HIV surveillance systems need high-quality, representative data to guide national responses, especially among the populations most affected by the epidemic-key and priority populations.
Between 2011-2013, the Ministry of Health (MoH) conducted five biological and behavioral surveys among key populations (women sex workers, men who have sex with men, people who inject drugs) and priority populations (long-haul truckers and miners) as part of the national system for HIV surveillance.
In this article we describe the main lessons learned during the implementation of these surveys, which include: the importance of multi-sectoral collaboration, how the survey results have served to raise the profile of these populations and increase advocacy, and, capacity building of government institutions as well as organizations of these populations.
Since traditional HIV surveillance systems often do not capture these hidden populations, it will be important to ensure that biological and behavioral surveillance surveys are an integral part of in-country HIV surveillance activities.
Research conducted by researchers from the surveillance area of the National Institute of Health (INS) and its partners reports that the first experience with the design, implementation and analysis of biological and behavioral surveys contributed to understanding the behavioral factors that contribute to HIV transmission among priority key populations in the country. These lessons learned provide opportunities for reflection on strategies for implementing future surveys.
This study was guided by the fact that Mozambique has one of the highest HIV prevalence rates in the world, estimated at 13.2% among adults aged 15-49 years. Men who pay for sex are considered a "bridge" to HIV infection. However, the characteristics of these men are still not very clear.
The present study aimed to describe the main characteristics of men who pay for sex, estimate the prevalence of paid sex by men, and investigate the risk factors associated with paid sex.
As methodology, data from 4,724 men, aged 15-49 years, were analyzed as part of the 2015 IMASIDA Survey. We analyzed associations between paid sex and different characteristics including socio-demographic, number of lifetime and recent sexual partners, condom use at last intercourse, self-reported symptoms of sexually transmitted infection (STI), and others.
As a result, the study points out that the overall prevalence of paid sex in the past 12 months was 10.4%, with Cabo Delgado province having the highest prevalence (38.8%).
Men who paid for sex in the past 12 months were mostly 20 to 24 years old 13.5%, unmarried/unmarried 17.8%, with primary education level 11.9%, from the lowest wealth quintile 14.0%, with more than three sexual partners other than their spouse 44.7% and self-reported ITS 44.2%.
HIV prevalence was higher among men who ever paid for sex compared to men who did not pay (13.1% vs. 9.4%,).
Men with more than 10 partners, from Cabo Delgado province, who reported STI symptoms in the past 12 months and HIV positive were more likely to pay for sex.
In conclusion, these results, which were made public in 2021, highlight the need for more comprehensive interventions to reduce the risks of infection during commercial and transactional sex.
Source: News