Prevalence and factors associated with syphilis, HIV and hepatitis B virus infections among men who have sex with men in Togo in 2017

Introduction Hepatitis B and other sexually transmitted infections (STIs) have been linked to an increased risk of HIV transmission and disease progression among men who have sex with men (MSM), but their frequency and distribution in this community have not been extensively studied in Togo. In addition, a holistic understanding of transmission patterns of these STIs is required in order to develop sustainable prevention strategies and reduce transmission among MSM. The objective of the study was to estimate the prevalence and factors associated with syphilis, HIV and hepatitis B virus (HBV) infections among men who have sex with men (MSM) in Togo in 2017. Method A cross-sectional study was conducted in eight main cities in Togo from August 1 to September 30, 2017. MSM aged 18 years and above were recruited using the respondent driven sampling method. Data including socio-demographic characteristics, human immunodeficiency virus (HIV) testing history, condom use patterns, sexual partners characteristics and behaviors were collected using a questionnaire during face-to-face interviews. Blood samples were drawn after the interview for STIs screening using rapid tests. Multivariate logistic regression analyses were performed to identify factors associated with syphilis, HBV and HIV infections among MSM. Results Out of a total of 711 MSM recruited, 69.7% were living in Lome, which is the capital city of Togo. Median age of study participants was 23 years, interquartile range (21–27 years) and 91.4% had at least secondary education level. At least three MSM over ten reported having condomless anal sex during the last month. The prevalence of syphilis, HIV, and HBV infection among 678 (95.3%) MSM who accepted the screening test was 0.0% [upper limit of 95% confidence interval (95% CI) 0.9%], 21.9% (95% CI [18.9–25.3%]), and 7.1% (95% CI [5.3–9.3%]), respectively. Among them, 7 (1.0%) (95% CI [0.4–2.2]) had HIV and HBV co-infection. The prevalence of HBV infection was not associated with HIV infection status (4.7% among MSM infected with HIV and 7.8% among MSM not infected with HIV, P  = 0.199). Age, place of residency, nationality, MSM membership, previous HIV screening, and living with a male partner were significantly associated with HIV infection ( P P  = 0.044) or older than 26 (aOR = 4.62; 95% CI [1.79–14.33]; P  = 0.003), and those living outside of Lome (aOR = 5.09; 95% CI [2.71–9.91]; P Conclusion Our findings emphasize the importance of targeting HIV and viral hepatitis testing and prevention efforts to populations at risk for STIs. Despite all the awareness campaigns, the prevalence of STIs among MSM remains high. This urges the implementation of routine screening, vaccine-based prevention, and education programs for this most-at-risk population.