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

• Main Authors: Mbita, Gaspar, Komba, Albert N, Casalini, Caterina, Bazant, Eva, Curran, Kelly, Christensen, Alice, Nyato, Daniel, Kim, Young Mi, Reed, Jason, Makyao, Neema, Kategile, Upendo, Conserve, Donaldson F, Faini, Diana, van Roosmalen, Jos, van den Akker, Thomas
• Format: Journal Article
• Language: English
• Published: 01.10.2022
• Subjects: 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
• ISSN: 1090-7165
• DOI: 10.1007/s10461-022-03667-9

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.