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MSM/WSW and HIV

MSM/WSW and HIV. Dr Mary Wangari Kuria Chairman Department of Psychiatry. MSM/WSW. MSM are men who have sex with men WSW are women who have sex with women – little is known about this population These are key population whose unique physical and mental health issues requires attention.

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MSM/WSW and HIV

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  1. MSM/WSW and HIV Dr Mary WangariKuria Chairman Department of Psychiatry

  2. MSM/WSW • MSM are men who have sex with men • WSW are women who have sex with women – little is known about this population • These are key population whose unique physical and mental health issues requires attention

  3. Do they exist in Kenya? Data[1]: Nyanza has the highest number(2765 ) Nairobi (1702) Coast(775)

  4. Characteristics of MSM • 2/3 are single • Mean age 26 years • 67% have secondary or college level of education • 67.8% are paid to have sex with men • Payment for sex with women: 62.6% of MSW/MSM reported that they also had sex with women. • Mean number of sex partners per week is 3.54

  5. Challenges associated with MSM/WSM • HIV/AIDS • ADA(alcohol and drug addiction) • Reproductive issues(human extintion) • Rectal prolapse and stool incontinence • Anxiety and depression? • Is it act of terrorism? • Should it be legalized or criminalized?

  6. MSM & HIV • Men who have sex with men (MSM) in sub-Saharan Africa experience a high burden of HIV infection [2]. • an estimated 18.9% of MSM are HIV-positive [3]. • 15% of the new prison infections in year 2012 is related to MSM

  7. MSM & HIV • A very significant % of the clients of the MSM are married men who keep their homosexual/bi-sexual actions secret from their heterosexual partners/wives. • The possibility of HIV cross over infections can be very high if they engage in unprotected anal sex.

  8. MSM/HIV/AUD TRIAD As defined by AUDIT (Alcohol Use Disorder Identification Test) • 35% of participants who drink had hazardous drinking, • 15% harmful drinking and • 21% alcohol dependence. • Total with Alcohol Use Disorder (AUD): 71%

  9. continued • Compared with those who are abstinent, alcohol dependence was associated with inconsistent condom use, penile or anal discharge, and two-fold higher odds of sexual violence. • Frequent drinking was associated with inconsistent condom use and partner number, while binge drinking was only linked with inconsistent condom use.[4]

  10. Role of mental health professionals • Research (why? • Involvement in policy formulation • MSM often require psychotherapy but do not know who turn to • Training of health professionals • De-stigmatization ? De-criminalization? Which way

  11. Why are MSM/ WSM? • Parenting ignorance • Childhood neglect(the presence of a man in bringing up a child though minimal is extremely important • Poor socialization • Cost of marriage initiation and maintenance

  12. MSM/WSM • Or Would this be just an insane world that is coming to an end? • We need to address all these issues and offer leadership in providing solutions because we will be held accountable here on earth and in heaven

  13. References 1. Geographic Mapping of Most at Risk Populations for HIV (MARPs) in Kenya, NACC and NASCOP, June 2012 ) 2. ZimitatC. Designing effective on-line continuing medical education. Med Teach. 2001;23:11722. 3. BeyrerC, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, et al. Global epidemiology of HIV infection in men who have sex with men.Lancet Infect Dis. 2012;380(9839):36777. 4. Luchters et al. BMC, Public Health 2011, 11:384

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