Lane, T., Osmand, T., Marr, A., et al. Journal of Acquired Immune Deficiency Syndromes (December 2016), 73(5): 609–611. doi:10.1097/QAI.0000000000001162.
The Mpumalanga Men’s Study comprised a series of integrated biological–behavioral surveillance surveys (IBBS), conducted in Mpumalanga Province, South Africa to assess HIV incidence among men who have sex with men (MSM). Between 2012 and 2015, the authors conducted three cross-sectional IBBS surveys of a respondent-driven sampling of 307 MSM, to evaluate the impact of Project Boithato, which aimed to reduce sexual risk behavior and increase regular uptake of HIV testing and care among MSM. Findings showed high HIV prevalence (28.9%), low levels of regular HIV testing, and poor linkage to care among MSM who knew their HIV-positive status. Successive surveys, conducted between 12 and 30 months after Boithato ended, allowed for follow-up for a recaptured cohort of 179 MSM. HIV prevalence in this cohort was 32.4 percent at baseline. The study observed 18 seroconversions, or incidence of 12.5/100 person–years. The authors noted that to their knowledge, this was the first incidence rate calculated from repeated IBBS observations of an MSM community in sub-Saharan Africa; and yielded an alarming representation of the HIV epidemic among MSM in a rural, resource-challenged community. They concluded that these findings indicate the urgent need for biomedical prevention and treatment programming for MSM in South Africa.