| Popis: |
Background: MSM and TG in Nepal experience considerable discrimination and marginalisation: they are subject to abuse from legal authorities and suffer from mental health issues and substance abuse. This study aims to assess the prevalence of HIV and syphilis, in addition to how individual and socio-structural factors influence sexual risk behaviour and health care service uptake, among MSM and TG in the Terai highway districts of Nepal. Methods: A cross-sectional survey was conducted in June 2016 among MSM and TG in eight Terai highway districts of Nepal, recruiting 340 MSM and TG through respondent driven sampling. The primary outcome variables were HIV and syphilis prevalence. The secondary outcome variables were sexual risk behaviour and health care service uptake. Logistic regression models were used to assess the individual and socio-structural determinants of sexual risk behaviour and health care service uptake. Results: The prevalence of HIV among MSM was 5%, whereas it was 13% in TG. The prevalence of active syphilis was 4% in the MSM group and 11% among TG. Among TG, 76% were involved in sex work, and 51% reported having experienced discrimination in one or more settings. In multivariable analysis, having visited an outreach centre was positively associated with condom use in the most recent sexual encounter among both MSM (AOR: 5.37, 95% CI: 2.42 - 11.94, p |
