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To evaluate HIV/STI prevalence among female sex workers (FSWs) in Botswana, and assess HIV-related risk behaviors. Cross-sectional study using time-location sampling in three districts of Botswana. Adjusted HIV prevalence at district level ranged from 53.5 to 68.5 %. Syphilis prevalence ranged from 3.7 to 14.5 %; chlamydia prevalence ranged from 4.8 to 16.3 %; and gonorrhoea prevalence ranged from 8.3 to 11.7 %. FSWs had been practicing sex work for a mean of 4.7 years, and had a mean of 7.6 sex partners in the week before the survey. While 67.1 % of FSWs surveyed reported always using condoms with clients in the past month. 59.5 % reported one or more of the following: being paid more not to use a condom, having a condom break, or being forced not to use a condom by clients. Predictors of HIV infection in the multivariate analysis included: age (over 30 years), perceiving oneself to be at high risk of HIV, selling sex for 2 or more years, and having a mean of 11 or more partners in the last week. High HIV prevalence, high rates of partner exchange, a sizable population, and Inconsistent condom use combine together help fuel the country's hyper epidemic. HIV prevention interventions need to take into account the important influence of clients and boyfriends on condom use behavior.

Background: Men who have sex with men (MSM) suffer significant stigma and discrimination; hence, they are reluctant to access health services. The Botswana Second National Strategic Framework for 2010-2016 stipulates the need to increase HIV prevention services for key populations as one of its prevention implementation strategies. We report here the prevalence of HIV and other sexually transmitted infections and risk factors for HIV infection among MSM in Botswana., Methods: We conducted a cross-sectional survey using respondent driven sampling in 3 districts of Botswana: Gaborone, Francistown, and Kasane., Results: Of the 454 participants recruited, most were Batswana (97.6%) with a mean age of 23.2 years (range, 18-53 years), with 74.9% aged between 20 and 29 years. The overall unadjusted HIV prevalence was 13.1% (95% confidence interval, 10.0-16.3), with 12.3%, 11.7%, and 25.9% in Gaborone, Francistown, and Kasane, respectively. Chlamydia trachomatis prevalence was higher than Neisseria gonorrhoeae in both urine and anal swabs, at 7.1% and 5.9%, respectively, versus 1.4% and 1.7%. Overall, 46.7% of respondents reported having sex with female partners. Men who have sex with men who thought they had a high chance of acquiring HIV had a significantly lower likelihood of using condom consistently than those who reported they had a lower chance of acquiring HIV (odds ratio = 0.4; 95% confidence interval, 0.2-0.7; P = 0.003)., Conclusion: HIV prevalence of MSM was lower than what has been reported in other sub-Saharan African countries with generalized epidemics; however, their degree of participation in heterosexual sex signifies sexual networks beyond the MSM subpopulation.

Objective: To evaluate HIV and syphilis prevalence among men who have sex with men (MSM) in Nigeria, and assess their HIV-related risk behaviours and exposure to HIV prevention interventions. Methods: Cross-sectional study using respondent-driven sampling conducted in Lagos, Kano and Cross River states, Nigeria, between July and September 2007. Results: A total of 879 MSM participated, 293 from each state. Eight participants (1.1%, CI 0.1% to 2.2%) in Cross River, 27 (9.3%, CI 5.7% to 15.4%) in Kano and 74 (17.4%, CI 12.3% to 23.2%) in Lagos tested positive for HIV. No syphilis was detected. The median age was 22 years. MSM reported an average of 4.2 male anal sex partners in the past 6 months. Between 24.4% (Lagos) and 36.0% (Kano) of MSM reported selling sex to other men. Up to 49.7% of MSM reported sex with a girlfriend and ≤ 6.5% purchased sex from female sex workers. Consistent condom use in commercial sex with other men over the past 6 months ranged from 28.0% (Cross River) to 34.3% (Kano), in contrast to between 23.9% (Kano) and 45.8% (Lagos) for non-commercial sex. Associations with HIV positivity included age in the three states, having been the receptive partner in anal sex in the past 6 months in Lagos and in Lagos and Kano feeling at risk of HIV. Conclusion: Large differentials in HIV prevalence between states together with high mobility, inconsistent condom use and behavioural links with female sex partners, have the potential for further HIV transmission within MSM networks, and between MSM and the general population. [ABSTRACT FROM AUTHOR]