Background Men who have sex with men (MSM) living with HIV are at increased risk for anal cancer.... more Background Men who have sex with men (MSM) living with HIV are at increased risk for anal cancer. We evaluated satisfaction with first-time anal cancer screening using high resolution anoscopy (HRA) as a cross sectional survey among men who have sex with men (MSM) attending a community-engaged clinic in Abuja, Nigeria. Methods Between March and August 2017, 342 MSM underwent screening and 307 (89%) completed a satisfaction survey that evaluated 8 domains related to expectations, convenience, staff interpersonal skills, physical surroundings, technical competence, pain/discomfort, general satisfaction, and intention to re-screen if symptomatic. The 22-item questionnaire used 5-point Likert scales ranging from 1 (strongly disagree) to 5 (strongly agree). For each domain, responses to specific items were averaged, aggregated, and converted to a 100-point scaled score (SS) with 25 and 75 corresponding to disagree and agree, respectively. Results Median age was 24 years (interquartile ra...
Twenty one medical laboratories were selected at random to participate in a prospective, cross-se... more Twenty one medical laboratories were selected at random to participate in a prospective, cross-sectional and analytical survey, to assess the quality of glucose testing in Abuja metropolis. Laboratories comprised 6 (28.6%) government hospital laboratories ( ...
Men who have sex with men (MSM) are disproportionately affected by HIV in Nigeria. A key strategy... more Men who have sex with men (MSM) are disproportionately affected by HIV in Nigeria. A key strategy in reducing transmission is to increase HIV testing uptake and linkage to treatment for those who test positive. HIV self-testing (HIVST) is an innovative strategy with the potential to increase uptake of HIV testing among key populations at higher risk for HIV. We conducted 23 in-depth-interviews with MSM and two focus group discussions with key opinion leaders to explore perceptions about the feasibility and acceptability of oral HIVST among MSM in Lagos, Nigeria. HIVST was highly acceptable because it was considered convenient to use, painless, private and addressed concerns about stigma. Concerns cited by participants included comprehensibility of instructions to perform and interpret results correctly, as well as lack of support mechanisms to facilitate post-test follow-up and linkage to care. Provision of adequate pre-test information was considered vital as part of the kit distri...
AIDS research and human retroviruses, Jan 17, 2018
To cluster anal microbiota and define microbial patterns associated with biological, clinical, an... more To cluster anal microbiota and define microbial patterns associated with biological, clinical, and behavioral correlates among Nigerian men who have sex with men (MSM) living with or at risk for HIV. In this cross-sectional pilot study, the 15 most abundant 16S taxa in the anal microbiota of 113 MSM underwent unsupervised K-means clustering and z-score comparisons to define similarities and dissimilarities among 4 microbiota taxonomic profiles. Distributions of oncogenic HPV (high-risk human papillomavirus [HR-HPV]), concurrent HIV, antiretroviral therapy (ART), and other clinical and behavioral data were evaluated using Fisher's exact and Kruskal-Wallis tests to determine biological signatures of cluster membership. Prevotella was consistently represented in each cluster, but the average composition ranged from 14% to 44%. Cluster 2 was enriched with a member of the Fusobacteria phylum, Sneathia (29%). More participants of cluster 2 were HIV infected and taking ART (83%, 5/6), ...
Antimicrobial-resistant Neisseria gonorrhoeae (NG) is a global public health issue that threatens... more Antimicrobial-resistant Neisseria gonorrhoeae (NG) is a global public health issue that threatens effectiveness of current treatments of NG. Increased use of nucleic acid amplification tests (NAATs) in lieu of cultures makes obtaining clinical isolates for susceptibility testing difficult and samples collected in commercial transport buffer for NAATs do not preserve viable organism, while molecular methods of assessing antibiotic susceptibility do not require viable organism. We evaluated 243 NG-positive samples in Aptima transport media including urine, oral, and rectal swabs from Nigerian men who have sex with men for markers to penicillinase-producing NG, ciprofloxacin ( GyrA and ParC mutations), and extended spectrum cephalosporins (ESCs, PenA mosaic [allele X], PonA, mtrR, PorB mutations) by real-time PCR. NG DNA was recovered in 75% (183/243) of samples. Of these, 93% (171/183) were positive for at least one resistance marker. We observed a prevalence of dual resistance marker...
Distribution of Cost and Determinants of Effectiveness in Provision of HIV Testing and Counsellin... more Distribution of Cost and Determinants of Effectiveness in Provision of HIV Testing and Counselling (HTC) for Male MARPs in Nigeria. Background HIV testing and counselling (HTC) remains the gateway to HIV prevention interventions and as countries scale-up towards universal access, priority backed with resource allocation should be given to aspects of HCT programmes that ensure value for money especially in resource poor settings. We evaluated the distribution of cost and determinants of effectiveness in the provision of HCT for male most-at-risk-population (MMARPs) (men who have sex with men (MSM) and men who inject drugs (MWID) in Nigeria. Methods MSM and MWID were provided with HTC through the Men’s Health Network, Nigeria (MHNN), an HIV prevention intervention between July 2009 and July 2012. Financial costs of providing HCT were estimated from a health provider perspective and classified as capital (rent, furniture, equipment) or recurrent (personnel, stationery, supplies, meetin...
Background Nigeria bears nearly 10% of the global burden of HIV/AIDS. Most of the patients dwell ... more Background Nigeria bears nearly 10% of the global burden of HIV/AIDS. Most of the patients dwell in the part of Nigeria known as the "North Central" geopolitical region. Sustaining HIV patients in this high risk region is critical for the overall success of the ART program in Nigeria. We assessed the level of adherence to ART and adherence determinants among participants who had been on ART for an average of three and half years. Methodology Eligible study participants initiated HAART between 2004 and 2010. HAART regimens contained AZT/3TC +NVP or EFV; AZT/3TC/NVP; 3TC/NVP/d4T; TDF/FTC +EFV or NVP and TDF+3TC+LPV/r. A composite adherence measure defined as not missing a dose and taking the correct dose and adhering to the correct frequency and correct schedule of drug administration was used to assess self-reported adherence over a period of three days. Self-reported adherence was validated with viral load test. Base line adherence was fixed at ≥95% adherence level. Signif...
Background Men who have sex with men (MSM) living with HIV are at increased risk for anal cancer.... more Background Men who have sex with men (MSM) living with HIV are at increased risk for anal cancer. We evaluated satisfaction with first-time anal cancer screening using high resolution anoscopy (HRA) as a cross sectional survey among men who have sex with men (MSM) attending a community-engaged clinic in Abuja, Nigeria. Methods Between March and August 2017, 342 MSM underwent screening and 307 (89%) completed a satisfaction survey that evaluated 8 domains related to expectations, convenience, staff interpersonal skills, physical surroundings, technical competence, pain/discomfort, general satisfaction, and intention to re-screen if symptomatic. The 22-item questionnaire used 5-point Likert scales ranging from 1 (strongly disagree) to 5 (strongly agree). For each domain, responses to specific items were averaged, aggregated, and converted to a 100-point scaled score (SS) with 25 and 75 corresponding to disagree and agree, respectively. Results Median age was 24 years (interquartile ra...
Twenty one medical laboratories were selected at random to participate in a prospective, cross-se... more Twenty one medical laboratories were selected at random to participate in a prospective, cross-sectional and analytical survey, to assess the quality of glucose testing in Abuja metropolis. Laboratories comprised 6 (28.6%) government hospital laboratories ( ...
Men who have sex with men (MSM) are disproportionately affected by HIV in Nigeria. A key strategy... more Men who have sex with men (MSM) are disproportionately affected by HIV in Nigeria. A key strategy in reducing transmission is to increase HIV testing uptake and linkage to treatment for those who test positive. HIV self-testing (HIVST) is an innovative strategy with the potential to increase uptake of HIV testing among key populations at higher risk for HIV. We conducted 23 in-depth-interviews with MSM and two focus group discussions with key opinion leaders to explore perceptions about the feasibility and acceptability of oral HIVST among MSM in Lagos, Nigeria. HIVST was highly acceptable because it was considered convenient to use, painless, private and addressed concerns about stigma. Concerns cited by participants included comprehensibility of instructions to perform and interpret results correctly, as well as lack of support mechanisms to facilitate post-test follow-up and linkage to care. Provision of adequate pre-test information was considered vital as part of the kit distri...
AIDS research and human retroviruses, Jan 17, 2018
To cluster anal microbiota and define microbial patterns associated with biological, clinical, an... more To cluster anal microbiota and define microbial patterns associated with biological, clinical, and behavioral correlates among Nigerian men who have sex with men (MSM) living with or at risk for HIV. In this cross-sectional pilot study, the 15 most abundant 16S taxa in the anal microbiota of 113 MSM underwent unsupervised K-means clustering and z-score comparisons to define similarities and dissimilarities among 4 microbiota taxonomic profiles. Distributions of oncogenic HPV (high-risk human papillomavirus [HR-HPV]), concurrent HIV, antiretroviral therapy (ART), and other clinical and behavioral data were evaluated using Fisher's exact and Kruskal-Wallis tests to determine biological signatures of cluster membership. Prevotella was consistently represented in each cluster, but the average composition ranged from 14% to 44%. Cluster 2 was enriched with a member of the Fusobacteria phylum, Sneathia (29%). More participants of cluster 2 were HIV infected and taking ART (83%, 5/6), ...
Antimicrobial-resistant Neisseria gonorrhoeae (NG) is a global public health issue that threatens... more Antimicrobial-resistant Neisseria gonorrhoeae (NG) is a global public health issue that threatens effectiveness of current treatments of NG. Increased use of nucleic acid amplification tests (NAATs) in lieu of cultures makes obtaining clinical isolates for susceptibility testing difficult and samples collected in commercial transport buffer for NAATs do not preserve viable organism, while molecular methods of assessing antibiotic susceptibility do not require viable organism. We evaluated 243 NG-positive samples in Aptima transport media including urine, oral, and rectal swabs from Nigerian men who have sex with men for markers to penicillinase-producing NG, ciprofloxacin ( GyrA and ParC mutations), and extended spectrum cephalosporins (ESCs, PenA mosaic [allele X], PonA, mtrR, PorB mutations) by real-time PCR. NG DNA was recovered in 75% (183/243) of samples. Of these, 93% (171/183) were positive for at least one resistance marker. We observed a prevalence of dual resistance marker...
Distribution of Cost and Determinants of Effectiveness in Provision of HIV Testing and Counsellin... more Distribution of Cost and Determinants of Effectiveness in Provision of HIV Testing and Counselling (HTC) for Male MARPs in Nigeria. Background HIV testing and counselling (HTC) remains the gateway to HIV prevention interventions and as countries scale-up towards universal access, priority backed with resource allocation should be given to aspects of HCT programmes that ensure value for money especially in resource poor settings. We evaluated the distribution of cost and determinants of effectiveness in the provision of HCT for male most-at-risk-population (MMARPs) (men who have sex with men (MSM) and men who inject drugs (MWID) in Nigeria. Methods MSM and MWID were provided with HTC through the Men’s Health Network, Nigeria (MHNN), an HIV prevention intervention between July 2009 and July 2012. Financial costs of providing HCT were estimated from a health provider perspective and classified as capital (rent, furniture, equipment) or recurrent (personnel, stationery, supplies, meetin...
Background Nigeria bears nearly 10% of the global burden of HIV/AIDS. Most of the patients dwell ... more Background Nigeria bears nearly 10% of the global burden of HIV/AIDS. Most of the patients dwell in the part of Nigeria known as the "North Central" geopolitical region. Sustaining HIV patients in this high risk region is critical for the overall success of the ART program in Nigeria. We assessed the level of adherence to ART and adherence determinants among participants who had been on ART for an average of three and half years. Methodology Eligible study participants initiated HAART between 2004 and 2010. HAART regimens contained AZT/3TC +NVP or EFV; AZT/3TC/NVP; 3TC/NVP/d4T; TDF/FTC +EFV or NVP and TDF+3TC+LPV/r. A composite adherence measure defined as not missing a dose and taking the correct dose and adhering to the correct frequency and correct schedule of drug administration was used to assess self-reported adherence over a period of three days. Self-reported adherence was validated with viral load test. Base line adherence was fixed at ≥95% adherence level. Signif...
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