Author(s): Sylvia Adebajo 1,*, Otibho Obianwu 1, George Eluwa 1, Lung Vu 2, Ayo Oginni 1, Waimar Tun 3, Meredith Sheehy 4, Babatunde Ahonsi 1, Adebobola Bashorun 5, Omokhudu Idogho 6, Andrew Karlyn 7
There is growing evidence that men who have sex with men (MSM) and men who inject drugs (MWID) in Nigeria are hyper-vulnerable to HIV infection - because of high levels of political, religious and cultural hostility as well as the criminalization of their behavior , , . According to the two rounds of the Integrated Biological Behavioural Surveillance Survey (IBBSS) conducted in Nigeria in 2007 and 2010, the estimated HIV prevalence among MSM increased from 13.5% in 2007 to 17.2% in 2010 and among PWID, HIV prevalence decreased from 5.2% in 2007 to 4.2% in 2010 , . The surveys also revealed low self-perceived risk, significant levels of risky sexual and injecting practices and poor health-seeking behaviours among MSM and MWID in Nigeria , .
Unbiased measurements of socially sensitive behaviours are necessary to accurately study sensitive behaviours that may determine acquisition and transmission of sexually transmitted infections (STIs) including HIV , . In some populations, an audio computer-based technology that enables respondents to self-administer questionnaires in complete privacy, such as the audio computer assisted self-interview (ACASI), has succeeded in eliciting unbiased responses for socially sensitive behaviours , , . Studies comparing responses from clinician interviews and ACASI of self-reports of socially sensitive behaviours revealed that ACASI responses were more complete for socially sensitive behaviours like admitting to having same-gender sex partners and illicit drug use, group sex, rape, commercial sex than face-to-face (FTF) interviews -. Advantages of ACASI formatted surveys include consistency in the way questions are asked thus, maximizing standardization; limiting handling of data forms, protecting participant confidentiality and direct data capturing thereby, decreasing staff effort and enhancing data quality , , , , .
The ACASI technology is ideal for research with key populations such as MSM and people who inject drugs (PWID) for reliable and frank reporting of sensitive behaviours. However there is limited testing of the instrument in low resource settings such as Nigeria , , , -. We evaluated differences in the reporting of risky HIV-related behaviours among MSM and MWID using ACASI and FTF. The hypothesis was that MSM and MWID interviewed by ACASI method would be more likely to report sensitive HIV-risk behaviours compared to those interviewed FTF.
This study was conducted at three Men's Health Network, Nigeria (MHNN) clinics in Abuja, located in north central Nigeria, and Lagos and Ibadan, both located in southwest Nigeria. MHNN provides HIV prevention services including behaviour change communications, HIV counselling and testing (HCT), syndromic management of STIs, and condom and lubricant distribution to key male populations (MSM and MWID) and their male and female sex partners.
Study populations and sampling strategy
MSM were defined as men aged 18 years and above who reported sexual activity (oral or anal) with another man at least once in the 12...