TY - JOUR
T1 - Correlates of Water-Based Lubricant Use Among Men Who Have Sex with Men in Blantyre, Malawi
AU - Rao, Amrita
AU - Ewing, Whitney
AU - Ketende, Sosthenes
AU - Wirtz, Andrea L.
AU - Jumbe, Vincent
AU - Trapence, Gift
AU - Kamba, Dunker
AU - Umar, Eric
AU - Beyrer, Chris
AU - Muula, Adamson S.
AU - Baral, Stefan
N1 - Funding Information:
Research for this study was funded through the U.S. Agency for International Development under USAID j Project SEARCH, Task Order No. 2, Contract No. GHH-I- 00-07-00032-00, beginning September 30, 2008, and is supported by PEPFAR. The Research to Prevention (R2P) Project is led by the Johns Hopkins Center for Global Health and is managed by the JHSPH Center for Communication Programs (CCP). The authors also acknowledge United Nations Development Programme (UNDP), United Nations Population Fund (UNFPA), UNAIDS, and Voluntary Services Overseas (VSO) for their additional support. The content and ideas expressed within the article do not engage the responsibility of UNAIDS, USAID, VSO, or UNDP.
Funding Information:
Research for this study was funded through the U.S. Agency for International Development under USAID | Project SEARCH, Task Order No. 2, Contract No. GHH-I-00-07-00032-00, beginning September 30, 2008, and is supported by PEPFAR. The Research to Prevention (R2P) Project is led by the Johns Hopkins Center for Global Health and is managed by the JHSPH Center for Communication Programs (CCP). The authors also acknowledge United Nations Development Programme (UNDP), United Nations Population Fund (UNFPA), UNAIDS, and Voluntary Services Overseas (VSO) for their additional support. The content and ideas expressed within the article do not engage the responsibility of UNAIDS, USAID, VSO, or UNDP.
PY - 2019/9
Y1 - 2019/9
N2 - Condom compatible lubricants (CCLs), including water-based lubricants (WBL) represent one strategy to prevent the breakage of latex condoms and thus decrease the risk of HIV transmission during anal intercourse. The analyses presented here characterize the correlates of WBL use during anal sex among men who have sex with men (MSM) in Blantyre, Malawi enrolled from April 2011 to March 2012 using respondent-driven sampling (RDS). Bivariate and multivariable logistic regression analyses with RDS-weighting were conducted on a total sample of 338 MSM. With RDS-weighting, 25.4% [95% confidence interval (CI): 20.3-31.4] of MSM (106/329) reported primarily using WBL during anal sex. In multivariable analysis, higher income [adjusted odds ratio (aOR): 5.9; 95% CI: 2.48-14.19], family being aware of their sexual practices (aOR: 2.52; 95% CI: 1.29-4.92), and reporting consistent condom use in the last 6 months (aOR: 1.27; 95% CI: 1.06-1.52) were positively associated with WBL use. Increasing age (per 1 year increase in age; aOR: 0.89; 95% CI: 0.83-0.95) was negatively associated with WBL. Taken together, these data highlight the limited uptake of WBL among MSM in Blantyre, Malawi, especially among older men and those belonging with lower income. Older MSM in Malawi are known to have a higher prevalence of HIV and lower reported use of WBL, suggesting significant risks of onward HIV transmission. Separately, the limited use among those with lower incomes suggests the need for free or subsidized distribution of CCL together with condoms and counseling about their use specifically for MSM in Malawi.
AB - Condom compatible lubricants (CCLs), including water-based lubricants (WBL) represent one strategy to prevent the breakage of latex condoms and thus decrease the risk of HIV transmission during anal intercourse. The analyses presented here characterize the correlates of WBL use during anal sex among men who have sex with men (MSM) in Blantyre, Malawi enrolled from April 2011 to March 2012 using respondent-driven sampling (RDS). Bivariate and multivariable logistic regression analyses with RDS-weighting were conducted on a total sample of 338 MSM. With RDS-weighting, 25.4% [95% confidence interval (CI): 20.3-31.4] of MSM (106/329) reported primarily using WBL during anal sex. In multivariable analysis, higher income [adjusted odds ratio (aOR): 5.9; 95% CI: 2.48-14.19], family being aware of their sexual practices (aOR: 2.52; 95% CI: 1.29-4.92), and reporting consistent condom use in the last 6 months (aOR: 1.27; 95% CI: 1.06-1.52) were positively associated with WBL use. Increasing age (per 1 year increase in age; aOR: 0.89; 95% CI: 0.83-0.95) was negatively associated with WBL. Taken together, these data highlight the limited uptake of WBL among MSM in Blantyre, Malawi, especially among older men and those belonging with lower income. Older MSM in Malawi are known to have a higher prevalence of HIV and lower reported use of WBL, suggesting significant risks of onward HIV transmission. Separately, the limited use among those with lower incomes suggests the need for free or subsidized distribution of CCL together with condoms and counseling about their use specifically for MSM in Malawi.
KW - HIV
KW - Malawi
KW - condom compatible lubricant
KW - epidemiology
KW - men who have sex with men
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U2 - 10.1089/aid.2018.0287
DO - 10.1089/aid.2018.0287
M3 - Article
C2 - 31204861
AN - SCOPUS:85071997900
VL - 35
SP - 833
EP - 841
JO - AIDS Research and Human Retroviruses
JF - AIDS Research and Human Retroviruses
SN - 0889-2229
IS - 9
ER -