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. 2012;7(8):e43818.
doi: 10.1371/journal.pone.0043818. Epub 2012 Aug 28.

Decline in HIV prevalence among young men in the general population of Cotonou, Benin, 1998-2008

Luc Béhanzin  1 , Souleymane Diabaté, Isaac Minani, Catherine M Lowndes, Marie-Claude Boily, Annie-Claude Labbé, Séverin Anagonou, Djimon Marcel Zannou, Anne Buvé, Michel Alary
Affiliations

Decline in HIV prevalence among young men in the general population of Cotonou, Benin, 1998-2008

Luc Béhanzin et al. PLoS One. 2012.

Abstract

Objective: To assess changes in the prevalence of HIV and other sexually transmitted infections, as well as in different proximal and distal factors related to HIV infection, in the general population of Cotonou between 1998 and 2008, while an intensive preventive intervention targeting the sex work milieu was ongoing.

Methods: A two-stage cluster sampling procedure was used to select the participants in each study. Subjects aged 15-49 who agreed to participate were interviewed and tested for HIV, syphilis, HSV-2, gonorrhoea and chlamydia. We used the Roa-Scott Chi-square test (proportions) and the Student's t test (means) for bivariate comparisons, and adjusted logistic regression models taking into account the cluster effect for multivariate analyses.

Results: HIV prevalence decreased significantly in men (3.4% in 1998 versus 2.0% in 2008, p = 0.048), especially in those aged 15-29 (3.0% to 0.5%, p = 0.002). Among men, the prevalence of gonorrhoea decreased significantly (1.1% to 0.3%, p = 0.046) while HSV-2 prevalence increased from 12.0% to 18.1% (p = 0.0003). The proportion of men who reported condom use at least once (29.3% to 61.0%, p<0.0001) and of those having attained a secondary educational level or more (17.1% to 61.3%, p<0.0001) also increased significantly. There was an overall decrease in the prevalence of syphilis (1.5% to 0.6%, p = 0.0003).

Conclusion: This is the first population-based study reporting a significant decline in HIV prevalence among young men in an African setting where overall prevalence has never reached 5%. The decline occurred while preventive interventions targeting the sex work milieu were ongoing and the educational level was increasing.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Univariate comparison of HIV/STI prevalence between 1998 and 2008 among women, Men and Overall, aged 15–49 years, general population of Cotonou, Benin.
P-values are from Roa-Scott chi-square tests (chi-square tests adjusted for the cluster effect). NG, Neisseria gonorrhoeae; CT, Chlamydia trachomatis; TP, Treponema pallidum; HSV-2, Herpes simplex virus type-2.
Figure 2
Figure 2. Multivariate comparison by age group of HIV prevalence between 1998 and 2008 among men and women, general population of Cotonou, Benin.
P-values are from Wald chi-square test from multivariate logistic models (taking into account the cluster affect and adjusting for marital status). There is a significant decline in HIV prevalence in men aged 15–29 years and a non-significant decrease among women aged 15–19 years. Irrespective of gender, there is a non-significant increase in HIV prevalence in all the other age groups. There were too few HIV-infected men aged 15–19 years in both studies (zero in 1998 and only one in 2008) to further break down the 15–29 age group among men.
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