Prevalence of HIV, Sexual Practices and Behaviors among Men Who Have Sex with Men in Kinshasa, Democratic Republic of Congo

Abstract

Human Immunodeficiency Virus (HIV) is a deadly sex-transmitted infection (STI) that remains a worldwide public health concern. Despite the progress recorded in the HIV prevention, we still observe high HIV prevalence especially among Men who have sex with Men (MSM). Within this latter group, the prevalence of HIV is reported to be higher and can therefore be transposed into the general population through the bisexuals. In the Democratic Republic of Congo (DRC), the response to HIV/AIDS among MSM requires updated data on the magnitude of the infection, the sexual practices and behaviors which are key factors in the pandemic spread. This study aimed to determine the prevalence of HIV and to describe the sexual practices and behaviors among MSM recruited in Kinshasa, DRC. We conducted a prospective cross-sectional study from March 2014 to December 2017 to recruit MSM through the snowball technique in Kinshasa, DRC. Our data were collected on a paper-printed questionnaire via an interview followed by whole blood sample collection for ELISA assays. Of 323 MSM recruited, the MSM were single in 88.5% (286/323) and bisexuals in 61.7% (195/316). Nine percent of them were HIV positive (30/323) at the ELISA assays. The prevalence of HIV was 40% (12/30) in the 21-25 age group; 50% (15/30) in MSM with superior education level; 85.1% (23/27) among single MSM. Almost the quarter of the MSM had > 5 homosexual partners in the last six months; 5.5% (18/323) had more than 20 homosexual intercourses while 13.3% (43/323) of them contracted 3-5 heterosexual sex acts in the last three months. During anal intercourses, 34.4% (110/319) played a passive role versus 24.1% (77/319) for a versatile role. The condom use was systematically reported in 27.2% (87/319) of participants. The MSM were one time likely to the HIV infection when they had a high education level [aOR 3.63(1.37-9.57)]. The fact of practicing more than three types of intercourse-anal, oral and others was five times more likely to be at risk for the HIV acquisition [aOR 5.31 (1.26-22.30)]. This study reports a high prevalence of HIV among MSM which is associated with the high-risk sexual practices and behaviors such as the bisexuality, the multiple sexual partners, and the diversity of anal intercourses.