HIV prevalence among gay men in Mozambique doubles in last decade

The urgent need to address HIV among gay men and other men who have sex with men in Mozambique has been laid bare by new research that suggests HIV prevalence has doubled in the last decade among this group. But factors such as age, education and HIV prevention awareness strongly influence HIV risk. 

What is the research about? 

This study compares findings from two bio-behavioural surveys conducted in 2011 and 2020–2021. Each survey involved around 1,500 men who have sex with men (aged 18+) living in urban areas.  

Why is this research important? 

This is the first study to analyse HIV prevalence trends over time among men who have sex with men in Mozambique. Understanding trends and risk factors is crucial to guiding public health policies and designing HIV prevention programmes that work. 

What did they find out? 

HIV prevalence among men who have sex with men increased from 7.1% in 2011 to 14.9% in 2021. This is higher than general adult HIV prevalence, which was 11.9% in 2021. 

Certain factors are significantly associated with having HIV. This means some groups of men who have sex with men are more likely to have HIV than others.  

For instance, HIV prevalence among uncircumcised men who have sex with men has risen from 11.7% to 25.1%. In contrast, HIV prevalence among men who have sex with men with a moderate understanding of HIV risk has fallen from 10.9% to 3.4%. Similarly, HIV prevalence among men who have sex with men who attended higher education has fallen from 16.7% to 5.9%.  

Older men who have sex with men (aged 30+) still have the highest HIV prevalence at 27.7%. Although this is a big decrease from 2010, when prevalence was 45.7% among this age group. Prevalence has also fallen among 25 to 29-year-olds (from 24.7% to 13.9%). But it has increased among 20 to 24-year-olds (from 4.1% to 6.4%) and 18 to 19-year-olds (from 1% to 3.5%). 

By location, HIV prevalence has risen significantly in Maputo (from 9.3% to 14.7%), and also in Nampula (from 3.9% to 5.7%). But it has fallen slightly in Beira (from 9.5% to 8.1%). 

HIV prevalence has fallen among married men who have sex with men (from 29.1% to 16.8%). But married men who have sex with men are 2.4 times more likely to have HIV than their non-married peers. 

What does this mean for HIV services? 

These findings show the continuing need to scale-up HIV information, prevention and treatment specifically for men who have sex with men. Prevention programmes should include voluntary medical male circumcision (VMMC), given the finding that circumcised men in the study were 60% less likely to have HIV than their non-circumcised peers.  

The rise in prevalence among different groups of men who have sex with men shows the need to ensure programmes not only cater for men who have sex with men in general, but put additional focus and resources into the sub-groups who are most at risk of HIV and most likely to be living with the virus.  

HIV prevalence among young men who have sex with men is still relatively low but infections are rising. This suggests there is a need for age-appropriate prevention information and commodities, such as PrEP and VMMC. Among older age groups, a mix of prevention and increased access to treatment should be priorities.