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(Fsw) and Men Who Have Sex with Men (Msm) in Burkina Faso, Togo and Cameroon

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(Fsw) and Men Who Have Sex with Men (Msm) in Burkina Faso, Togo and Cameroon EXAMINING RISK FACTORS FOR HIV AND ACCESS TO ServICES AMONG FEMALE SEX WORKerS (FSW) AND MEN WHO HAve SEX WITH MEN (MSM) IN BURKINA FASO, TOGO AND CAMerOON EXAMINING RISK FACTORS FOR HIV AND ACCESS TO SERVICES AMONG FEMALE SEX WORKERS (FSW) AND MEN WHO HAVE SEX WITH MEN (MSM) IN BURKINA FASO, TOGO AND CAMEROON March 2014 Authors: Erin Papworth, Ashley Grosso, Sosthenes Ketende, Andrea Wirtz, Charles Cange, Caitlin Kennedy, Matthew Lebreton, Odette Ky-Zerbo, Simplice Anato, Stefan Baral The USAID | Project SEARCH, Task Order No.2, is funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00032-00, beginning September 30, 2008, and supported by the President’s Emergency Plan for AIDS Relief. The Research to Prevention (R2P) Project is led by the Johns Hopkins Center for Global Health and managed by the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP). Examining Risk Factors for HIV and Access to Services among KP in West Africa ACKNOWLEDGEMENTS The study was implemented by USAID | Project SEARCH, Task Order No. 2: Research to Prevention (R2P). R2P is based at the Johns Hopkins University (JHU) in Baltimore, Maryland, USA. Stefan Baral with the R2P team at JHU designed the study and provided technical assistance during its implementation. In Burkina Faso, the study was implemented by the Programme d’Appui au Monde Associative et Communautaire de lute contre le VIH/SIDA, la tuberculose et le paludisme (PAMAC) in close partnership with l’Institut de Recherche en Sciences de la Santé (IRSS). In Togo, the study was implemented by Espoir-Vie Togo (EVT) in close partnership with Arc en Ciel and Force en Action pour le Mieux être de la Mère et de l'Enfant (FAMME). In Cameroon, the study was implemented by Metabiota and the Care and Health Program (CHP). The National AIDS Control Committees in Cameroon, Togo and Burkina Faso were instrumental in the oversight, direction, supervision and data validation, and we are grateful for the incredible government engagement and ownership of this work in each respective country. We would specially like to thank Dr. Vincent Pitche of Togo; Drs. Jean Bosco Elat and Serge Billong of Cameroon; and Drs. Andre Joseph Tiendrebeogo, Didier Romuald Bakouan and Joseph Aimé Bidiga of Burkina Faso for their invaluable support and input. We would like to thank the women and men who embraced this research project and chose to participate in this study. The impressive mobilization of men who have sex with men (MSM) and female sex workers (FSW) in Burkina Faso, Cameroon and Togo ensured the successful completion of all research activities. Without the leadership of these communities, this study would not have been possible. We would like to acknowledge the graduate students who contributed to this project: Benjamin Liestman, Ping-An (Annie) Chen, Claire Holland, Travis Lim, Emily Hurley, Sahnah Lim, Kim Dam, Sarah Peitzmeier, Jennifer Wilburn, Ju Nyeong Park, Jongwoo (Antonio) Lee, Amanda Bowes, Jennifer Sherwood, and Louis An. Additionally, Andrea Vazzano, Kathleen Ridgeway, and Brandon Howard from the R2P team in Baltimore assisted with the editing and formatting of the final report. From USAID West Africa, Laurent Kapesa provided significant technical input to this project. Alison Cheng and Sarah Sandison from USAID in Washington provided oversight and technical assistance for the project. This work was supported by USAID|Project SEARCH, Task Order No. 2, funded by the US Agency for International Development under Contract No. GHH-I-00-07-00032-00, beginning 30 September 2008, and by the President’s Emergency Plan for AIDS Relief. Recommended citation: Papworth E, Grosso A, Ketende S, Wirtz A, Cange C, Kennedy C, Lebreton M, Ky- Zerbo O, Anato S, and Baral S. Examining Risk Factors for HIV and Access to Services among Female Sex Workers (FSW) and Men who have Sex with Men (MSM) in Burkina Faso, Togo, and Cameroon. March 2014. Baltimore: USAID | Project Search: Research to Prevention. Page 2 Examining Risk Factors for HIV and Access to Services among KP in West Africa ACRONYMS ACMS Association Camerounaise pour le Marketing Social, Cameroon ACODEDUGN Association des Couches défavorisées et Vulnérables du Grand-Nord, Cameroon ACODEVO Association des Couches défavorisées et Vulnérables de l'Océan, Cameroon ADEFHO Association pour la Défense des Homosexuels, Cameroon AIDS Acquired Immune Deficiency Syndrome AIDSETI AIDS Empowerment and Treatment International, Burkina Faso AIDS ACODEV Aide Auprès des Couches Défavorisées et Vulnérables, Cameroon ANC Antenatal care ART Antiretroviral therapy ASAD Association d'Assistance au Développement, Cameroon CAMFAIDS Cameroonian Foundation For AIDS CAMNAFAW Cameroon National Association for Family Welfare CBO Community-based organization CCP Center for Communication Programs CD4 Cluster of differentiation 4 CDC Centers for Disease Control CERS Comité d'éthique sur la recherche dans la santé (ethics committee for health research), Burkina Faso CFA Communauté Financière Africaine (African Financial Community) franc CHP Care and Health Program, Cameroon CI Confidence interval CNERSH Comité National d'Ethique de la Recherche pour la Santé Humaine, Cameroon. CNLS Comité National de Lutte contre le SIDA (national committee to combat AIDS) COFENHO Collectif des Familles des Enfants Homosexuels, Cameroon CPHHR Center for Public Health and Human Rights CSI Centre de Santé Intégrée, Cameroon DHS Demographic and Health Survey DROS Division de la Recherche Opérationnelle en Santé, Cameroon ESPK Espace Sante Prévention De Kribi, Cameroon EVT Espoir Vie Togo FAMME Force en Action pour le Mieux être de la Mère et de l'Enfant (strength in action for the betterment of the mother and the child), Togo FSW Female sex worker GIZ Gesellschaft für Internationale Zusammenarbeit, Cameroon GPS Global Positioning System GTC Groupe Technique Central, Cameroon GTR Groupe Technique Régional, Cameroon GV Global Viral Page 3 Examining Risk Factors for HIV and Access to Services among KP in West Africa GVFI Global Viral Forecasting Initiative HAART Highly active antiretroviral therapy HAPP HIV/AIDS Prevention Program, Cameroon HCT HIV counseling and testing HEVECAM Hévéa du Cameroun, Cameroon HIV Human immunodeficiency virus HRW Human Rights Watch HSH Les hommes ayant des relations sexuelles avec des hommes (men who have sex with men) IBBS Integrated Biological and Behavioral Surveillance INS Institut National de la Statistique, Cameroon IRSS L’Institut de Recherche en Sciences de la Santé (the health sciences research institute), Burkina Faso JHU Johns Hopkins University KI Key informant KP Key population LGBT Lesbian, gay and bisexual and transgender LMIC Low- and middle-income countries MEASURE Monitoring and Evaluation to ASsess and Use REsults MINJUSTICE Ministère de la Justice, Cameroon MINSANTE Minister of Public Health, Cameroon mm3 Cubic millimeter MSEM Modified social ecological model MSM Men who have sex with men NGO Nongovernmental organization NSUM Network scale up method ONSP Observatoire National de la Santé Publique, Cameroon OR Odds ratio PAEMH Projet d'Assistance et d'Encadrement des Minorités Homosexuelles, Cameroon PAMAC Programme d’appui au monde associative et communautaire de lute contre le VIH/SIDA, la tuberculose et le paludisme (the world associative and community support program of fight against HIV/AIDS, tuberculosis and malaria) PEP Post-exposure prophylaxis PEPFAR President's Emergency Plan for AIDS Relief PLACE Priorities for Local AIDS Control Efforts PLWHIV People living with HIV PMI Protection Maternelle et Infantile, Cameroon PMTCT Prevention of mother-to-child transmission PWID People who inject drugs PWUD People who use drugs Page 4 Examining Risk Factors for HIV and Access to Services among KP in West Africa R2P Research to Prevention RDS Respondent driven sampling SEARCH Supporting evaluation and research to combat HIV SID'ADO Adolescents contre le SIDA, Cameroon SSA Sub-Saharan Africa STI Sexually transmitted infection UNAIDS Joint United Nations Programme on HIV/AIDS UNGASS United Nations general assembly special session on HIV/AIDS US United States USA United States of America USAID United States Agency for International Development USD United States dollar WCA West and central Africa Page 5 Examining Risk Factors for HIV and Access to Services among KP in West Africa TABLE OF CONTENTS ACKNOWLEDGEMENTS ........................................................................................................... 2 ACRONYMS ........................................................................................................................... 3 TABLE OF CONTENTS .............................................................................................................. 6 EXECUTIVE SUMMARY .......................................................................................................... 10 Introduction ............................................................................................................................................... 10 Methods ...................................................................................................................................................... 11 Results ......................................................................................................................................................... 12 Burkina Faso .......................................................................................................................................
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