SOCIAL NETWORKING AND HIV ASSOCIATED-SEXUAL RISK BEHAVIOURS AMONG MEN WHO HAVE SEX WITH MEN (MSM) AND PEOPLE WHO INJECT DRUGS (PWID) IN ABUJA METROPOLISC. IFEKANDU1, S. Fagorusi2, B. Abdullahi Daniya1, G. Eluwa1, E. Luther-Onyebuchi3, O. Ezire3, S. Sangowawa1, J. Njab1, S. Adebajo1

1Population Council, Nigeria; 2Ahmadu Bello University Zaria; 3Society for Family Health

20th International AIDS Society ConferenceMelbourne, Australia (20–25 July 2014)

MSM/PWID HIV Situation• HIV prevalence rate of 3.4% translates to over 2.9 million people living with the virus.1 – 3rd highest burden of people infected with HIV in the world.

• 36.7% of MSM and 9.3% of PWIDs in Abuja were HIV positive (highest in 6 study states).2

• Know why they are at increased risk, however few studies have been conducted to deepen our understanding of why MSM and PWID still practice high level of risk behaviors.

Social Networking in Nigeria• >48 million internet users as of June 2012

– Largest internet population in Africa; 11th in the world

• Social networking sites (SNS)– Websites: Badoo (2 million), Facebook (11 million).

– Mobile Instant Messaging: WhatsApp (14 million), Blackberry Messenger (BBM; 3.5 million), 2go (over 1 million ).

• 1 in 4 MSM in Abuja is an active user of SNS via their smartphones and handheld devices.

Study Objective• Provide further insight into HIV-related sexual patterns that may influence HIV vulnerability and use of social networking sites in these sub-populations in Abuja metropolis.

Methods• Qualitative research conducted in December 2012. • Involved structured focus group discussions (FGDs) and in-depth interviews (IDIs) with 48 MSM and 48 PWID.– MSM: 3 FGDs and 18 IDIs– PWID: 3 FGDs and 18 IDIs

• Respondents recruited through: – Key opinion leaders (KOL)– Social networking sites

• Ethical Institutional Review Board (IRB) approval obtained from local IRB and Population Council.

RESULTS

MSM –Characteristics• Mean age: 25 years. • Almost all reported having penetrative anal sex with >10 partners in the last 12 months

• Inconsistent condom use was also reported• Half of them perceive themselves as bisexuals and expressed desire to marry due to societal pressure.

My father knew I was gay. He has caught me pants-down with a man on several occasions; yet he is threatening me with his wealth. He refused me going to the UK to study for masters because he fears that I may marry a  man over there in England. He has insisted I must marry a woman if I must inherit his wealth. He told me that he rather see me dead than coming out of my closet.

— MSM

MSM—Use of SNS• About 9 out of 10 of the respondents rely on virtual hotspots such as SNS to seek sexual partners.

My phone is my hunting ground. It is always on security lock. I don’t hang out anymore to avoid kito (scandals)… if I need market; I just click on my “Badoo” or “2go”. They are more reliable for hunting [seeking sexual partners].

— MSM

• Almost all reported meeting at least one or more new sexual partners every month via SNS.

• Reported that since the introduction of the Same-sex Marriage Prohibition Bill in Nigeria in 2008, SNS has been a more reliable medium of socialization and seeking new partners.

• Most of the sexual partners they met via the SNS are usually hidden-MSM and are unaware of high risk of unprotected anal sex.

PWID—Characteristics• Mean age: 23 years. • 10 were females: half reported exchanging sex for money and drugs.

• 25% of male PWID sold sex to both male and female sexual partners in exchange for drugs.

[I am not] gay but I have some of them as my oga (boss)… sometimes when I need money to buy my milk (crack/cocaine), I will go to them and we go play (have sex) and he will find me small money to go flex. …I get some sugar mummies too [paying female sex partners]….

• >50% reported inconsistent condom use; condom negotiation is determined by the paying partner.

PWID—Injecting behaviors• 5% of the participants rely on already used needles from health facilities’ dustbins.

• 14% share unclean needles with injecting partners.

PWID—Use of SNS• 1 in 10 respondents rely on SNS to access pyscho-active substances.

I am a bishop (drug-dealer) but my congregation…come for my church. They ask for my prayers (drugs) via their WhatsApp or a ping. All I need is to find out which kind prayer they want (the particular substance). Those aji-butters from Maitama (PWID from highbrow areas), na me Bishop dey go celebrate mass for their Aso-rock (I deliver the drugs to their homes).

— PWID

• SNS apps, e.g., WhatsApp and BBM, enable access to a wider range of drugs compared to physical hotspots.

• Almost all the PWID who rely on SNS to obtain drugs reported they now have unlimited access to any substance. – Physical hotspots are usually hindered by constant harassments from the law enforcement agencies.

Features Common to MSM and PWIDMSM PWID

Some of the MSM are PWID Some of the PWID are MSM

Some sold sex to female paying partners

Some sold sex to both male and female partners

Higher SES MSM rely more on virtual hotspots for seeking sex partners

Higher SES PWID rely more on virtual hotspots for buying of pyscho-active substances

Both MSM and PWID preferred virtual hotspots (e.g., Badoo, Facebook, Blackberry Messenger and WhatsApp) more than geographic hotspots: I. Due to greater social network access via smart phones and

handheld devicesII.Provides protection from harassment by law enforcement agencies

I watched my neighbors, including my biological brother beat up an effeminate gay man in my neighborhood. One of them once said to me ‘I am suspecting you and if I catch you… you will be my bush meat for that day…’. I prefer the internet to hook up with my lovers.

Conclusions

• Virtual hotspots/networking sites are a common connectivity mode for MSM and PWID in Abuja.

• A high proportion of MSM and PWID SNS users engage in high-risk sexual and injection behaviors; virtual hotspots may increase the vulnerability of MSM and PWID.

• Further research should be conducted on the use of social networking platforms by key populations as a possible HIV prevention intervention entry point.

References1.NARHS Plus II 20122.Integrated Biological and

Behavioural Surveillance Survey (IBBSS) 2010

Acknowledgements• Study participants• SHiPS for MARPs (Abuja Field Office)• HIV Division of Population Council, Nigeria• Post-graduate school, Development Communication: Ahmadu Bello University Zaria, Nigeria:

• This research has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID. The views expressed are those of the authors and should not be construed to represent the positions of the USAID. The abstract made use of SHiPS for MARPS project data.

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