Background

HIV impacts key populations such as men who have sex with men (MSM) disproportionately. This study, called the Ghana Men’s Study II (GMSII), was a mapping and population size estimation (MPSE) study and integrated bio-behavioral surveillance survey (IBBSS) conducted amongst MSM in Ghana. The term MSM refers to a form of sexual behaviour. It is not limited to individuals with any one sexual orientation or gender expression or identity. For the purpose of this study, MSM referred to all biological males who have sex with other biological males, irrespective of the person’s sexual orientation and gender expression. Three objectives guided the implementation of the IBBSS amongst MSM. The
rst was to assess the prevalence of HIV and other selected sexually transmitted infections (STIs) (i.e. Hepatitis B, HBV), Syphilis, and Herpes Simplex Virus Type 2, HSV-2). Secondly behavioral risk factors that contribute to the HIV vulnerability of MSM in Ghana was also assessed through an anonymous behavioral survey. Finally, the GMS II generated estimates of the size and distribution of MSM in the 10 regions in Ghana. The implicit aim of the study was to provide recommendations to address gaps in access to critical prevention, treatment, care and support services for MSM. Overall, the results of the MPSE and the IBBSS will be used to inform the National HIV and AIDS Strategic Plan 2016-2020 of Ghana.

Methodology

This study had three parts. First pre-surveillance formative research was conducted in order to inform implementation of the IBBSS. The main goal of the pre-surveillance formative research was to assess the acceptability of using respondent driven sampling (RDS) to recruit MSM into the IBBSS. Secondly, the IBBSS was implemented to assess HIV risk taking behaviours and HIV and STI prevalence amongst MSM. Finally, a MPSE was implemented to determine the scale and size of the MSM population in Ghana.

MSM across 10 selected regions of Ghana were recruited using RDS. The following regions were included in the GMS II: Greater Accra Region (Accra and Tema); Eastern Region (Koforidua); Brong-Ahafo Region (Sunyani); Western Region (Takoradi); Central Region (Cape Coast): Ashanti region (Kumasi); Northern region (Tamale); Upper East (Bolgatanga); Upper West (Wa) and the Volta region (Ho). Implementation of the IBBSS took place in all 10 regions of Ghana. For data analysis purposes, Wa, Tamale and Bolgatanga were collapsed and renamed to Northern Ghana.