Men who have sex with men (MSM) are a population at high risk of HIV infection. In order to end HIV, we need targeted prevention strategies for this key population and the Sibanye study has been researching just that.
The Sibanye study recorded the uptake of a package of HIV prevention tools in MSM in sites around South Africa over the course of a year. The offered tools and services included HIV testing, counselling, condom and lubricant choices, treatment for STIs, PrEP, PEP and more. The project finished in 2016 and whilst data analysis is ongoing, there are fascinating results coming out.
Karen Dominguez, from the Desmond Tutu HIV Foundation who worked on the Sibanye study, summarised that just under half the participants (male at birth but with any gender identity) had HIV, which is a very high figure. Additionally, around half of the HIV positive participants already knew their status but the rest were newly diagnosed. Additionally, around half the candidates had a sexually transmitted infection (STI) although only a very small portion had any symptoms. Nine times more participants had an asymptomatic (symptomless) STI than participants who knew their status.
STIs are rampant in South Africa, especially STIs that have no symptoms. A different study of 600 rural women showed that 25% of them were diagnosed with an STI and in most of these cases there were no symptoms. These studies indicate a need for awareness campaigns and an increase in targeted treatment and prevention.
Whilst these data show that MSM are still a high-risk group for STIs, the cohort was also enthusiastic about prevention methods. Over the course of the study, over 90,000 condoms were distributed to participants. Flavoured condoms were preferred to plain, which was indicated in questionnaires and supported by condom uptake. Interest in PrEP was high, with most of the patients that began a course of PrEP adhering to the drug.
MSM are a key population at unbelievable risk of HIV and STIs, which these data confirm. The Sibanye study highlights that there is still need for targeted prevention and active care interventions. It also demonstrates that MSM are interested in using PrEP and targeting this key population for PrEP is feasible.
This research meeting we were fortunate to have Karen Dominguez and Prof Linda-Gail Bekker speaking on their respective research projects. Dominguez spoke about the Sibanye study, which evaluated how men who have sex with men (MSM) respond to different HIV interventions. Bekker summarised the latest research around the HIV prevention drug, Pre Exposure Prophylaxis or PrEP, including busting common myths or misconceptions about the drug.
Written by Caroline Reid