Sexually transmitted infection knowledge levels, socio-demographic characteristics and sexual behaviour among men who have sex with men: results from a cross-sectional survey in Nairobi, Kenya

Background High rates of sexually transmitted infections (STIs) among men who have sex with men (MSM) have been reported, there is little research on their STI knowledge. Our study sought to characterize knowledge and awareness of STIs among MSM in Nairobi, Kenya. Methods We mobilized MSM aged ≥18 years from Nairobi into a cross-sectional study. To determine their understanding about STIs, a pre-tested structured questionnaire was administered. Knowledge score was generated by summing up the number of responses answered correctly by a participant. We dichotomized scores as “low” and “high”, by splitting the group at <12 and ≥12 which was the mean. Results A total of 404 participants were interviewed between the month of March and August 2020. The mean age was 25.2 (SD=6.4) years. Majority were single (80.4%) and Christians (84.2%). All participants had some formal education ranging from primary to tertiary; the majority (92.3%) had secondary education or more. Most (64.0%) were employed and their monthly income ranged from <50->150 USD. Almost all (98.5%) were Kenyans. Of the 404 (90.6%) self-identified as male and (47.5%) reported to be exclusively top partners. Many (39.9%) reported being both bottom and top, while those reporting to be bottom partners were, (12.6%). The last 12 months, (55.4%) of the participants reported having sex with men only and (88.6%) reported to have had more than one sexual partner. Participants scored an average of 12.2, out of 29 SD 4.5. The multivariable modelling revealed that participants aged ≥25 years were more likely to have a higher knowledge score compared with the participants aged 18-24 years (aOR=0.973, CI: 0.616-1.538). Regarding education and occupation, participants who had tertiary education and those who were employed were more likely to have a higher knowledge score compared with the participants who had primary education and were not employed (aOR=2.627, CI:1.142-6.043) (aOR=0.922, CI:0.401-2.117). Participants who were earning (USD >150) were more likely to have a higher knowledge score compared to the ones who were not earning (aOR=2.520, CI: 0.900-7.055). Further bisexual men were more likely to have a higher knowledge score compared with the participants who were having sex with men only (aOR= 1.550, CI: 1026-2.342) Conclusion Participant’s knowledge level regarding STIs was low. We recommend health care workers to continue educating patients about STIs. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement DKN received a scholarship to study her Masters degree. Conception and design of the study was done by DKN.This work was partially funded by IAVI with the generous support of USAID and other donors a full list of IAVI donors is available at [www.iavi.org][1]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical consideration and study approval number Approval of the study was sought from Kenyatta University Board of Post Graduate studies. Ethical Clearance was given by Kenyatta University ethics review committee (PKU/1071/11121). Permission to conduct the study was sought from the National Council for Science, Technology and Innovations (NACOSTI), and from Nairobi County and sub-county facilities. Confidentiality and anonymity of the information given by the participants was protected by ensuring that the names of the participants were not indicated in the data collection tools. Participants were reimbursed in the local currency equivalent of $2 USD in compensation for their time. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All relevant data are within the manuscript and its Supporting Information files. [1]: http://www.iavi.org