Predictors of HIV Among 1 Million Clients in High-Risk Male Populations in Tanzania

AIDS Behav. 2022 Oct;26(10):3185-3198. doi: 10.1007/s10461-022-03667-9. Epub 2022 Apr 1.

Abstract

The World Health Organization identified men as an essential group to target with HIV testing and treatment strategies;: men who have sex with men (MSM) and male clients of female sex workers (CFSW) account for 35% of new HIV infections globally. Using a cross-sectional design from a community-based HIV prevention project in Tanzania (October 2015-September 2018) and multivariable logistic regression, we identified predictors of HIV seropositivity among men. Of 1,041,343 men on their initial visit to the project, 36,905 (3.5%) were MSM; 567,005 (54.5%) were CFSW; and 437,343 (42.0%) were other men living near hotspots (OMHA). Three predictors of HIV seropositivity emerged across all three groups: being uncircumcised, having sexually transmitted infection symptoms, and harmful drinking of alcohol before sex. Any reported form of gender-based violence among MSM and OMHA and inconsistent condom use among CFSW were associated with HIV seropositivity. These findings may inform community HIV strategies like self-testing, delivery of pre-exposure prophylaxis and antiretroviral therapy, and behavioral change communication targeting men at higher risk of infection.

Keywords: Male client of female sex workers; Men living in areas with high risk of HIV; Men who have sex with men; Sexually transmitted infections; Tanzania.

MeSH terms

  • Cross-Sectional Studies
  • Female
  • HIV Infections* / diagnosis
  • HIV Infections* / epidemiology
  • HIV Infections* / prevention & control
  • HIV Seropositivity*
  • Homosexuality, Male
  • Humans
  • Male
  • Sex Workers*
  • Sexual and Gender Minorities*
  • Sexually Transmitted Diseases* / prevention & control
  • Tanzania / epidemiology