with a man and a woman in Senegal - ELIHoS Project, ANRS 12139

BackgroundMen who have sex with other men (MSM) are in Africa a vulnerable population which has hitherto been insufficiently explored. Given the high rate of bisexuality among MSM, it is important to understand their risk-taking behaviours regarding both men and women.MethodsA socio-behavioural survey was carried out in 2007 among 501 MSM recruited using the snowball sampling method. We explore in this article why a condom was not used during last sexual intercourse with a man and with a woman, bearing in mind the respondent’s characteristics, type of relationship and the context of the sexual act.Results489 men reported that they had had sexual intercourse at least once with another man during the previous year, and 358 with a man and with a woman. With another man, the main risk factors are sexual intercourse in a public place (adjusted OR = 6.8), and non-participation in an MSM prevention program (adjusted OR = 3.1). The risks, although non-significant at 5%, are higher among younger men (18-19 years) and older men (35 years and over), and among vulnerable people (unemployed). With a woman, sexual intercourse with the respondent’s wife is hardly ever protected (2%). Otherwise, risks are high when the female partner is very young (15 years or younger, adjusted OR = 5.3) and when the man has not participated in an MSM prevention campaign (adjusted OR = 2.3).ConclusionHaving participated in a prevention program specifically targeting MSM constitutes a major prevention factor. However, these programs targeting MSM must address their heterosexual practices and the specific risks involved

Sexual practices at last sexual intercourse.

<p>Sum of columns exceeds 100% (several answers possible).</p

Unprotected anal or vaginal sex at last sexual intercourse with a man and at last sexual intercourse with a woman (bivariate analysis).

<p>Continue in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0013189#pone-0013189-t003" target="_blank">Table 3</a>.</p

Factors associated with unprotected anal or vaginal sex at last sexual intercourse with a man and at last sexual intercourse with a woman (logistic regression).

a<p>Base: 489 MSM who had had at least one male sexual partner over the past year.</p>b<p>Base: 358 MSM who had had both male and female sexual partners over the past year.</p><p>aOR: adjusted Odds Ratio. 95% CI: 95% Confidence Interval.</p

Table 2 continued.

a<p>Base: 489 MSM who had had at least one male sexual partner over the past year.</p>b<p>Base: 358 MSM who had had both male and female sexual partners over the past year.</p>c<p>Wald test for bivariate logistic regression of the overall variable (null hypothesis: all odds ratio of modalities are equal to 1).</p><p>na: not applicable.</p

Reduction in risk-taking behaviors among MSM in Senegal between 2004 and 2007 and prevalence of HIV and other STIs. ELIHoS Project, ANRS 12139

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Unexpected high circulation of Plasmodium vivax in asymptomatic children from Kédougou, southeastern Senegal

Abstract Background Malaria in Senegal is due essentially to infections by Plasmodium falciparum and, to a lesser extent to Plasmodium malariae and Plasmodium ovale. By the use of molecular methods, detection of Plasmodium vivax has been recently reported in the region of Kedougou, raising the question of appraisal of its potential prevalence in this setting. Methods A retrospective serological study was carried out using 188 samples taken from 2010 to 2011 in a longitudinal school survey during which 48 asymptomatic children (9–11 years) were recruited. Four collections of samples collected during two successive dry and rainy seasons were analysed for antibody responses to P. vivax and P. falciparum. Recombinant P. falciparum and P. vivax MSP1 antigens and total P. falciparum schizont lysate from African 07/03 strain (adapted to culture) were used for ELISA. Nested PCR amplification was used for molecular detection of P. vivax. Results A surprising high prevalence of IgG responses against P. vivax MSP1 was evidenced with 53% of positive samples and 58% of the individuals that were found positive to this antigen. There was 77% of responders to P. falciparum outlined by 63% of positive samples. Prevalence of responders did not differ as function of seasons. Levels of antibodies to P. falciparum fluctuated with significant increasing between dry and rainy season (P < 0.05), contrary to responses to P. vivax. There was a significant reciprocal relationship (P < 10−3) between antibody responses to the different antigens, but with weak coefficient of correlation (Rho around 0.3) underlining a variable profile at the individual level. Clear molecular signature was found in positive IgG to P. vivax msp1 samples by PCR. Conclusion This cross-sectional longitudinal study highlights the unexpected high circulation of P. vivax in this endemic area. Sero-immunology and molecular methods are powerful additive tools to identify endemic sites where relevant control measures have to be settled and monitored