(P53) PREVALENCE OF AND TRANSMISSION RISK FACTORS ASSOCIATED WITH HIV AMONG MEN WITH URETHRAL DISCHARGE SYNDROME IN PUBLIC HEALTH FACILITIES IN KAMPALA, UGANDA

Background:
HIV and sexually transmitted infections (STIs) control in men is a major public health concern in Sub-Saharan Africa. Epidemiological data on HIV in male urethral discharge syndrome (UDS) are limited; national HIV prevalence in men 15-49 years is 3.6%. We describe the prevalence of HIV and associated risk factors among men with UDS in public clinics in Kampala, Uganda.

Methods:
A cross sectional study of men with UDS was conducted from October 2019 to July 2022. An interviewer-administered demographic and socio-behavioral questionnaire was administered. HIV testing used point-of-care tests (Standard Diagnostics, Giheung-gu, Korea) with confirmatory algorithmic testing. Bivariate and multivariable log binomial regression adjusted for age, alcohol intake in the past 6 months and antibiotics use in the past 2 weeks was conducted to determine the factors associated with prevalent HIV.

Results:
Of 450 participants, 441(98%) were included in this analysis; 9 declined HIV testing. Median age was 24(IQR 22-32) years, 87%(N=384) reported a previous HIV test. Overall, 18%(n=81) were living with HIV;33.6% and 4.7% in men aged ≥25 and <25 years respectively. Seven (8.6%) were new HIV diagnoses. 94% with established HIV were on antiretrovirals, only 52% had suppressed viral loads by self-report. Participants reported ‘always’ condom use (1.1%), transactional sex (45.4%), multiple partners (59.6%); 46.7% had notified their partners of symptoms. Multivariable analysis demonstrated significant associations between HIV and older age (aPR,6.06; 95% C.I, 3.29-11.17; P<0.01), alcohol use in past 6 months (aPR,0.64; 95% C.I, 0.43-0.94; P=0.023) and antibiotic use in prior 2 weeks (aPR,0.62; 95% C.I, 0.43-0.89; P=0.010).

Conclusion:
Men aged ≥25 years seeking care for UDS in public facilities have a high prevalence of HIV and behaviors associated with STIs. HIV was negatively associated with alcohol and antibiotic use prior to clinic visit. Men with UDS represent a key, previously untargeted, population for HIV testing, prevention and treatment services.