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HIV/Sexually Transmitted Infection Prevalence and Sexual Behavior of Men Who Have Sex With Men in 3 Districts of Botswana: Results From the 2012 Biobehavioral Survey

Tafuma, Taurayi Adriano MD*; Merrigan, Mike B. DrPH; Okui, Lillian A. MD; Lebelonyane, Refiletswe MD*; Bolebantswe, Jerry FNP*; Mine, Madisa PhD§; Chishala, Samule Bsc§; Moyo, Sikhulilekho MSc§; Thela, Telefo Bsc*; Rajatashuvra, Adhikary PhD

doi: 10.1097/OLQ.0000000000000160
Original Study

Background: Men who have sex with men (MSM) suffer significant stigma and discrimination; hence, they are reluctant to access health services. The Botswana Second National Strategic Framework for 2010–2016 stipulates the need to increase HIV prevention services for key populations as one of its prevention implementation strategies. We report here the prevalence of HIV and other sexually transmitted infections and risk factors for HIV infection among MSM in Botswana.

Methods: We conducted a cross-sectional survey using respondent driven sampling in 3 districts of Botswana: Gaborone, Francistown, and Kasane.

Results: Of the 454 participants recruited, most were Batswana (97.6%) with a mean age of 23.2 years (range, 18–53 years), with 74.9% aged between 20 and 29 years. The overall unadjusted HIV prevalence was 13.1% (95% confidence interval, 10.0–16.3), with 12.3%, 11.7%, and 25.9% in Gaborone, Francistown, and Kasane, respectively. Chlamydia trachomatis prevalence was higher than Neisseria gonorrhoeae in both urine and anal swabs, at 7.1% and 5.9%, respectively, versus 1.4% and 1.7%. Overall, 46.7% of respondents reported having sex with female partners. Men who have sex with men who thought they had a high chance of acquiring HIV had a significantly lower likelihood of using condom consistently than those who reported they had a lower chance of acquiring HIV (odds ratio = 0.4; 95% confidence interval, 0.2–0.7; P = 0.003).

Conclusion: HIV prevalence of MSM was lower than what has been reported in other sub-Saharan African countries with generalized epidemics; however, their degree of participation in heterosexual sex signifies sexual networks beyond the MSM subpopulation.

A study on men who have sex with men in the 3 districts of Botswana found an HIV prevalence of 13.1% and revealed that heterosexual behavior was common among them.

From the *Ministry of Health, Gaborone, Botswana; †Family Health International 360, Gaborone, Botswana; ‡Botswana-Harvard Partnership, Gaborone, Botswana; §Botswana-Harvard HIV Reference Laboratory, Gaborone, Botswana; and ¶Family Health International 360, Washington, DC

Acknowledgment: This work was made possible by the generous support of the American people through the US Agency for International Development (USAID). Financial assistance was provided by USAID to Family Health International 360 under the terms of the Preventive Technologies Agreement No. GHO-A-00-09-00016-00. The contents do not necessarily reflect the views of USAID or the United States Government.

Conflict of interest: None declared.

Correspondence: Taurayi AdrianoTafuma, MD, Ministry of Health, Postnet Kgale View, P.O Box 73ACJ, Gaborone, Botswana. E-mail:

Received for publication December 12, 2013, and accepted June 3, 2014.

© Copyright 2014 American Sexually Transmitted Diseases Association