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Intern. AIDS Soc."],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Young men who have sex with men (MSM) and transgender women (TGW) face stigmas that hinder access to healthcare. The aim of the study was to understand age\u2010related determinants of healthcare needs and engagement among MSM and TGW.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The TRUST\/RV368 cohort provides integrated prevention and treatment services for HIV and other sexually transmitted infections (STIs) tailored to the needs of sexual and gender minorities. MSM and TGW aged \u226516\u00a0years in Abuja and \u226518\u00a0years Lagos, Nigeria, completed standardized behavioural questionnaires and were tested for HIV, <jats:italic>Neisseria gonorrhoeae<\/jats:italic> (NG) and <jats:italic>Chlamydia trachomatis<\/jats:italic> (CT) every three months for up to 18\u00a0months. Logistic regression was used to estimate adjusted odds ratios (aORs) for associations of age and other factors with outcomes of interest upon enrolment, including HIV care continuum steps \u2013 HIV testing, ART initiation and viral suppression &lt;1000\u00a0copies\/mL. Cox proportional hazards models were used to calculate adjusted hazard ratios (aHRs) for associations with incident infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between March 2013 and February 2019, 2123 participants were enrolled with median age 23 (interquartile range 21 to 27) years. Of 1745 tested, 865 (49.6%) were living with HIV. HIV incidence was 11.6\/100 person\u2010years [PY], including 23.1\/100PY (95% CI 15.5 to 33.1) among participants aged 16 to 19\u00a0years and 23.8\/100 PY (95% CI 13.6 to 39.1) among TGW. Compared to participants aged \u226525\u00a0years, those aged 16 to 19\u00a0years had decreased odds of prior HIV testing (aOR 0.40 [95% CI 0.11 to 0.92]), disclosing same\u2010sex sexual practices to healthcare workers (aOR 0.53 [95% CI 0.36 to 0.77]) and receiving HIV prevention information (aOR 0.60 [95% CI 0.41 to 0.87]). They had increased odds of avoiding healthcare (aOR 1.94 [95% CI 1.3 to 2.83]) and engaging in transactional sex (aOR 2.76 [95% CI 1.92 to 3.71]). Age 16 to 19\u00a0years was independently associated with increased incidence of HIV (aHR 4.09 [95% CI 2.33 to 7.49]), NG (aHR 3.91 [95% CI 1.90 to 8.11]) and CT (aHR 2.74 [95% CI 1.48 to 5.81]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Young MSM and TGW demonstrated decreased healthcare engagement and higher incidence of HIV and other STIs as compared to older participants in this Nigerian cohort. Interventions to address unique obstacles to healthcare engagement by adolescents and young adults are needed to curb the spread of HIV and other STIs among MSM and TGW in Nigeria.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25599","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T07:57:30Z","timestamp":1601539050000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Association of age with healthcare needs and engagement among Nigerian men who have sex with men and transgender women: cross\u2010sectional and longitudinal analyses from an observational cohort"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9372-9359","authenticated-orcid":false,"given":"Habib O","family":"Ramadhani","sequence":"first","affiliation":[{"name":"Institute of Human Virology University of Maryland School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5947-265X","authenticated-orcid":false,"given":"Trevor A","family":"Crowell","sequence":"additional","affiliation":[{"name":"Henry M. 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