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  1. Rodah Wanjiru1,
  2. Joshua Kimani2,
  3. Adrian Smith3
  1. 1Partners for Health and Development in Africa, Nairobi, Kenya
  2. 2Partners for Health and Development in Africa, Nairobi, Kenya
  3. 3University of Oxford, Nuffield Department of Population Health, Old Road Campus, Oxford, UK


Background Men who have sex with men (MSM) are a key target population for HIV prevention and control in Kenya. Although male sex workers remain the focus of research in Nairobi, HIV/STI prevalence has not been assessed among the wider MSM population since 2010. This study set out to reassess prevalence and associations of HIV and other STIs.

Methods Respondent-driven sampling recruited 618 MSM. Eligibility criteria were age 18+, male (birth or currently), Nairobi residence and consensual oral or anal intercourse with a man in the last year. Consenting participants completed an online survey including current experience of STI symptoms. Participants tested for HIV [Determine, First Response [2nd gen] and GeneXpert HIV-Qual [4th gen]], syphilis [RPR/TPHA], hepatitis B and C [HBsAg and HCV ELISA], urine and rectal chlamydia and gonorrhea [GeneXpert CTNG]. Associations with prevalent HIV were assessed using multivariate logistic regression.

Results HIV prevalence was 26.4% [22.6–30.6] including 0.5% [0.2–1.5] detected solely on 4th gen testing. Prevalent HIV was independently associated with age, lower education, Kenyan birth, transgender identity and exclusive sex with men in the past 3 months but dependently associated with STI symptoms. Prevalence of syphilis was 0.8% [0.3–1.9]; hepatitis B 4.4% [3.4–6.9]; hepatitis C 0.5% [0.2–1.5]. Current symptoms consistent with urethritis were reported by 6.4% [4.5–9.0] of participants. Prevalence of urethral GC and CT were 4.4% [2.9–6.7] and 7.3% [5.2–10.3] respectively. Symptoms consistent with proctitis were reported by 8.6% [6.3–11.6] of participants. The prevalence of rectal GC and CT were 13.3% [10.4–16.8] and 8.7% [6.7–11.2] respectively. Overall, only 17.7% [9.2–31.2] of participants with urethral CT/NG and 17.8% [10.7–28.0] rectal CT/NG were symptomatic.

Conclusion The burden of HIV among gay, bisexual and other MSM (GBMSM) remains considerably higher than other men in Nairobi, whilst the prevalence of syphilis and hepatitis C are relatively low. Chlamydia and gonorrhoea infections, particularly rectal, are common and frequently asymptomatic. Capacity of GBMSM-friendly and community-based providers to offer CT/NG screening should be prioritised.

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