HIV/AIDS in mid-sized cities in Senegal: From individual to place-based vulnerability

In Senegal, recent data indicates that the HIV epidemic is increasingly driven by concurrent sexual partners among men and women in stable relationships. In order to respond to this changing epidemiological profile in Senegal, multi-lateral and national AIDS actors require information about these emerging trends in unstudied populations. To that end, this study has several objectives, first, to assess local dynamics of sexual behaviors among individuals at popular socializing venues in areas at increased risk of HIV transmission; and then to examine how particular venues may influence risks of HIV transmission. In 2013 we collected data at 314 venues in 10 cities in Senegal using PLACE methodology. These venues were listed with collaboration of 374 community informants. They are places where commercial sex workers, MSM, and individuals who are not part of any identified risk group socialize and meet new sexual partners. We conducted 2600 interviews at the 96 most popular venues. A significant portion of the sample reports buying or selling sex and the majority engaged in behavior considered high-risk for transmitting sexual infections. Almost a quarter of patrons interviewed in venues were young people aged 15-24 years. Types of venues described were very diverse. Half of them were venues (n = 156) where sex workers could be solicited and almost a third were venues where MSM could meet male partners (n = 90). The study showed existing pockets of vulnerability to HIV in Thies, Bignona or Saly that are not evident from aggregate HIV data. These early findings suggest links between risky behaviors and type of venue on the one hand and type of city on the other hand. Finally, these findings offer complementary insight to existing studies of HIV vulnerability in Senegal and support a case for venue-based interventions.