Recent studies have demonstrated that African MSM are less likely to have UAI if they use water-based lubricants (WBL), have been counseled about the risks of UAI, and more likely to have UAI if they regularly drink alcohol or do not know that HIV can be transmitted via anal intercourse [8,10]. Understanding condom use among MSM in the African context is especially relevant as in all three countries, not always wearing condoms was highly predictive of being HIV positive.