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Young key populations left behind : the necessity for a targeted response in Mozambique

(2021) PLOS ONE. 16(12).
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Abstract
Introduction The first exposure to high-risk sexual and drug use behaviors often occurs during the period of youth (15-24 years old). These behaviors increase the risk of HIV infection, especially among young key populations (KP)-men how have sex with men (MSM), female sex workers (FSW), and people who inject drugs (PWID). We describe the characteristics of young KP participants in the first Biobehavioral Surveillance (BBS) surveys conducted in Mozambique and examine their risk behaviors compared to adult KP. Methods Respondent-driven sampling (RDS) methodology was used to recruit KP in three major urban areas in Mozambique. RDS-weighted pooled estimates were calculated to estimate the proportion of young KP residing in each survey city. Unweighted pooled estimates of risk behaviors were calculated for each key population group and chi-square analysis assessed differences in proportions between youth (aged less than 24 years old) and older adult KP for each population group. Results The majority of MSM and FSW participants were young 80.7% (95% CI: 71.5-89.9%) and 71.9% (95% CI: 71.9-79.5%), respectively, although not among PWID (18.2%, 95% CI: 13.2-23.2%). Young KP were single or never married, had a secondary education level or higher, and low employment rates. They reported lower perception of HIV risk (MSM: 72.3% vs 56.7%, p<0.001, FSW: 45.3% vs 24.4%, p<0.001), lower HIV testing uptake (MSM: 67.5% vs 72.3%, p<0.001; FSW: 63.2% vs 80.6%; p<0.001, PWID: 53.3% vs 31.2%; p = 0.001), greater underage sexual debut (MSM: 9.6% vs 4.8%, p<0.001; FSW: 35.2% vs 22.9%, p<0.001), and greater underage initiation of injection drug use (PWID: 31.9% vs 7.0%, p<0.001). Young KP also had lower HIV prevalence compared to older KP: MSM: 3.3% vs 27.0%, p<0.001; FSW: 17.2% vs 53.7%, p<0.001; and PWID: 6.0% vs 55.0%, p<0.001. There was no significant difference in condom use across the populations. Conclusion There is an immediate need for a targeted HIV response for young KP in Mozambique so that they are not left behind. Youth must be engaged in the design and implementation of interventions to ensure that low risk behaviors are sustained as they get older to prevent HIV infection.
Keywords
Multidisciplinary, RISK BEHAVIORS, HIV-INFECTION, SEX WORKERS, MEN, PEOPLE, DRUGS

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Citation

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MLA
Boothe, Makini, et al. “Young Key Populations Left behind : The Necessity for a Targeted Response in Mozambique.” PLOS ONE, vol. 16, no. 12, 2021, doi:10.1371/journal.pone.0261943.
APA
Boothe, M., Semá Baltazar, C., Sathane, I., Raymond, H. F., Fazito, E., Temmerman, M., & Luchters, S. (2021). Young key populations left behind : the necessity for a targeted response in Mozambique. PLOS ONE, 16(12). https://doi.org/10.1371/journal.pone.0261943
Chicago author-date
Boothe, Makini, Cynthia Semá Baltazar, Isabel Sathane, Henry F. Raymond, Erika Fazito, Marleen Temmerman, and Stanley Luchters. 2021. “Young Key Populations Left behind : The Necessity for a Targeted Response in Mozambique.” PLOS ONE 16 (12). https://doi.org/10.1371/journal.pone.0261943.
Chicago author-date (all authors)
Boothe, Makini, Cynthia Semá Baltazar, Isabel Sathane, Henry F. Raymond, Erika Fazito, Marleen Temmerman, and Stanley Luchters. 2021. “Young Key Populations Left behind : The Necessity for a Targeted Response in Mozambique.” PLOS ONE 16 (12). doi:10.1371/journal.pone.0261943.
Vancouver
1.
Boothe M, Semá Baltazar C, Sathane I, Raymond HF, Fazito E, Temmerman M, et al. Young key populations left behind : the necessity for a targeted response in Mozambique. PLOS ONE. 2021;16(12).
IEEE
[1]
M. Boothe et al., “Young key populations left behind : the necessity for a targeted response in Mozambique,” PLOS ONE, vol. 16, no. 12, 2021.
@article{8738140,
  abstract     = {{Introduction

The first exposure to high-risk sexual and drug use behaviors often occurs during the period of youth (15-24 years old). These behaviors increase the risk of HIV infection, especially among young key populations (KP)-men how have sex with men (MSM), female sex workers (FSW), and people who inject drugs (PWID). We describe the characteristics of young KP participants in the first Biobehavioral Surveillance (BBS) surveys conducted in Mozambique and examine their risk behaviors compared to adult KP.

Methods

Respondent-driven sampling (RDS) methodology was used to recruit KP in three major urban areas in Mozambique. RDS-weighted pooled estimates were calculated to estimate the proportion of young KP residing in each survey city. Unweighted pooled estimates of risk behaviors were calculated for each key population group and chi-square analysis assessed differences in proportions between youth (aged less than 24 years old) and older adult KP for each population group.

Results

The majority of MSM and FSW participants were young 80.7% (95% CI: 71.5-89.9%) and 71.9% (95% CI: 71.9-79.5%), respectively, although not among PWID (18.2%, 95% CI: 13.2-23.2%). Young KP were single or never married, had a secondary education level or higher, and low employment rates. They reported lower perception of HIV risk (MSM: 72.3% vs 56.7%, p<0.001, FSW: 45.3% vs 24.4%, p<0.001), lower HIV testing uptake (MSM: 67.5% vs 72.3%, p<0.001; FSW: 63.2% vs 80.6%; p<0.001, PWID: 53.3% vs 31.2%; p = 0.001), greater underage sexual debut (MSM: 9.6% vs 4.8%, p<0.001; FSW: 35.2% vs 22.9%, p<0.001), and greater underage initiation of injection drug use (PWID: 31.9% vs 7.0%, p<0.001). Young KP also had lower HIV prevalence compared to older KP: MSM: 3.3% vs 27.0%, p<0.001; FSW: 17.2% vs 53.7%, p<0.001; and PWID: 6.0% vs 55.0%, p<0.001. There was no significant difference in condom use across the populations.

Conclusion

There is an immediate need for a targeted HIV response for young KP in Mozambique so that they are not left behind. Youth must be engaged in the design and implementation of interventions to ensure that low risk behaviors are sustained as they get older to prevent HIV infection.}},
  articleno    = {{e0261943}},
  author       = {{Boothe, Makini and Semá Baltazar, Cynthia and Sathane, Isabel and Raymond, Henry F. and Fazito, Erika and Temmerman, Marleen and Luchters, Stanley}},
  issn         = {{1932-6203}},
  journal      = {{PLOS ONE}},
  keywords     = {{Multidisciplinary,RISK BEHAVIORS,HIV-INFECTION,SEX WORKERS,MEN,PEOPLE,DRUGS}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{14}},
  title        = {{Young key populations left behind : the necessity for a targeted response in Mozambique}},
  url          = {{http://doi.org/10.1371/journal.pone.0261943}},
  volume       = {{16}},
  year         = {{2021}},
}

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