HIV Risk Perception and Risk Behaviors among Men Who Have Sex with Men in Nigeria

Abstract

Background: Some studies have shown that greater perceived vulnerability to HIV is associated with less involvement in risk taking. We evaluated prevalence and correlates of HIV risk perception among men who have sex with men (MSM) in Nigeria. Methods: A cross sectional study using respondent driven sampling (RDS) was conducted in six Nigerian states in 2010. Weighted HIV risk perceptions were calculated using an RDS analytic tool. Logistic regression was used to determine correlates of HIV risk perception, stratified by state. Results: The total number of MSM ranged from 217 in Abuja to 314 in Cross River state. Median age ranged from 22 years in Cross River state to 26 years in Kano. HIV risk perception ranged from 10% in Cross River state to 58% in Kaduna state and was 38%, 44%, 19% and 20% in Kano, Lagos, Abuja and Oyo states respectively. Factors associated with HIV risk perception include purchasing sex (AOR: 3.11, 95% CI: 1.09-8.88) and never being tested for HIV (AOR = 0.34, 95% CI: 0.14 - 0.85] in Cross River; no comprehensive knowledge of HIV (AOR = 0.21, 95% CI: 0.05 - 0.90) and receptive anal partners (AOR = 10.07, 95% CI: 2.07 - 49.02) in Abuja; being older than 25 years (AOR = 0.16, 95% CI: 0.03 - 0.98) in Kano; no exposure to peer education in Kaduna (AOR = 0.08, 95% CI: 0.01 - 0.89); never being tested for HIV in Lagos (AOR = 0.11, 95% CI: 0.03 - 0.40) and Oyo state (AOR = 0.21, 95% CI: 0.06 - 0.80) and selling sex (AOR = 3.24, 95% CI: 1.00 - 10.61) in Oyo state. Conclusion: This study shows that HIV risk perception and comprehensive HIV knowledge are very low among MSM in Nigeria. Heterogeneity in associated factors suggests that targeted interventions are needed to increase HIV risk perception in the different states. The role of HIV counseling and testing in increasing risk perception needs further evaluation.