Original Research

Condomless anal intercourse among HIV-positive and HIV-negative men who have sex with men in Zimbabwe

Munyaradzi P. Mapingure, Innocent Chingombe, Tafadzwa Dzinamarira, Diego Cuadros, Grant Murewanhema, Brian Moyo, Chesterfield Samba, Amon Mpofu, Owen Mugurungi, Helena Herrera, Godfrey Musuka
Southern African Journal of HIV Medicine | Vol 25, No 1 | a1583 | DOI: https://doi.org/10.4102/sajhivmed.v25i1.1583 | © 2024 Munyaradzi P. Mapingure, Innocent Chingombe, Tafadzwa Dzinamarira, Diego Cuadros, Grant Murewanhema, Brian Moyo, Chesterfield Samba, Amon Mpofu, Owen Mugurungi, Helena Herrera, Godfrey Musuka | This work is licensed under CC Attribution 4.0
Submitted: 08 March 2024 | Published: 30 September 2024

About the author(s)

Munyaradzi P. Mapingure, Innovative Public Health and Development Solutions, Harare, Zimbabwe
Innocent Chingombe, Innovative Public Health and Development Solutions, Harare, Zimbabwe
Tafadzwa Dzinamarira, ICAP at Columbia University, Harare, Zimbabwe
Diego Cuadros, Digital Epidemiology Laboratory, Digital Futures, University of Cincinnati, Cincinatti, United States
Grant Murewanhema, Unit of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
Brian Moyo, AIDS and TB Programmes, Ministry of Health and Child Care, Harare, Zimbabwe
Chesterfield Samba, Gay and Lesbian Association of Zimbabwe (GALZ), Harare, Zimbabwe
Amon Mpofu, National AIDS Council, Harare, Zimbabwe
Owen Mugurungi, AIDS and TB Programmes, Ministry of Health and Child Care, Harare, Zimbabwe
Helena Herrera, School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
Godfrey Musuka, International Initiative for Impact Evaluation, Harare, Zimbabwe

Abstract

Background: Men who have sex with men (MSM) are disproportionately impacted by HIV in sub-Saharan Africa (SSA), where condomless anal intercourse (CAI) is a major driver of HIV transmission among this hidden subpopulation.

Objectives: To determine CAI drivers and prevalence among HIV-positive and HIV-negative MSM.

Method: Data from 1538 MSM who participated in a biobehavioural survey in Zimbabwe were used. Secondary statistical data analysis methods were used to determine prevalences and drivers of CAI.

Results: A high prevalence of CAI, of at least 30%, among HIV-positive and HIV-negative MSM was found. Factors that led to a statistically significant higher CAI among HIV-positives compared to HIV-negatives included drunkenness (35% vs. 25%, P = 0.01), fear of partner (13% vs. 9%, P = 0.017), trusting the partner (10% vs. 6%, P = 0.008), and being offered more money (10% vs. 6%, P = 0.003).

Conclusion: Our findings indicate that economic, socio-behavioural and perceptual dimensions increase men’s likelihood to engage in risky sexual behaviour, suggesting the need for HIV prevention efforts that provide tailored education regarding HIV risk among MSM in SSA. This is the first large biobehavioural survey that generated valuable information useful for analysing condomless anal sex among MSM in Zimbabwe.


Keywords

HIV; MSM; condomless anal intercourse; sexual behaviour; condom use; biobehavioural survey

Sustainable Development Goal

Goal 3: Good health and well-being

Metrics

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