DRUG USE AND SEXUAL RISK BEHAVIOURS AMONG MEN WHO HAVE SEX WITH MEN IN KADUNA METROPOLIS, NORTH CENTRAL NIGERIA I. Suleiman 1, O. Otibho 1, J. Njab 1, S. Sangowawa 1, A. Oginni 1, G. Eluwa 1, S. Adebajo 1, B. Ahonsi 1, B. Keshinro 2, T. Kene 2 1 Population Council Nigeria; 2 Walter Reed Program—Nigeria (WRP-N) AIDS 2014, 20th International AIDS Conference Melbourne, Australia July 20 – 25, 2014

Background Recreational drug use is associated with engaging in risky sexual risk behaviours which may lead to increased risk of HIV exposure. In Nigeria, little attention has been paid to the effects of recreational drug use and alcohol on the HIV vulnerabilities of men who have sex with men (MSM). Study aimed to determine the association between recreational drug use and sexual risk behaviours among MSM in Kaduna Metropolis.

Methods Data collected on sexual risk behaviours and HIV sero-status with a structured HIV testing and counseling client intake form – Administered to MSM at a community health clinic in Kaduna State Descriptive (frequencies and percentages) and inferential analyses (multivariate binary logistic regression) of the data were conducted.

Kaduna State, Nigeria Located in the North West Geo-Political Zone of Nigeria. Former headquarters of the Northern Region. Population: 6,113,503. Religion: 56% Muslims, 46% Christians. Social and political center. Cosmopolitan.

Clinic Located in Kaduna south Clients are mainly key population Access to MSM through peer referrals from Key Opinion Leaders Referrals from other prevention programmes and implementing organizations working with key populations 1,470 MSM accessed clinic between May 2013 to January 2014

Characteristics of the clients Of the 1,470 MSM who accessed the clinic: – ~53% aged 15–24 years – 68% had secondary school education – 48% were employed – 39% were students – 11% were married

Recreational drug and alcohol use in the last 6 months

HIV knowledge and risk behaviors 77% engaged in unprotected sex with a casual partner in past 3 months 72% engaged in transactional sex in past 6 months 61% in multiple sexual partnerships 56% had comprehensive knowledge of HIV (UNAIDS) Indicator ~11% reported a history of STIs in past 6 months 5.6% tested positive for HIV from the 1,470 MSM who under went HIV counseling and testing (HCT)

Associations between drug use and sexual behavior Recreational drug use Had unprotected sexTransactional sexMultiple sexual partnership %CORAOR%CORAOR%CORAOR No Yes (1.62, 2.82) 3.67 (2.66, 5.05) (1.65, 2.76) 3.90 (2.91, 5.24) (11.73, 23.83) 9.36 (6.39, 3.72) Controlled for occupation, marital status, HIV status, history of STIs, and comprehensive knowledge of HIV MSM who used recreational drugs were more likely to have engaged in unprotected sex, transactional sex, and multiple sexual partnerships compared to those that did not

Conclusions Drug and alcohol use is common; injecting drug use not common. Drug and alcohol use among MSM is high and is associated with sexual risk behaviours. Interventions for MSM should address risks associated with both sexual behaviours and recreational drug and alcohol use. MSM-friendly clinics can be an effective way to reach a high number of MSM and provide risk reduction services.

Acknowledgements Study participants HIV and AIDS Division, Population Council, Nigeria Walter Reed Programme, Nigeria (WRP-N) US Military Health Research Programme (MHRP) This research has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through U.S. Department of Defense. The views expressed are those of the authors and should not be construed to represent the positions of the U.S. Army or the Department of Defense.

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