Abstract
Background:Effective condom use is a critical intervention to limit the spread of HIV and other sexually transmitted infections, particularly among individuals in high-risk networks who practice anal sex. We characterized condom failures in cisgender men who have sex with men and transgender women in Nigeria.Setting:The TRUST/RV368 cohort provided condoms, compatible lubricants, and safer sex education to men who have sex with men and transgender women at community-engaged health centers in Abuja and Lagos, Nigeria.Methods:Participants completed structured interview questions about condom usage and failure every 3-6 months. Robust Poisson regression models with generalized estimating equations were used to estimate relative risks and 95% confidence intervals for prespecified factors potentially associated with condom failure in the previous month.Results:From September 2013 to September 2019, 2221 of 2737 participants (81.1%) reported condom use for anal sex with a male partner in the last month, and 305 (13.7%) reported condom failure during this time. Multivariate analyses demonstrated an increased risk of condom failure at postenrollment visits, as well as in participants who reported frequent Internet use, 2 or more casual sexual partners, and 2-4 main sexual partners. Those who cohabited with a woman had reduced risk.Conclusions:Condom failure was common in this population despite freely available condoms, compatible lubrication, and education. Increased risk of condom failure over time could reflect message fatigue a ceiling for effective condom use, or new uptake of condoms by inexperienced users.
Original language | English (US) |
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Pages (from-to) | 329-338 |
Number of pages | 10 |
Journal | Journal of Acquired Immune Deficiency Syndromes |
Volume | 86 |
Issue number | 3 |
DOIs | |
State | Published - Mar 1 2021 |
Keywords
- Nigeria
- condoms
- gender
- key and vulnerable populations
- men who have sex with men
- risk factors
- transgender people
ASJC Scopus subject areas
- Infectious Diseases
- Pharmacology (medical)