Situational Analysis Of Men Who Have Sex With Men And The STI Client Friendly Clinic Service in Johor 2014-2018

  • Viral hepatitis and HIV
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Background:
Over the last decade, the transmission of HIV in Johor showed a major shift from Persons Who Inject Drugs (PWID) to men who have sex with men (MSM). HIV infections due to MSM reported a tenfold increase from 5%to 56% in 2011 and 2018 respectively. A situational analysis was done to describe the demography of MSM, risk behavior patterns among them and the role of current STI Client Friendly Clinic (STI-CFC) in addressing the problem.

Methods:
Five years data (2014-2018) on MSM who live with HIV in Johor, Malaysia from the National AIDS Registry (NAR) were analyzed for the demographics characteristic of MSM. The 2017 Integrated Biological and Behavioural Surveillance (IBBS) Survey data on MSM in Johor was used to describe their risk behavior patterns and data from the local STI-CFC was studied for the performance of the clinic in terms of utilization and detection of cases. Data was analyzed using IBM SPSS Version 24.0.

Results:
The overall prevalence of HIV among MSM was 30.3% and among them 91% were below 40 years. Mean age at sex debut was 19 ± 4.3. Forty-four percent of MSM had a regular sex partner. Only 60.6% of MSM had adequate knowledge on risk and transmission. Inconsistent condom use patterns were seen among different partners ranging from 44.4% to 72.4%. The average attendance to the local STI-CFC was 13 clients a month and 87% referred by the non-governmental organization (NGO). One or two HIV cases were detected monthly.

Conclusion:
This situational analysis revealed that age below 40, inadequate knowledge, inconsistent condom use and not having regular sex partners as factors to consider for targeted intervention among MSM in Johor. To address these factors, a multimodal approach was introduced to the existing STI-CFC in mid-2017. This new and comprehensive approach includes focused outreach activities, engagement of the relevant NGOs & media and personalized care for the clients.

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