MEN WHO HAVE SEX WITH MEN (MSM) AND RISK FACTORS ASSOCIATED WITH CONDOM USE AT LAST SEXUAL INTERCOURSE WITH A MAN AND A WOMAN IN SENEGAL ELIHoS Project.

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MEN WHO HAVE SEX WITH MEN (MSM) AND RISK FACTORS ASSOCIATED WITH CONDOM USE AT LAST SEXUAL INTERCOURSE WITH A MAN AND A WOMAN IN SENEGAL ELIHoS Project (ANRS 12139) Larmarange J., Wade A. S., Diop A. K., Diop O., Gueye K., Marra A., Desgrées du Loû A. for ELIHoS Group Contact: joseph.larmarange@ceped.org AIDS 2010 CONFERENCE • ORAL POSTER PRESENTATION: WEPDC102 SESSION : MSM and Transgender People: Addressing Prevention and Care Needs

MEN HAVING SEX WITH MEN AND FACTORS OF NOT USING A CONDOM IN SENEGAL Context and Methods In Senegal, among MSM (results from a previous survey): high HIV prevalence: 21.5% in 2004 (<1% in general population) high rate of bisexuality: 74% of MSM had had both male and female partners over the past year (in 2004) ELIHoS Survey: a new socio-behavioral survey conducted in 2007 among 501 MSM recruiting using snowball sampling in three places (Dakar, Mbour / Thiès, Saint-Louis) Analysis: factors associated with not using a condom for an anal or vaginal penetration at last sexual intercourse with a man (among all MSM) and last sexual intercourse with a women (among bisexual over the past year only) taking into account respondent’s characteristics, type of relationship and context of the sexual act 21 JULY 2010 • VIENNA MEN HAVING SEX WITH MEN AND FACTORS OF NOT USING A CONDOM IN SENEGAL

Results: factors associated with unprotected sex Last sexual intercourse with a man a woman Significant factors at 5% (multivariate regression) Sexual intercourse in a public place (aOR=6.8) Has not participated in a MSM prevention program (aOR = 3.1) Hardly ever protected (2%) with the spouse Partner very young (<15) (aOR=5.3) Has not participated in a MSM prevention program (aOR = 2.3) Not significant at 5% but factors showing some trends Partner is young (<20) Younger(<20) and older (>35) MSM Unemployed Not knowing partner’s HIV status 21 JULY 2010 • VIENNA MEN HAVING SEX WITH MEN AND FACTORS OF NOT USING A CONDOM IN SENEGAL

MEN HAVING SEX WITH MEN AND FACTORS OF NOT USING A CONDOM IN SENEGAL Key findings Type of relationship and context of sexual act are determinant to understand unprotected sex. Prevention programs should insist upon the necessity of always carrying a condom. Screening of both partners, in particular with the wife, should be highly recommended. Having participated in a prevention program specifically targeting MSM constitutes a major prevention factor, both with men and women. So, MSM programs are effective and must be pursed and extended. However, these programs must address heterosexual practices of MSM. 21 JULY 2010 • VIENNA MEN HAVING SEX WITH MEN AND FACTORS OF NOT USING A CONDOM IN SENEGAL

Contact: joseph.larmarange@ceped.org Thank you Contact: joseph.larmarange@ceped.org