{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:08:00Z","timestamp":1787062080416,"version":"build-2736575974"},"reference-count":30,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2020,10,4]],"date-time":"2020-10-04T00:00:00Z","timestamp":1601769600000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,8,24]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate HIV prevalence and associated risk factors among men who have sex with men (MSM) in Dar es Salaam, Tanzania following the implementation of the national comprehensive package of HIV interventions for key population (CHIP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional survey using respondent-driven sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Dar es Salaam, Tanzania\u2019s largest city.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Men who occasionally or regularly have sex with another man, aged 18 years and above and living in Dar es Salaam city at least 6\u2009months preceding the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>HIV prevalence was the primary outcome. Independent risk factors for HIV infection were examined using weighted logistics regression modelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 777 MSM with a mean age of 26 years took part in the study. The weighted HIV prevalence was 8.3% (95% CI: 6.3%\u201310.9%) as compared with 22.3% (95% CI: 18.7%\u201326.4%) observed in a similar survey in 2014. Half of the participants had had sex with more than two partners in the month preceding the survey. Among those who had engaged in transactional sex, 80% had used a condom during last anal sex with a paying partner. Participants aged 25 and above had four times higher odds of being infected than those aged 15\u201319 years. HIV infection was associated with multiple sexual partnerships (adjusted OR\/AOR, 3.0; 95%\u2009CI: 1.8\u201312.0), not having used condom during last sex with non-paying partner (AOR, 4.1; 95%\u2009CI: 1.4\u20137.8) and ever having engaged in group sex (AOR, 3.4; 95%\u2009CI: 1.7\u20133.6).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HIV prevalence among MSM in Dar es Salaam has decreased by more than a half over the past 5 years, coinciding with implementation of the CHIP. It is nonetheless two times as high as that of men in the general population. To achieve the 2030 goal, behavioural change interventions and roll out of new intervention measures such as pre-exposure prophylaxis are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-036460","type":"journal-article","created":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T17:27:09Z","timestamp":1601918829000},"page":"e036460","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["HIV prevalence among men who have sex with men following the implementation of the HIV preventive guideline in Tanzania: respondent-driven sampling survey"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6810-8312","authenticated-orcid":false,"given":"Mwijage","family":"Alexander Ishungisa","sequence":"first","affiliation":[{"name":"Behavioral Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania"},{"name":"Medical Botany, Plant Breeding and Agronomy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kare","family":"Moen","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germana","family":"Leyna","sequence":"additional","affiliation":[{"name":"Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neema","family":"Makyao","sequence":"additional","affiliation":[{"name":"National AIDS Control Programme, Ministry of Health, Tanzania National AIDS Control Program, Dar es Salaam, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Ramadhan","sequence":"additional","affiliation":[{"name":"National AIDS Control Programme, Ministry of Health, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theis","family":"Lange","sequence":"additional","affiliation":[{"name":"Section of Biostatistics, University of Copenhagen, Kobenhavns, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan Wolf","family":"Meyrowitsch","sequence":"additional","affiliation":[{"name":"Global Health Section, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mucho","family":"Mizinduko","sequence":"additional","affiliation":[{"name":"Epidemiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Likindikoki","sequence":"additional","affiliation":[{"name":"Department of Sychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melkzedeck","family":"Leshabari","sequence":"additional","affiliation":[{"name":"Department of Behavioral Sciences, Muhimbili University College of Health Sciences, Dar es Salaam, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elia John","family":"Mmbaga","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics, Muhimbili University Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania"},{"name":"Community Medicine and Global Health, Universitetet i Oslo Avdeling for samfunnsmedisin, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,10,5]]},"reference":[{"key":"2025121223462066000_10.10.e036460.1","article-title":"Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: the global burden of disease study 2015","volume":"3","year":"2016","journal-title":"Lancet HIV"},{"key":"2025121223462066000_10.10.e036460.2","unstructured":"NBS Statistics . 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Tanzania HIV\/AIDS and malaria indicator survey 2011-2012. Dar es salaam, Tanzania: Zanzibar AIDS Commission (ZAC), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), ICF International, 2013."},{"key":"2025121223462066000_10.10.e036460.15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040339"},{"key":"2025121223462066000_10.10.e036460.16","first-page":"129","article-title":"Abdool R: HIV and substance abuse: the dual epidemics challenging Zanzibar","volume":"5","author":"Dahoma MJ","year":"2006","journal-title":"African Journal of Drugs and Alcohol Studies"},{"key":"2025121223462066000_10.10.e036460.17","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2008.034991"},{"key":"2025121223462066000_10.10.e036460.18","unstructured":"UNAIDS . 90\u201390\u201390\u2014an ambitious treatment target to help end the AIDS epidemic. Geneva, Switzerland: UNAIDS, 2014. http:\/\/wwwunaidsorg\/en\/resources\/"},{"key":"2025121223462066000_10.10.e036460.19","unstructured":"Programme NAC . Comprehensive guideline for HIV prevention among key population in Tanzania. Dar es Salaam, Tanzania: NACP, 2016."},{"key":"2025121223462066000_10.10.e036460.20","unstructured":"Mmbaga EJ LG , Mpembeni R , Moen K , et al . Intergrated biobehavioral survey among men who have sex with men in Dar ES Salaam, Tanzania. Dar es Salaam, Tanzania: National AIDS Control Program, MUHAS, 2014."},{"key":"2025121223462066000_10.10.e036460.21","doi-asserted-by":"publisher","DOI":"10.1525\/sp.2002.49.1.11"},{"key":"2025121223462066000_10.10.e036460.22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9531.2011.01244.x"},{"key":"2025121223462066000_10.10.e036460.23","doi-asserted-by":"crossref","unstructured":"Coulaud PJ S-TL , Mimi M , Maradan G , et al . Changes in risky sexual behaviours among West African MSM enrolled in a quarterly HIV testing and counselling prevention programme. Sex Transm Infect 2019;2019.","DOI":"10.1136\/sextrans-2018-053892"},{"key":"2025121223462066000_10.10.e036460.24","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1177\/0956462418823411","article-title":"Transactional sex, condomless anal sex, and HIV risk among men who have sex with men","volume":"30","author":"Mgbako","year":"2019","journal-title":"Int J STD AIDS"},{"key":"2025121223462066000_10.10.e036460.25","unstructured":"Coulaud PJ S-TL , m Mimi M , M\u2019madi Mrenda B , et al . Combined sexual behavioral profiles in HIV-seronegative men who have sex with men in West Africa. Arch Sex Behav 2019;2019."},{"key":"2025121223462066000_10.10.e036460.26","doi-asserted-by":"crossref","unstructured":"Mbita GMA , Plotkin M , Casalini C , et al . 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