Access to HIV Services at Non-Governmental and Community-Based Organizations among Men Who Have Sex with Men (MSM) in Cameroon: An Integrated Biological and Behavioral Surveillance Analysis

作者：Holland Claire E^*; Papworth Erin; Billong Serge C; Kassegne Sethson; Petitbon Fanny; Mondoleba Valentin; Moukam Laure Vartan; Macauley Isaac; Ntsama Simon Pierre Eyene; Yomb Yves Roger; Eloundou Jules; Mananga Franz; Tamoufe Ubald; Baral Stefan D

来源：PLos One, 2015, 10(4): e0122881.

DOI：10.1371/journal.pone.0122881

Background
Men who have sex with men (MSM) are more likely to be living with HIV than other adult men in low- and middle-income countries. MSM experience barriers to accessing HIV services including a lack of available specialized care, and community-level stigma and discrimination. This study aims to examine the uptake of HIV services at non-governmental and community- based organizations (NGOs/CBOs) to identify ways to improve coverage of HIV prevention and treatment among MSM.
Methods
An Integrated Biological and Behavioral Surveillance (IBBS) survey was conducted in Yaounde and Douala, Cameroon in 2011 using the respondent driven sampling (RDS) method to recruit and interview 239 MSM in Yaounde and 272 MSM in Douala.
Results
MSM in Yaounde were statistically significantly more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they had any STI symptoms (aOR 2.17 CI 1.02-4.59. p=0.04), or if they had a larger MSM social network (aOR 1.02 CI 1.01-1.04. p<0.01). MSM in Douala were more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they were living with HIV (aOR 3.60 CI 1.35-9.60. p=0.01), or if they reported higher numbers of male sexual partners (aOR 1.17 CI 1.00-1.36. p=0.046). Compared to men in Douala, MSM in Yaounde were significantly less likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months ( aOR 0.22 CI 0.14-0.34. p=<0.01).
Conclusions
With appropriate funding and resources, community-based organizations that provide care specifically for MSM can improve access to HIV prevention, treatment, and care services. Additionally, using social networks to reach MSM can connect greater numbers of the population to effective HIV interventions, which will improve health outcomes and decrease onward transmission of HIV.

• 出版日期2015-4-23