Sexual Violence and the Increased Risk of HIV among MSM in Nigeria

Gay men and other men who have sex with men (MSM) are disproportionately affected by HIV and prone to sexual violence. While the association between HIV and sexual violence is well documented, the evidence is not conclusive from the few available studies among MSM in sub-Saharan Africa. The objective of this study was to estimate the prevalence of sexual violence and its association with HIV among MSM in Nigeria. The study was a secondary data analysis of the 2020 Integrated Biological & Behavioral Surveillance Survey (IBBSS) conducted among key populations in Nigeria's six geopolitical zones. Sexual violence was operationalized as self-reported forced sex by any person in the past 12 months. We performed weighted descriptive statistics and logistic regression analysis. The prevalence of sexual violence in the 4,324 MSM included in the analysis was 16.4% (95%CI = 15.3-17.5%). The highest prevalence was among MSM who reported injection drug use (49.0%, 95% CI = 41.7-56.6%), followed by those who engaged in transactional sex (29.6%, 95%CI = 27.0-32.2%). Among MSM who reported sexual violence, 36.1% (95%CI = 32.6-39.7%) tested HIV positive compared with 23.2% (95% CI: 21.8-24.6) in those who did not. After controlling for sociodemographic and behavioral characteristics, MSM who had been victims of sexual violence had higher odds of testing HIV positive (aOR = 1.87, 95%CI = 1.53-2.29). Sexual violence is prevalent and associated with HIV among MSM in Nigeria. Our findings further support the call to address sexual violence in this key population through the integration of preventive and care interventions into existing HIV programmes.