Characterizing social cohesion and gender identity as risk determinants of HIV among cisgender men who have sex with men and transgender women in Côte d'Ivoire

Alexander Moran; Ayden Scheim; Carrie Lyons; Benjamin Liestman; Fatou Drame; Sosthenes Ketende; Daouda Diouf; Ibrahima Ba; Rebecca Ezouatchi; Amara Bamba; Abo Kouame; Stefan Baral

doi:10.1016/j.annepidem.2019.11.003

Characterizing social cohesion and gender identity as risk determinants of HIV among cisgender men who have sex with men and transgender women in Côte d'Ivoire

Alexander Moran, Ayden Scheim, Carrie Lyons, Benjamin Liestman, Fatou Drame, Sosthenes Ketende, Daouda Diouf, Ibrahima Ba, Rebecca Ezouatchi, Amara Bamba, Abo Kouame, Stefan Baral

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

Abstract

Purpose: HIV prevalence has been previously estimated among cisgender men who have sex with men (MSM) in Côte d'Ivoire; however, limited data exist relating to the role of social cohesion and gender identity within this population. This study aims to examine these factors as risk determinants of HIV among MSM in Côte d'Ivoire. Methods: We conducted a cross-sectional study using respondent-driven sampling for recruitment with a structured sociobehavioral instrument and testing for HIV. After respondent-driven sampling adjustment, chi-squared tests and bivariate logistic regression and multivariate logistic regression analyses were performed to characterize social and identity-based risk determinants of biologically confirmed prevalent HIV infection. Results: HIV prevalence was 11.2% (n = 146/1301). Transgender woman identity was associated with higher odds of HIV compared with cisgender MSM (aOR = 3.4, 95% CI [2.0–5.8], P <. 001). Having a combined social cohesion score of medium (aOR = 0.4, 95% CI [0.2–0.8], P <. 01) or high (aOR = 0.2, 95% CI [0.1–0.3], P <. 001) was associated with lower odds of HIV compared with a low score. Conclusion: These data suggest that social cohesion is a determinant of prevalent HIV infection in Côte d'Ivoire among gay men, other cisgender MSM, and transgender women. The differences in HIV burden and social cohesion between transgender women and cisgender MSM highlight the need to better target the diversity of people traditionally included in the MSM umbrella to ensure comprehensive HIV prevention and treatment interventions.

Original language	English (US)
Pages (from-to)	25-32
Number of pages	8
Journal	Annals of epidemiology
Volume	42
DOIs	https://doi.org/10.1016/j.annepidem.2019.11.003
State	Published - Feb 2020

Keywords

Côte d'Ivoire
Gay
Gender identity
Social cohesion
Stigma
Transgender

ASJC Scopus subject areas

Epidemiology

Access to Document

10.1016/j.annepidem.2019.11.003

Cite this

Moran, A., Scheim, A., Lyons, C., Liestman, B., Drame, F., Ketende, S., Diouf, D., Ba, I., Ezouatchi, R., Bamba, A., Kouame, A., & Baral, S. (2020). Characterizing social cohesion and gender identity as risk determinants of HIV among cisgender men who have sex with men and transgender women in Côte d'Ivoire. Annals of epidemiology, 42, 25-32. https://doi.org/10.1016/j.annepidem.2019.11.003

Moran, A, Scheim, A, Lyons, C, Liestman, B, Drame, F, Ketende, S, Diouf, D, Ba, I, Ezouatchi, R, Bamba, A, Kouame, A & Baral, S 2020, 'Characterizing social cohesion and gender identity as risk determinants of HIV among cisgender men who have sex with men and transgender women in Côte d'Ivoire', Annals of epidemiology, vol. 42, pp. 25-32. https://doi.org/10.1016/j.annepidem.2019.11.003

@article{35dabda9b4b9493a88a935965035ac71,

title = "Characterizing social cohesion and gender identity as risk determinants of HIV among cisgender men who have sex with men and transgender women in C{\^o}te d'Ivoire",

abstract = "Purpose: HIV prevalence has been previously estimated among cisgender men who have sex with men (MSM) in C{\^o}te d'Ivoire; however, limited data exist relating to the role of social cohesion and gender identity within this population. This study aims to examine these factors as risk determinants of HIV among MSM in C{\^o}te d'Ivoire. Methods: We conducted a cross-sectional study using respondent-driven sampling for recruitment with a structured sociobehavioral instrument and testing for HIV. After respondent-driven sampling adjustment, chi-squared tests and bivariate logistic regression and multivariate logistic regression analyses were performed to characterize social and identity-based risk determinants of biologically confirmed prevalent HIV infection. Results: HIV prevalence was 11.2% (n = 146/1301). Transgender woman identity was associated with higher odds of HIV compared with cisgender MSM (aOR = 3.4, 95% CI [2.0–5.8], P <. 001). Having a combined social cohesion score of medium (aOR = 0.4, 95% CI [0.2–0.8], P <. 01) or high (aOR = 0.2, 95% CI [0.1–0.3], P <. 001) was associated with lower odds of HIV compared with a low score. Conclusion: These data suggest that social cohesion is a determinant of prevalent HIV infection in C{\^o}te d'Ivoire among gay men, other cisgender MSM, and transgender women. The differences in HIV burden and social cohesion between transgender women and cisgender MSM highlight the need to better target the diversity of people traditionally included in the MSM umbrella to ensure comprehensive HIV prevention and treatment interventions.",

keywords = "C{\^o}te d'Ivoire, Gay, Gender identity, Social cohesion, Stigma, Transgender",

author = "Alexander Moran and Ayden Scheim and Carrie Lyons and Benjamin Liestman and Fatou Drame and Sosthenes Ketende and Daouda Diouf and Ibrahima Ba and Rebecca Ezouatchi and Amara Bamba and Abo Kouame and Stefan Baral",

note = "Funding Information: Funding Sources: Data collection was supported by a grant from the Global Fund to Enda Sant{\'e}. Additional data analyses and SB's effort was supported by the National Institutes of Mental Health and Office of AIDS Research of the National Institutes of Health under award number R01MH110358. This publication was made possible with help from the Johns Hopkins University Center for AIDS Research, an NIH funded program (P30AI094189), which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. AFH, MVW, RK, LR, and AA received no funding for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2019 Elsevier Inc.",

year = "2020",

month = feb,

doi = "10.1016/j.annepidem.2019.11.003",

language = "English (US)",

volume = "42",

pages = "25--32",

journal = "Annals of epidemiology",

issn = "1047-2797",

publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Characterizing social cohesion and gender identity as risk determinants of HIV among cisgender men who have sex with men and transgender women in Côte d'Ivoire

AU - Moran, Alexander

AU - Scheim, Ayden

AU - Lyons, Carrie

AU - Liestman, Benjamin

AU - Drame, Fatou

AU - Ketende, Sosthenes

AU - Diouf, Daouda

AU - Ba, Ibrahima

AU - Ezouatchi, Rebecca

AU - Bamba, Amara

AU - Kouame, Abo

AU - Baral, Stefan

N1 - Funding Information: Funding Sources: Data collection was supported by a grant from the Global Fund to Enda Santé. Additional data analyses and SB's effort was supported by the National Institutes of Mental Health and Office of AIDS Research of the National Institutes of Health under award number R01MH110358. This publication was made possible with help from the Johns Hopkins University Center for AIDS Research, an NIH funded program (P30AI094189), which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. AFH, MVW, RK, LR, and AA received no funding for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2019 Elsevier Inc.

PY - 2020/2

Y1 - 2020/2

N2 - Purpose: HIV prevalence has been previously estimated among cisgender men who have sex with men (MSM) in Côte d'Ivoire; however, limited data exist relating to the role of social cohesion and gender identity within this population. This study aims to examine these factors as risk determinants of HIV among MSM in Côte d'Ivoire. Methods: We conducted a cross-sectional study using respondent-driven sampling for recruitment with a structured sociobehavioral instrument and testing for HIV. After respondent-driven sampling adjustment, chi-squared tests and bivariate logistic regression and multivariate logistic regression analyses were performed to characterize social and identity-based risk determinants of biologically confirmed prevalent HIV infection. Results: HIV prevalence was 11.2% (n = 146/1301). Transgender woman identity was associated with higher odds of HIV compared with cisgender MSM (aOR = 3.4, 95% CI [2.0–5.8], P <. 001). Having a combined social cohesion score of medium (aOR = 0.4, 95% CI [0.2–0.8], P <. 01) or high (aOR = 0.2, 95% CI [0.1–0.3], P <. 001) was associated with lower odds of HIV compared with a low score. Conclusion: These data suggest that social cohesion is a determinant of prevalent HIV infection in Côte d'Ivoire among gay men, other cisgender MSM, and transgender women. The differences in HIV burden and social cohesion between transgender women and cisgender MSM highlight the need to better target the diversity of people traditionally included in the MSM umbrella to ensure comprehensive HIV prevention and treatment interventions.

AB - Purpose: HIV prevalence has been previously estimated among cisgender men who have sex with men (MSM) in Côte d'Ivoire; however, limited data exist relating to the role of social cohesion and gender identity within this population. This study aims to examine these factors as risk determinants of HIV among MSM in Côte d'Ivoire. Methods: We conducted a cross-sectional study using respondent-driven sampling for recruitment with a structured sociobehavioral instrument and testing for HIV. After respondent-driven sampling adjustment, chi-squared tests and bivariate logistic regression and multivariate logistic regression analyses were performed to characterize social and identity-based risk determinants of biologically confirmed prevalent HIV infection. Results: HIV prevalence was 11.2% (n = 146/1301). Transgender woman identity was associated with higher odds of HIV compared with cisgender MSM (aOR = 3.4, 95% CI [2.0–5.8], P <. 001). Having a combined social cohesion score of medium (aOR = 0.4, 95% CI [0.2–0.8], P <. 01) or high (aOR = 0.2, 95% CI [0.1–0.3], P <. 001) was associated with lower odds of HIV compared with a low score. Conclusion: These data suggest that social cohesion is a determinant of prevalent HIV infection in Côte d'Ivoire among gay men, other cisgender MSM, and transgender women. The differences in HIV burden and social cohesion between transgender women and cisgender MSM highlight the need to better target the diversity of people traditionally included in the MSM umbrella to ensure comprehensive HIV prevention and treatment interventions.

KW - Côte d'Ivoire

KW - Gay

KW - Gender identity

KW - Social cohesion

KW - Stigma

KW - Transgender

UR - http://www.scopus.com/inward/record.url?scp=85077370624&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85077370624&partnerID=8YFLogxK

U2 - 10.1016/j.annepidem.2019.11.003

DO - 10.1016/j.annepidem.2019.11.003

M3 - Article

C2 - 31902624

AN - SCOPUS:85077370624

SN - 1047-2797

VL - 42

SP - 25

EP - 32

JO - Annals of epidemiology

JF - Annals of epidemiology

ER -

Characterizing social cohesion and gender identity as risk determinants of HIV among cisgender men who have sex with men and transgender women in Côte d'Ivoire

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this