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Wang P, Wei C, McFarland W, Raymond HF. The Development and the Assessment of Sampling Methods for Hard-to-Reach Populations in HIV Surveillance. J Urban Health 2024:10.1007/s11524-024-00880-w. [PMID: 38787451 DOI: 10.1007/s11524-024-00880-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 05/25/2024]
Abstract
Due to stigma or legal issues, populations with higher HIV risk are often hard to reach, which impedes accurate population estimation of HIV burden. To better sample hard-to-reach populations (HTRPs) for HIV surveillance, various sampling methods have been designed and/or used since HIV epidemic following the first reported AIDS cases in 1981. This paper describes the development and the assessment (i.e., validity and reproducibility) of approximately eight sampling methods (e.g., convenience sampling, snowball sampling, time location sampling, and respondent-driven sampling) for HTRPs in HIV surveillance, with a focus on respondent-driven sampling (RDS). Compared to other methods, RDS has been greatly assessed. However, current evidence is still inadequate for RDS to be considered the best option for sampling HTRPs. The field must continue to assess RDS and to develop new sampling approaches or modifications to existing approaches.
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Affiliation(s)
- Peng Wang
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chongyi Wei
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Willi McFarland
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Henry F Raymond
- School of Public Health, Rutgers University, Piscataway, NJ, USA.
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2
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Blondeel K, Mirandola M, Gios L, Folch C, Noestlinger C, Cordioli M, De Sutter P, Temmerman M, Toskin I. Sexual satisfaction, an indicator of sexual health and well-being? Insights from STI/HIV prevention research in European men who have sex with men. BMJ Glob Health 2024; 9:e013285. [PMID: 38789276 PMCID: PMC11129029 DOI: 10.1136/bmjgh-2023-013285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 03/31/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Although sexual health has been holistically defined to include sexual satisfaction, it has been largely absent in health services and sexual and reproductive health and rights programmes in many parts of the world. We propose sexual satisfaction as a useful indicator, as one of the proxy measures for sexual health and well-being and as a component of well-being in general. METHODS The Sialon II project is a multicentre biological and behavioural cross-sectional community-based survey implemented across 13 European cities during 2013-2014 among men who have sex with men. Sexual satisfaction was explored using one single item: 'How satisfied are you with your sex life?' A multivariable multilevel logistic random-intercept model was estimated to identify factors associated with reporting positive sexual satisfaction versus negative sexual satisfaction. RESULTS Age, the number of partners and self-reported HIV status were not significantly associated with sexual satisfaction in the multivariate model. Participants reporting an insertive role or reported both an insertive and receptive role during the last anal intercourse were more likely to be sexually satisfied, compared with a receptive role. Participants reporting anal intercourse with a condom were more likely to be satisfied than those declaring no anal intercourse in the last 6 months, but no significant association was found compared with anal intercourse without condom. Knowledge of HIV-serostatus concordance with the last sexual partner was positively correlated with sexual satisfaction. Having had sexual intercourse with non-steady partners only in the last 6 months was negatively correlated. The more positive participants perceived their work/school, parents and friends/acquaintances' attitudes towards gay or bisexual persons, the higher the odds they were satisfied with their sexual life. CONCLUSION Using a single item on sexual satisfaction in a bio-behavioural study, our analysis has shown that it is associated with individual, interpersonal and social/structural factors and has proven its usefulness as a sexual health indicator among men who have sex with men.
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Affiliation(s)
- Karel Blondeel
- Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), World Health Organization, Geneva, Switzerland
- Ghent University Faculty of Medicine and Health Sciences, Gent, Belgium
| | - Massimo Mirandola
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lorenzo Gios
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Cinta Folch
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT) Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Maddalena Cordioli
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Petra De Sutter
- Ghent University Faculty of Medicine and Health Sciences, Gent, Belgium
| | - Marleen Temmerman
- Ghent University Faculty of Medicine and Health Sciences, Gent, Belgium
- Centre of Excellence in Women, Adolescents and Child Health, The Aga Khan University, Nairobi, Kenya
| | - Igor Toskin
- Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), World Health Organization, Geneva, Switzerland
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3
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Stengaard AR, Combs L, Supervie V, Croxford S, Desai S, Sullivan AK, Jakobsen SF, Santos Q, Simões D, Casabona J, Lazarus JV, de Wit JBF, Amort FM, Pharris A, Nerlander L, Raben D. HIV seroprevalence in five key populations in Europe: a systematic literature review, 2009 to 2019. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2021; 26. [PMID: 34823636 PMCID: PMC8619876 DOI: 10.2807/1560-7917.es.2021.26.47.2100044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background In Europe, HIV disproportionately affects men who have sex with men (MSM), people who inject drugs (PWID), prisoners, sex workers, and transgender people. Epidemiological data are primarily available from national HIV case surveillance systems that rarely capture information on sex work, gender identity or imprisonment. Surveillance of HIV prevalence in key populations often occurs as independent studies with no established mechanism for collating such information at the European level. Aim We assessed HIV prevalence in MSM, PWID, prisoners, sex workers, and transgender people in the 30 European Union/European Economic Area countries and the United Kingdom. Methods We conducted a systematic literature review of peer-reviewed studies published during 2009–19, by searching PubMed, Embase and the Cochrane Library. Data are presented in forest plots by country, as simple prevalence or pooled across multiple studies. Results Eighty-seven country- and population-specific studies were identified from 23 countries. The highest number of studies, and the largest variation in HIV prevalence, were identified for MSM, ranging from 2.4–29.0% (19 countries) and PWID, from 0.0–59.5% (13 countries). Prevalence ranged from 0.0–15.6% in prisoners (nine countries), 1.1–8.5% in sex workers (five countries) and was 10.9% in transgender people (one country). Individuals belonging to several key population groups had higher prevalence. Conclusion This review demonstrates that HIV prevalence is highly diverse across population groups and countries. People belonging to multiple key population groups are particularly vulnerable; however, more studies are needed, particularly for sex workers, transgender people and people with multiple risks.
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Affiliation(s)
- Annemarie Rinder Stengaard
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lauren Combs
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Virginie Supervie
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | | | | | - Ann K Sullivan
- Directorate of HIV and Sexual Health, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Stine Finne Jakobsen
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Quenia Santos
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Daniel Simões
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, Porto, Portugal.,Grupo de Ativistas em Tratamentos (GAT), Lisboa, Portugal
| | - Jordi Casabona
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - John B F de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | - Frank M Amort
- FH JOANNEUM, University of Applied Sciences, Bad Gleichenberg, Austria
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Lina Nerlander
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Dorthe Raben
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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4
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Sherriff NS, Jones AM, Mirandola M, Gios L, Marcus U, Llewellyn C, Rosinska M, Folch C, Dias S, Toskin I, Alexiev I, Kühlmann-Berenzon S. Factors related to condomless anal intercourse between men who have sex with men: results from a European bio-behavioural survey. J Public Health (Oxf) 2021; 42:e174-e186. [PMID: 31090894 PMCID: PMC7251420 DOI: 10.1093/pubmed/fdz052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 04/17/2019] [Indexed: 12/11/2022] Open
Abstract
Background Relationship status is an important factor associated with condomless anal intercourse (CAI) amongst men who have sex with men (MSM). Methods A multi-centre bio-behavioural survey with MSM was conducted in 13 European cities (n = 4901) exploring factors associated with CAI via bivariate and multivariate multilevel logistic regression analyses. Results Likelihood of CAI with casual partners was associated with being ‘out’ to a majority (AOR = 1.19;95% CI 1,1.42); knowing their HIV status (AOR = 1.86; 95% CI 1.25,2.76); using substances (1–2 AOR = 1.39; 95% CI 1.16,1.63, 2+ AOR = 1.81; 95% CI 1.35,2.42); being older (AOR = 0.98; 95% CI 0.97,0.99); successful sero-communication (AOR = 0.79; 95% CI 0.67,0.94); and, not having a recent HIV test (AOR = 0.78; 95% CI 0.66,0.92). CAI with steady partners was associated with successful sero-communication (AOR = 2.72; 95% CI 2.72,3.66); not having a recent HIV test (AOR = 1.26; 95% CI 1.09,1.46), and; being older (AOR = 0.99; 95% CI 0.98,0.99). Conclusions Understandings of partner type and/or relationship status in relation to CAI amongst MSM can potentially play an important role in the development of culturally appropriate HIV/STI prevention and risk-reduction efforts targeting at-risk MSM. Our results speak to the need to consider segmented and tailored public health and health promotion initiatives for MSM with differing CAI behaviours and relationship profiles.
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Affiliation(s)
- N S Sherriff
- School of Health Sciences, University of Brighton, Brighton, BN1 9PH, UK.,Centre for Transforming Sexuality & Gender, University of Brighton, Brighton, Brighton, BN1 9PH, UK
| | - A M Jones
- School of Health Sciences, University of Brighton, Brighton, BN1 9PH, UK.,Research and Development Department, Sussex Partnership NHS Foundation Trust, Worthing, United Kingdom, BN13 3EP, UK
| | - M Mirandola
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - L Gios
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - U Marcus
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - C Llewellyn
- Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PH, UK
| | - M Rosinska
- National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
| | - C Folch
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya / CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - S Dias
- Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública & GHTM, Universidade NOVA de Lisboa, Portugal
| | - I Toskin
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - I Alexiev
- National Reference Laboratory of HIV, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - S Kühlmann-Berenzon
- Department of Public Health Analysis and Data Management, Public Health Agency of Sweden, Solna, Sweden
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5
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Gios L, Mirandola M, Sherriff N, Toskin I, Blondeel K, Dias S, Staneková D, Folch C, Schink SB, Nöstlinger C, Berghe WV, Naseva E, Alexiev I. Being in the Closet. Correlates of Outness Among MSM in 13 European Cities. JOURNAL OF HOMOSEXUALITY 2021; 68:415-433. [PMID: 31483215 DOI: 10.1080/00918369.2019.1656033] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Data for MSM continue to show a high risk of acquiring HIV-STIs. Within this population, outness seems to have an impact on both risk-taking and on health seeking behaviors. The objective of this study was to assess the relationship between socio-demographic, behavioral characteristics, testing behaviors, and outness level among MSM using data from a multi-center bio-behavioral cross-sectional study carried out in 13 EU cities. A multilevel analysis was conducted to identify factors associated with being open ("out") versus not being open ("in"). A total of 4,901 MSM were enrolled in the study and were classified as "out" in 71% of the cases. MSM "out" were more likely to report HIV testing and being reached by HIV prevention programs compared to MSM who were "in." The results confirm the key role of outness in relation to different healthy and risky behavior, ranging from testing to party-drug use.
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Affiliation(s)
- Lorenzo Gios
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - Massimo Mirandola
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - Nigel Sherriff
- School of Health Sciences, University of Brighton , Brighton, UK
| | - Igor Toskin
- Department of Reproductive Health and Research, World Health Organization , Geneva, Switzerland
| | - Karel Blondeel
- Department of Reproductive Health and Research, World Health Organization , Geneva, Switzerland
- Faculty of Medicine and Health Sciences, Ghent University , Ghent, Belgium
| | - Sonia Dias
- Escola Nacional de Saúde Pública Universidade, Universidade NOVA de Lisboa, Centro de Investigação em Saúde Pública , Lisboa, Portugal
| | - Danica Staneková
- NRC for HIV/AIDS, Slovak Medical University , Bratislava, Slovak Republic
| | - Cinta Folch
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Department Salut, Generalitat de Catalunya/CIBER Epidemiologia y Salud Pública (CIBERESP) , Barcelona, Spain
| | | | - Christiane Nöstlinger
- Department of Public Health, Institute of Tropical Medicine , Antwerp, Belgium
- Faculty of Psychology, University of Vienna , Vienna, Austria
| | - Wim Vanden Berghe
- Department of Public Health, Institute of Tropical Medicine , Antwerp, Belgium
- Scientific Institute of Public Health , Brussels, Belgium
| | - Emilia Naseva
- Faculty of Public Health, Medical University of Sofia , Sofia, Bulgaria
| | - Ivailo Alexiev
- National Reference Laboratory of HIV, National Center of Infectious and Parasitic Diseases , Sofia, Bulgaria
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6
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Dias S, Gama A, Sherriff N, Gios L, Berghe WV, Folch C, Marcus U, Staneková DV, Pawlęga M, Caplinskas S, Naseva E, Klavs I, Velicko I, Mirandola M, Nöstlinger C. Process evaluation of a bio-behavioural HIV research combined with prevention among GBMSM in 13 European countries. Glob Public Health 2021; 17:672-687. [PMID: 33460361 DOI: 10.1080/17441692.2021.1874469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Comparative European data using Second Generation Surveillance System (SGSS) are scarce among gay, bisexual and other men who have sex with men. This study evaluated the implementation of Sialon II, a bio-behavioural HIV research combined with targeted HIV prevention in 13 European cities conducted in collaboration with community partners. A mixed-methods process evaluation assessed the project's coverage, outputs, quality, challenges and opportunities for improvement. Data collected through structured questionnaire from 71 data collectors from community-based organisations and semi-structured interviews with 17 managers of participating gay venues were analysed. Overall implementation was successful, achieving 4901 valid behavioural questionnaires and obtaining 4716 biological samples. Challenges in conducting bio-behavioural research in gay venues related to strict research protocols and unfavourable characteristics of venues. Formative research, collaboration with community gay venues, and offering HIV prevention emerged as facilitators. Community researchers' training was crucial for fidelity to research protocols, increased trust amongst communities and enabled data collectors to effectively address practical problems in the field. Scientifically sound SGSS with community participation is feasible and allows for including 'hard-to-reach' populations. Prevention benefits include awareness raising, capacity building and sexual health promotion in gay venues. The findings are beneficial for epidemiological research among other HIV key populations.
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Affiliation(s)
- Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal.,Comprehensive Health Research Centre (CHRC), Lisboa, Portugal
| | - Ana Gama
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal.,Comprehensive Health Research Centre (CHRC), Lisboa, Portugal
| | - Nigel Sherriff
- School of Health Sciences, University of Brighton, Brighton, UK
| | - Lorenzo Gios
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Cinta Folch
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya/CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Ulrich Marcus
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | | | - Saulius Caplinskas
- Centre for Communicable Diseases and AIDS, Mykolas Romeris University, Vilnius, Lithuania
| | - Emilia Naseva
- Ministry of Health, Program "Prevention and Control of HIV/AIDS", Sofia, Bulgaria
| | - Irena Klavs
- National Institute of Public Health, Ljubljana, Slovenia
| | - Inga Velicko
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Massimo Mirandola
- Epidemiology Unit - UOC Infectious Diseases, Verona University Hospital, Verona, Italy
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- Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
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7
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Mirandola M, Gios L, Sherriff N, Marcus U, Toskin I, Rosinska M, Schink S, Kühlmann-Berenzon S, Suligoi B, Folch C, Nöstlinger C, Dias S, Stanekova D, Klavs I, Caplinskas S, Rafila A, Marin C, Alexiev I, Zohrabyan L, Noori T, Menel-Lemos C, On Behalf Of The Sialon Ii Network. Quantifying unmet prevention needs among MSM in Europe through a multi-site bio-behavioural survey. ACTA ACUST UNITED AC 2019; 23. [PMID: 30621823 PMCID: PMC6290532 DOI: 10.2807/1560-7917.es.2018.23.49.1800097] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Introduction The HIV epidemic represents an important public health issue in Europe particularly among men who have sex with men (MSM). Global AIDS Monitoring indicators (GAM) have been widely and jointly promoted as a set of crucial standardised items to be adopted for monitoring and responding to the epidemic. Methods The Sialon II study, implemented in 13 European cities (2013-14), was a complex multi-centre integrated bio-behavioural cross-sectional survey targeted at MSM, with a concomitant collection of behavioural and biological (oral fluid or blood specimens) data. Rigorous sampling approaches for hard-to-reach populations were used (time-location sampling and respondent-driven sampling) and GAM indicators were calculated; sampling frames were adapted to allow weighted estimates of GAM indicators. Results 4,901 MSM were enrolled. HIV prevalence estimates ranged from 2.4% in Stockholm to 18.0% in Bucharest. When exploring city-level correlations between GAM indicators, prevention campaigns significantly correlated with levels of condom use and level of HIV testing among MSM. Conclusion The Sialon II project has made an important contribution to the monitoring and evaluation of the HIV epidemic across Europe, integrating the use of GAM indicators within a second generation HIV surveillance systems approach and in participatory collaboration with MSM communities. It influenced the harmonisation of European data collection procedures and indicators via GAM country reporting and contributed essential knowledge informing the development and implementation of strategic, evidence-based HIV prevention campaigns for MSM.
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Affiliation(s)
- Massimo Mirandola
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lorenzo Gios
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Nigel Sherriff
- School of Health Sciences, University of Brighton, Brighton, United Kingdom
| | - Ulrich Marcus
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Igor Toskin
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Magdalena Rosinska
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Susanne Schink
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Sharon Kühlmann-Berenzon
- Department of Public Health Analysis and Data Management, Public Health Agency of Sweden, Solna, Sweden
| | - Barbara Suligoi
- Centro Operativo AIDS, Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy
| | - Cinta Folch
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya / CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Christiane Nöstlinger
- Faculty of Psychology, University of Vienna, Austria.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sonia Dias
- Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública & GHTM, Universidade NOVA de Lisboa, Portugal
| | - Danica Stanekova
- NRC for HIV/AIDS, Slovak Medical University, Bratislava, Slovak Republic
| | - Irena Klavs
- National Institute of Public Health, Ljubljana, Slovenia
| | - Saulius Caplinskas
- Centre for Communicable Diseases and AIDS, Mykolas Romeris University, Vilnius, Lithuania
| | - Alexandru Rafila
- National Institute of Infectious Diseases Prof. Dr. Matei Bals, Bucharest, Romania
| | | | - Ivailo Alexiev
- National Reference Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Lev Zohrabyan
- Regional Support Team Joint United Nations Programme on HIV/AIDS (UNAIDS), Moscow, Russia
| | - Teymur Noori
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Cinthia Menel-Lemos
- Consumers, Health, Agriculture and Food Executive Agency (Chafea), Luxembourg
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8
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Strömdahl S, Hoijer J, Eriksen J. Uptake of peer-led venue-based HIV testing sites in Sweden aimed at men who have sex with men (MSM) and trans persons: a cross-sectional survey. Sex Transm Infect 2019; 95:575-579. [PMID: 31113905 PMCID: PMC6902060 DOI: 10.1136/sextrans-2019-054007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/01/2019] [Accepted: 05/05/2019] [Indexed: 01/12/2023] Open
Abstract
Objectives HIV testing among high-risk groups is a key intervention to diagnose persons living unknowingly with HIV to enable linkage to care and effective antiretroviral treatment. This study aimed to evaluate the uptake of Testpoint, the first large-scale HIV testing programme in Sweden where peer, non-healthcare personnel offered venue-based testing. Testing was performed by staff from the Swedish Foundation for Lesbian, Gay, Bisexual and Transgender Rights (RFSL Sweden) and testing was performed at the RFSL offices, gay clubs and gay cruising areas, as well as at various gay festivals. The test was a rapid test using capillary blood from a finger prick. Methods A cross-sectional survey of all persons aged >18 years who came for HIV testing at one of Testpoint’s locations in Sweden between 1 February and 31 December 2016. Results 595 respondents (96% response rate) were included. Five persons were diagnosed with HIV and referred for treatment and care. A fifth of participants had never tested for HIV before. More than half of the participants were foreign born and the median age was 31 years. About one-fifth of participants stated they would not have tested through the healthcare system if Testpoint was not available. Conclusions Testpoint reached their target population of young, foreign-born men who have sex with men (MSM) as well as first time testers and persons who stated that they would not have tested within the healthcare system. Such peer HIV testing outside the healthcare setting is a possible way of increasing uptake of testing in high-risk groups.
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Affiliation(s)
- Susanne Strömdahl
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Jonas Hoijer
- Department of Surgical Sciences, Uppsala Universitet, Uppsala, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jaran Eriksen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden .,Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
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9
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Leluţiu-Weinberger C, Rendina HJ, Mirandola M, Gios L, Folch C, Rafila A, Pachankis JE. The Role of Gay-Related Stigma in HIV-Risk Behavior Among Sexual Minority Men in Europe. AIDS Behav 2019; 23:684-694. [PMID: 30302655 DOI: 10.1007/s10461-018-2306-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Sexual orientation stigma stems from discriminatory social contexts and may ultimately impact the behavioral health of stigmatized individuals through stress-related pathways. Sexual minority stigma is of particular concern in Europe given the diversity of social contexts on the continent and sexual minority men's rapidly increasing risk of HIV infection, especially in Central and Eastern Europe, potentially rooted in stigma. This study assesses whether stigma in the ubiquitous social contexts surrounding sexual minority men (e.g., family, workplace, government) may place them at higher risk for HIV contraction across six countries. We utilized a large cross-sectional survey sample of HIV-negative sexual minority men (N = 2087; mean age = 31.6, SD = 9.7) from six European countries to test whether those who reported sexual orientation stigma also engaged in more HIV risk-related behaviors, including condomless sex with casual partners (in the absence of PrEP) and substance use before and during sex. Regression analyses were performed in Mplus. We found that a one standard deviation increase in reported sexual orientation stigma was significantly associated with the following during the last sexual encounter: a 19% increase in odds of sex under the influence of alcohol, 27% increase in odds of sex under the influence of cannabis, 49% increase in odds of sex under the influence of illicit drugs, an 11% increase in odds of condomless sex with casual partners in the past 6 months, and a 26% increase in odds of knowing where to receive an HIV test. Sexual minority men who reported perceiving greater sexual orientation-related stigma within their ubiquitous social contexts were significantly more likely to report sexual risk and alcohol and drug use during their last sexual encounter, yet reported more knowledge of preventive services. Contextual stigma might serve as a precursor to behavioral risks of HIV infection, generating maladaptive stress responses capable of being modified through individually-focused interventions. Structural interventions are also needed to ultimately reduce stigma at its source.
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Affiliation(s)
- Corina Leluţiu-Weinberger
- Rutgers Biomedical and Health Sciences, School of Nursing and François-Xavier Bagnoud Center, Rutgers, State University of New Jersey, 65 Bergen Street, Rm 846 North, Newark, NJ, 07101, USA.
| | - H Jonathon Rendina
- Department of Psychology and the Center for HIV Educational Studies and Training (CHEST), Hunter College, City University of New York, New York, NY, USA
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA
| | - Massimo Mirandola
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- Veneto Region - Department of Health, CReMPE - Regional Coordination Centre for European Project Management, the Verona University Hospital, Verona, Italy
| | - Lorenzo Gios
- Veneto Region - Department of Health, CReMPE - Regional Coordination Centre for European Project Management, the Verona University Hospital, Verona, Italy
| | - Cinta Folch
- Departament de Salut, Center Estudis Epidemiològics sobre les Infections de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Alexandru Rafila
- Universitatea de Medicină şi Farmacie "Carol Davila", Bucureşti, România
- Institutul Naţional de Boli Infecţioase "Prof. Dr. Matei Balş", Bucureşti, România
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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10
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Mravčík V, Pitoňák M, Hejzák R, Janíková B, Procházka I. HIV epidemic among men who have sex with men in the Czech Republic, 2016: high time for targeted action. ACTA ACUST UNITED AC 2018; 22. [PMID: 29208160 PMCID: PMC5725790 DOI: 10.2807/1560-7917.es.2017.22.48.17-00079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Reported incidence of human immunodeficiency virus (HIV) infection in the Czech Republic increased steeply over the past decade from 90 new cases in 2005 to 266 in 2015. This increase is almost exclusively attributed to sexual transmissions between men who have sex with men (MSM). In 2015, there were 79% (n=210) newly diagnosed cases among MSM, 17% (n=45) were attributed to heterosexual transmission and 1% (n=3) to people who inject drugs. Interventions targeted at MSM have not yet been prioritised in the broadly focused national HIV prevention strategy which this is envisaged to change in the programme set out for 2018 to 2022. The national budget for HIV prevention has been reduced, however, and this remains. Availability of voluntary counselling and testing has decreased substantially in the past decade. Post- and pre-exposure prophylaxis for sexual intercourse among MSM are not part of the HIV prevention policy and the concept of treatment as prevention is not fully recognised. Provision of a combined prevention strategy with a focus on MSM, reflecting the above factors including stigmatisation, should contribute to reverse the development of a concentrated HIV epidemic among MSM in the Czech Republic.
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Affiliation(s)
- Viktor Mravčík
- National Institute of Mental Health, Klecany, Czech Republic.,Department of Addictology, First Faculty of Medicine, Charles University and General Teaching Hospital, Prague, Czech Republic.,National Monitoring Centre for Drugs and Addiction, Office of the Government of the Czech Republic, Prague, Czech Republic
| | - Michal Pitoňák
- National Institute of Mental Health, Klecany, Czech Republic
| | | | - Barbara Janíková
- Department of Addictology, First Faculty of Medicine, Charles University and General Teaching Hospital, Prague, Czech Republic.,National Monitoring Centre for Drugs and Addiction, Office of the Government of the Czech Republic, Prague, Czech Republic
| | - Ivo Procházka
- Institute of Sexology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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11
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Mirandola M, Gios L, Joanna Davis R, Furegato M, Breveglieri M, Folch C, Staneková D, Nita I, Stehlíková D. Socio-demographic factors predicting HIV test seeking behaviour among MSM in 6 EU cities. Eur J Public Health 2017; 27:313-318. [PMID: 27615734 DOI: 10.1093/eurpub/ckw144] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background HIV testing is generally accepted as being the lynchpin of a prevention strategy to tackle the HIV epidemic among MSM. However, few studies have analysed in detail the factors that influence HIV test seeking behaviour. Methods The objective of this article is to analyse the relationship between HIV test seeking behaviour and individual, social and demographic factors in a sample of MSM recruited though a multi-centre bio-behavioural cross-sectional study. A multi-level analysis was conducted to identify factors associated with HIV test seeking behaviour. Results A total of 2400 men were included in the sample. Age, self-reported sexual orientation, residence, household composition, educational status and perceived homonegativity all seem to impact on test seeking behaviour. Conclusions The results suggest the need for more targeted testing promotion strategies among MSM that take structural and environmental factors into consideration, as part of a comprehensive public health strategy to address the HIV epidemic.
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Affiliation(s)
- Massimo Mirandola
- CReMPE - Regional Coordination Centre for European Project Management Veneto Region - Department of Health, Verona University Hospital, Verona, Italy.,Infectious Diseases Section, Department of Pathology, Verona University Hospital - Veneto Region, Verona, Italy
| | - Lorenzo Gios
- CReMPE - Regional Coordination Centre for European Project Management Veneto Region - Department of Health, Verona University Hospital, Verona, Italy
| | - Ruth Joanna Davis
- CReMPE - Regional Coordination Centre for European Project Management Veneto Region - Department of Health, Verona University Hospital, Verona, Italy
| | - Martina Furegato
- CReMPE - Regional Coordination Centre for European Project Management Veneto Region - Department of Health, Verona University Hospital, Verona, Italy
| | - Michele Breveglieri
- CReMPE - Regional Coordination Centre for European Project Management Veneto Region - Department of Health, Verona University Hospital, Verona, Italy
| | - Cinta Folch
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Danica Staneková
- NRC for HIV/AIDS, Slovak Medical University, Bratislava, Slovak Republic
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12
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Socio-demographic Characteristics, Sexual and Test-Seeking Behaviours Amongst Men Who have Sex with Both Men and Women: Results from a Bio-behavioural Survey in 13 European Cities. AIDS Behav 2017. [PMID: 28643241 DOI: 10.1007/s10461-017-1831-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Within the MSM population, men who have sex with both men and women (MSMW) are identified as a high-risk group both worldwide and in Europe. In a multi-centred bio-behavioural cross-sectional study, we aimed to assess the relationship(s) between socio-demographic factors, stigma, sexual behavioural patterns, test seeking behaviour and sero-status amongst MSMW. A multi-level analysis was conducted to identify factors associated with being MSMW versus Men who have Sex with Men Only (MSMO). A total of 4901 MSM were enrolled across the 13 study sites. Participants were categorised as MSMW in the 12.64% of the cases. Factors such as educational status, perceived homonegativity, testing facilities knowledge and HIV testing lifetime seem to be relevant factors when characterising the MSMW group. The results highlight the vulnerability of MSMW and the wide spectrum of risky behavioural and psycho-social patterns, particularly in terms of HIV testing, 'outness', and perceived stigma.
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Gama A, Martins MO, Dias S. HIV Research with Men who Have Sex with Men (MSM): Advantages and Challenges of Different Methods for Most Appropriately Targeting a Key Population. AIMS Public Health 2017; 4:221-239. [PMID: 29546214 PMCID: PMC5690451 DOI: 10.3934/publichealth.2017.3.221] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 05/16/2017] [Indexed: 12/27/2022] Open
Abstract
The difficulty in accessing hard-to-reach populations as men who have sex with men presents a dilemma for HIV surveillance as their omission from surveillance systems leaves significant gaps in our understanding of HIV/AIDS epidemics. Several methods for recruiting difficult-to-access populations and collecting data on trends of HIV prevalence and behavioural factors for surveillance and research purposes have emerged. This paper aims to critically review different sampling approaches, from chain-referral and venue-based to respondent-driven, time-location and internet sampling methods, focusing on its main advantages and challenges for conducting HIV research among key populations, such as men who have sex with men. The benefits of using these approaches to recruit participants must be weighed against privacy concerns inherent in any social situation or health condition. Nevertheless, the methods discussed in this paper represent some of the best efforts to effectively reach most-at-risk subgroups of men who have sex with men, contributing to obtain unbiased trends of HIV prevalence and HIV-related risk behaviours among this population group.
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Affiliation(s)
- Ana Gama
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisboa, Portugal
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Gama A, Abecasis A, Pingarilho M, Mendão L, Martins MO, Barros H, Dias S. Cruising Venues as a Context for HIV Risky Behavior Among Men Who Have Sex With Men. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1061-1068. [PMID: 26987977 DOI: 10.1007/s10508-016-0707-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/01/2015] [Accepted: 02/05/2016] [Indexed: 06/05/2023]
Abstract
We examined differences in sexual risk behaviors, HIV prevalence, and demographic characteristics between men who have sex with men (MSM) who visit different types of venues to meet sexual partners, and identified correlates of high-risk behaviors. A cross-sectional behavioral survey was conducted with a venue-based sample of 1011 MSM in Portugal. Overall, 36.3 % of MSM usually visit cruising venues to meet sexual partners (63.7 % only visit social gay venues). Cruising venues' visitors reported higher HIV prevalence (14.6 % [95 % CI 11-18 %] vs. 5.5 % [95 % CI 4-7 %]). Visiting cruising venues was more likely among those older, reporting high number of male sexual partners, group sex, and unprotected anal sex with a partner whose HIV status was unknown. Cruising venues play an important role in increasing risk of HIV transmission among MSM who frequent them. Venue-focused behavioral interventions that promote healthy sexual behaviors are needed.
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Affiliation(s)
- Ana Gama
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, n. 100, 1349-008, Lisbon, Portugal.
| | - Ana Abecasis
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, n. 100, 1349-008, Lisbon, Portugal
| | - Marta Pingarilho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, n. 100, 1349-008, Lisbon, Portugal
| | - Luís Mendão
- Grupo Português de Ativistas sobre Tratamentos de VIH/SIDA, Lisbon, Portugal
| | - Maria O Martins
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, n. 100, 1349-008, Lisbon, Portugal
| | - Henrique Barros
- Institute of Public Health of University of Porto, University of Porto Medical School, Porto, Portugal
| | - Sónia Dias
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, n. 100, 1349-008, Lisbon, Portugal
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Gios L, Mirandola M, Toskin I, Marcus U, Dudareva-Vizule S, Sherriff N, Breveglieri M, Furegato M, Folch C, Ferrer L, Montoliu A, Nöstlinger C, Vanden Berghe W, Kühlmann-Berenzon S, Velicko I, Dias S, Suligoi B, Regine V, Stanekova D, Rosińska M, Caplinskas S, Klavs I, Alexiev I, Rafila A. Bio-behavioural HIV and STI surveillance among men who have sex with men in Europe: the Sialon II protocols. BMC Public Health 2016; 16:212. [PMID: 26935752 PMCID: PMC4776381 DOI: 10.1186/s12889-016-2783-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/26/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Globally, the HIV epidemic continues to represent a pressing public health issue in Europe and elsewhere. There is an emerging and progressively urgent need to harmonise HIV and STI behavioural surveillance among MSM across European countries through the adoption of common indicators, as well as the development of trend analysis in order to monitor the HIV-STI epidemic over time. The Sialon II project protocols have been elaborated for the purpose of implementing a large-scale bio-behavioural survey among MSM in Europe in line with a Second Generation Surveillance System (SGSS) approach. METHODS/DESIGN Sialon II is a multi-centre biological and behavioural cross-sectional survey carried out across 13 European countries (Belgium, Bulgaria, Germany, Italy, Lithuania, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and the UK) in community settings. A total of 4,966 MSM were enrolled in the study (3,661 participants in the TLS survey, 1,305 participants in the RDS survey). Three distinct components are foreseen in the study protocols: first, a preliminary formative research in each participating country. Second, collection of primary data using two sampling methods designed specifically for 'hard-to-reach' populations, namely Time Location Sampling (TLS) and Respondent Driven Sampling (RDS). Third, implementation of a targeted HIV/STI prevention campaign in the broader context of the data collection. DISCUSSION Through the implementation of combined and targeted prevention complemented by meaningful surveillance among MSM, Sialon II represents a unique opportunity to pilot a bio-behavioural survey in community settings in line with the SGSS approach in a large number of EU countries. Data generated through this survey will not only provide a valuable snapshot of the HIV epidemic in MSM but will also offer an important trend analysis of the epidemiology of HIV and other STIs over time across Europe. Therefore, the Sialon II protocol and findings are likely to contribute significantly to increasing the comparability of data in EU countries through the use of common indicators and in contributing to the development of effective public health strategies and policies in areas of high need.
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Affiliation(s)
- Lorenzo Gios
- Veneto Region - Department of Health, CReMPE - Regional Coordination Centre for European Project Management, the Verona University Hospital, Verona, Italy.
| | - Massimo Mirandola
- Veneto Region - Department of Health, CReMPE - Regional Coordination Centre for European Project Management, the Verona University Hospital, Verona, Italy. .,Department of Pathology, Infectious Diseases Section, the Verona University Hospital - Veneto Region, Verona, Italy.
| | - Igor Toskin
- Department of Reproductive Health & Research, World Health Organization, Geneva, Switzerland.
| | - Ulrich Marcus
- Department for Infectious Diseases Epidemiology, Robert Koch-Institute, Berlin, Germany.
| | - Sandra Dudareva-Vizule
- Department for Infectious Diseases Epidemiology, Robert Koch-Institute, Berlin, Germany.
| | - Nigel Sherriff
- Centre for Health Research, University of Brighton, Brighton, UK.
| | - Michele Breveglieri
- Veneto Region - Department of Health, CReMPE - Regional Coordination Centre for European Project Management, the Verona University Hospital, Verona, Italy.
| | - Martina Furegato
- Veneto Region - Department of Health, CReMPE - Regional Coordination Centre for European Project Management, the Verona University Hospital, Verona, Italy.
| | - Cinta Folch
- Institut Catala d'Oncologia (ICO), Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
| | - Laia Ferrer
- Institut Catala d'Oncologia (ICO), Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
| | - Alexandra Montoliu
- Institut Catala d'Oncologia (ICO), Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
| | | | - Wim Vanden Berghe
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | | | - Inga Velicko
- Department of Monitoring and Evaluation, Public Health Agency of Sweden, Solna, Sweden.
| | - Sónia Dias
- Institute of Hygiene and Tropical Medicine & GHTM, Universidade Nova de Lisboa, Lisbon, Portugal.
| | - Barbara Suligoi
- Centro Operativo AIDS, Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy.
| | - Vincenza Regine
- Centro Operativo AIDS, Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy.
| | - Danica Stanekova
- NRC for HIV/AIDS, Slovak Medical University, Bratislava, Slovak Republic.
| | - Magdalena Rosińska
- Department of Epidemiology, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland.
| | | | - Irena Klavs
- National Institute of Public Health, Ljubljana, Slovenia.
| | - Ivailo Alexiev
- National Reference Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria.
| | - Alexandru Rafila
- National Institute of Infectious Diseases Prof. Dr. Matei Bals, Bucharest, Romania
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Martí-Pastor M, García de Olalla P, Barberá MJ, Manzardo C, Ocaña I, Knobel H, Gurguí M, Humet V, Vall M, Ribera E, Villar J, Martín G, Sambeat MA, Marco A, Vives A, Alsina M, Miró JM, Caylà JA. Epidemiology of infections by HIV, Syphilis, Gonorrhea and Lymphogranuloma Venereum in Barcelona City: a population-based incidence study. BMC Public Health 2015; 15:1015. [PMID: 26438040 PMCID: PMC4594901 DOI: 10.1186/s12889-015-2344-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 09/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the evolution of HIV infection, gonorrhea, syphilis and lymphogranuloma venereum (LGV), and their epidemiological characteristics in Barcelona city. METHODS Population-based incidence study of all newly occurring diagnoses of HIV infection, syphilis, gonorrhea and LGV detected in Barcelona between January 2007 and December 2011. A descriptive analysis was performed. The annual incidence rates per 100,000 inhabitants were calculated by sex, sexual conduct and educational level. To estimate global sex-specific rates we used the Barcelona city census; for the calculation of rates by sexual conduct and educational level we used estimates of the Barcelona Health Interview Survey. Trends were analysed using the chi-squared test for linear trend. RESULTS HIV. 66.8 % of the HIV cases were men who had sex with men (MSM). The incidence rates in MSM over the study period were from 692.67/100,000 to 909.88/100,000 inh. Syphilis. 74.2 % of the syphilis cases were MSM. The incidence rates in MSM were from 224.9/100,000 to 891.97/100,000 inh. and the MSM with a university education ranged from 196.3/100,000 to 1020.8/100,000. Gonorrhea. 45.5 % of the gonorrhea cases were MSM. The incidence rates in MSM were from 164.24/100,000 to 404.79/100,000 inh. and the MSM with university education ranged from 176.7/100,000 to 530.1/100,000 inh.. Lymphogranuloma venereum (LGV). 95.3 % of the LGV cases are MSM. The incidence rates in MSM were from 24.99/100,000 to 282.99/100,000 inh. and the MSM with university education ranged from 9.3/100,000 to 265/100,000 inh. CONCLUSION An increase in cases of STI was observed. These STI mainly affected MSM with a university education. Continuing to monitor changes in the epidemiology of STI, and identifying the most affected groups should permit redesigning preventive programs, with the goal of finding the most efficient way to reach these population groups.
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Affiliation(s)
- Marc Martí-Pastor
- Epidemiology Service, Agencia de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain.
- Teaching Unit of Preventive Medicine and Public Health, PSMAR-UPF-ASPB, Barcelona, Spain.
| | - Patricia García de Olalla
- Epidemiology Service, Agencia de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain.
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - Maria-Jesús Barberá
- Infectious Diseases, Hospital Vall de Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | | | - Inma Ocaña
- Infectious Diseases, Hospital Vall de Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | | | - Mercè Gurguí
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Victoria Humet
- Departament de Justicia, Direcció General de Serveis Penitenciaris i de Rehabilitació, Barcelona, Spain.
| | - Martí Vall
- Infectious Diseases, Hospital Vall de Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Esteban Ribera
- Infectious Diseases, Hospital Vall de Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Judit Villar
- Infectious Diseases, Hospital del Mar, Barcelona, Spain.
| | - Gemma Martín
- Infectious Diseases, Hospital del Mar, Barcelona, Spain.
| | - Maria A Sambeat
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Andres Marco
- Departament de Justicia, Direcció General de Serveis Penitenciaris i de Rehabilitació, Barcelona, Spain.
| | | | - Mercè Alsina
- Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
| | - Josep M Miró
- Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
| | - Joan A Caylà
- Epidemiology Service, Agencia de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain.
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
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Staneková D, Kramárová P, Wimmerová S, Hábeková M, Takáčová M, Mojzesová M. HIV and risk behaviour among men who have sex with men in Slovakia (2008-2009). Cent Eur J Public Health 2015; 22:239-44. [PMID: 25622481 DOI: 10.21101/cejph.a3914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The HIV infection remains a major public health issue in the world and especially in those countries where there exists unprotected sexual intercourse between people of the same sex. It is namely the category of men having sex with men (MSM) that still represents a group at high risk of being infected with HIV or transmitting the virus. The aim of our study was to present HIV 2nd generation surveillance data on MSM in Slovakia in the period between the years 2008 and 2009. Time-location sampling (TLS) was used to recruit participants and oral fluid samples together with completed anonymous questionnaires were collected simultaneously. The oral fluids were tested with use of the Genscreen HIV ½ version 2, (Bio-Rad) and Western Blot (Genlabs) diagnostic kits. The data analysis was performed using Stata version 8. Saliva testing revealed HIV prevalence of 6.1% (21/349) among MSM in Slovakia. 75% of HIV-positive cases were undiagnosed. The high-risk behaviour of MSM in respect to the number of their sexual partners as well as drug and condom usage did not correspond with their relatively high knowledge about HIV/AIDS. People's attitude towards MSM was found to be the worst in the religious context. Though our results reflect a relative good knowledge of MSM about HIV/AIDS infection, new HIV-positive cases and high-risk behaviour still appear, suggesting the need for more effective HIV prevention among members of this high-risk group in Slovakia.
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Risk factors associated with HIV infection among male homosexuals and bisexuals followed in an open cohort study: Project Horizonte, Brazil (1994-2010). PLoS One 2014; 9:e109390. [PMID: 25279670 PMCID: PMC4184869 DOI: 10.1371/journal.pone.0109390] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 09/10/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There has recently been an increase in HIV infection rates among men who have sex with men (MSM). This study aimed at investigating risk factors associated with incident HIV infection in a MSM cohort-Project Horizonte, Belo Horizonte, Minas Gerais, Brazil. METHODOLOGY This is a nested case-control study in an ongoing open cohort of homosexual and bisexual men, carried out in 1994-2010, during which 1,085 volunteers were enrolled. Each HIV seroconverted volunteer (case) was compared with three randomly selected HIV negative controls, matched by admission date and age (±3 years). During follow-up, 93 volunteers seroconverted and were compared with 279 controls. PRINCIPAL FINDINGS The risk factors associated with HIV seroconversion were: contact with partner's blood during sexual relations (OR 3.7; 95% CI 1.2-11.6), attendance at gay saunas in search for sexual partners (OR 2.6; 95% CI 1.3-5.4), occasional intake of alcohol when flirting and engaging in sexual activity (OR 2.5; 95% CI 1.3-5.1), inconsistent use of condoms in receptive anal sex (OR 2.4; 95% CI 1.1-5.4), little interest to look up information about AIDS (OR 2.6; 95% CI 1.0-6.7) particularly in newspapers (OR 3.4; 95% CI 1.4-8.1). CONCLUSIONS This study shows that MSM are still engaging in risk behavior, such as unprotected anal intercourse, despite taking part in a cohort study on various preventive measures. New preventive strategies in touch with the epidemic's development and the specificities of this particular population are needed.
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Pylli M, Middleton N, Charalambous A, Raftopoulos V. HIV prevalence, sexual and HIV testing behaviors among men who have sex with men in the Republic of Cyprus: 2011-2012 data from a cross-sectional study. BMC Infect Dis 2014; 14:432. [PMID: 25100634 PMCID: PMC4131022 DOI: 10.1186/1471-2334-14-432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 07/25/2014] [Indexed: 11/22/2022] Open
Abstract
Background The Republic of Cyprus is recognized as a low level HIV epidemic country with strong evidence of an increase in the transmission through the male to male sexual contact. Little is known about the factors that influence the sexual and HIV testing behavior in the Republic of Cyprus. Methods This is the first bio-behavioral study among men who have sex with men (MSM) in three major cities in the Republic of Cyprus, conducted between 2011 and 2012. Eligible participants were sampled in gay venues by using time-location sampling. Results Estimated HIV prevalence was 2.5%. The mean age of the sample was 29 ± 6.6 years old. One out of three MSM has not been tested for HIV in the last year. Multivariate logistic regression analysis revealed that the educational level (AOR 0.23, 95% CI 0.09-0.55), the cocaine use (AOR 3.78, 95% CI 1.21-11.83) as well as the type of sexual partner i.e. steady vs casual (AOR 0.18, 95% 0.08-0.45) were significantly associated with condom use in the last anal intercourse. Conclusions HIV prevalence among MSM in the Republic of Cyprus remains low; however more efforts are needed in order to increase HIV awareness and prevent the expansion of HIV epidemic in broader community.
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Affiliation(s)
| | | | | | - Vasilios Raftopoulos
- Cyprus University of Technology, Nursing Department, Mediterranean Research Centre for Public Health and Quality of Care, 15, Vragadinou Str, 3041 Limassol, Cyprus.
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Estimates of the number of people living with HIV in Italy. BIOMED RESEARCH INTERNATIONAL 2014; 2014:209619. [PMID: 25136562 PMCID: PMC4124713 DOI: 10.1155/2014/209619] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 06/15/2014] [Indexed: 12/03/2022]
Abstract
Objective. To estimate the HIV prevalence and the number of people living with HIV (PLHIV) in Italy with a projection for 2020. Methods. Two methods elaborated by Joint United Nations Programme on HIV/AIDS (UNAIDS) were used: Estimate and Projection Package and Spectrum.
Results. A total of 123,000 (115,000–145,000) individuals aged 15 or more were estimated to be living with HIV in Italy at the end of 2012 and the estimated HIV prevalence was 0.28 (0.24–0.32) per 100 residents aged 15 or more. In 2012, the estimated number of new HIV infections among adults was 3,000 (2,700–4,000), and the number of adults in need for ART was 93,000 (80,000–110,000). The projection estimates that 130,000 (110,000–150,000) adults will live with HIV/AIDS in 2020 in Italy. Conclusion. Estimates of PLHIV in Italy stress the high number of PLHIV in need of care and treatment, as well as the need for more information and prevention campaigns.
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Vanden Berghe W, Nöstlinger C, Hospers H, Laga M. International mobility, sexual behaviour and HIV-related characteristics of men who have sex with men residing in Belgium. BMC Public Health 2013; 13:968. [PMID: 24139406 PMCID: PMC3853336 DOI: 10.1186/1471-2458-13-968] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 10/01/2013] [Indexed: 11/10/2022] Open
Abstract
Background European men who have sex with men (MSM) continue to be disproportionally affected by the human immunodeficiency virus (HIV). Several factors are contributing to the rates of new HIV infections among MSM. The aim of this study was to investigate the potential role of travel behaviour and sexual mobility in the spread of HIV and sexually transmitted infections (STI) among European MSM. Methods Belgian data from the first pan-European MSM internet survey EMIS was used (n=3860) to explore individual and contextual determinants of sexual behaviour among MSM, who resided in Belgium at the time of data collection and who reported having had sexual contact abroad in the last 12 months. Descriptive and bivariate analyses were performed. Odds ratios and 95% confidence intervals were calculated by means of logistic regression. Results MSM who practiced unprotected anal intercourse UAI during their last sexual encounter abroad were less likely to be living in a large city (OR:0.62, 95% CI:0.45-0,86, p<0.01) and more likely to be HIV positive (OR:6.20, 95% CI:4.23-9.06, p<0.001) ), to have tested HIV positive in the last 12 months (OR:3.07, 95% CI:1.07-8.80, p<0.05), to have been diagnosed with any STI in the last 12 months (OR:2.55; 95% CI:1.77-3.67, p<0.05), to have used party drugs (OR:2.22, 95% CI:1.59-3.09, p<0.001), poppers (OR:1.52, 95% CI:1.07-2.14, p<0.001) and erection enhancing substances (OR:2.23, 95% CI:1.61-3.09, p<0.001) compared to MSM who did not have UAI with their last sexual partner abroad. Men having had UAI in the last 12 months were more likely to have done so in a neighbouring country of Belgium (OR:1.66, 95% CI:1.21-2.29, p<0.001). Different sexual behavioural patterns related to condom use and drug use were identified according to HIV test status among travelling men. Conclusions The results of this study provide evidence for the role of international mobility and sexual behavior while travelling, in the spread of HIV and STI among MSM in Europe. Further, the findings underline the need for development of European cross-border HIV and STI interventions with coherent messages and prevention policies for MSM.
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Affiliation(s)
- Wim Vanden Berghe
- Department of Public Health, Institute of Tropical Medicine HIV/AIDS Center (IHAC), Antwerp, Belgium.
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22
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Meulbroek M, Ditzel E, Saz J, Taboada H, Pérez F, Pérez A, Carrillo A, Font G, Marazzi G, Uya J, Cabrero J, Ingrami M, Marín R, Coll J, Pujol F. BCN Checkpoint, a community-based centre for men who have sex with men in Barcelona, Catalonia, Spain, shows high efficiency in HIV detection and linkage to care. HIV Med 2013; 14 Suppl 3:25-8. [DOI: 10.1111/hiv.12054] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2013] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - J Saz
- Projecte dels NOMS-Hispanosida
| | | | - F Pérez
- Projecte dels NOMS-Hispanosida
| | - A Pérez
- Projecte dels NOMS-Hispanosida
| | | | - G Font
- BCN Checkpoint; Barcelona; Spain
| | | | - J Uya
- BCN Checkpoint; Barcelona; Spain
| | | | | | - R Marín
- BCN Checkpoint; Barcelona; Spain
| | - J Coll
- BCN Checkpoint; Barcelona; Spain
| | - F Pujol
- Projecte dels NOMS-Hispanosida
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Bozicevic I, Handanagic S, Lepej SZ, Begovac J. The emerging and re-emerging human immunodeficiency virus epidemics in Europe. Clin Microbiol Infect 2013; 19:917-29. [PMID: 24205884 DOI: 10.1111/1469-0691.12313] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We provide a summary of the current status of the human immunodeficiency virus (HIV) epidemic, including data on the transmission of drug-resistant virus in the European Region of the WHO. The review was conducted by searching the reports of the European Centre for Disease Prevention and Control and the United Nations General Assembly Special Session country reports to identify the number of HIV cases reported in 2002-2011, the number of HIV tests performed, and the results of the most recent HIV surveys in at-risk groups. In the West, a 5-year linear trend analysis suggests an increase in the number of reported HIV cases in Belgium, Greece, and Iceland, and a decline in The Netherlands, Ireland, Portugal, Switzerland, and the UK. In the Centre, the number of reported cases increased in Bulgaria and Turkey, and in the East, the number of reported cases increased in Armenia, Georgia, and Ukraine. Estonia and Latvia reported a significant downward trend. HIV transmission in men who have sex with men (MSM) and heterosexual transmission accounted for, respectively, 40% and 38% of newly reported HIV cases in the West in 2011, whereas the epidemic in the Centre is predominantly concentrated in MSM. Although injection drug use remains the key driving force of the epidemic in the East, there is increasing evidence of sexual transmission from the core groups of injection drug users, and increasing spread within MSM. The pattern of transmitted drug resistance (TDR) is heterogeneous accross Europe; a significant number of clusters of TDR have been recently observed in several European countries.
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Affiliation(s)
- I Bozicevic
- WHO Collaborating Centre for HIV Surveillance, University of Zagreb School of Medicine, Zagreb, Croatia
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Changing blood donor screening criteria from permanent deferral for men who have sex with men to individual sexual risk assessment: no evidence of a significant impact on the human immunodeficiency virus epidemic in Italy. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 11:441-8. [PMID: 23867178 DOI: 10.2450/2013.0162-12] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 04/30/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND In 2001, the criteria for blood donor eligibility in Italy were modified by a ministerial decree from a permanent deferral for "men who have sex with men" to an individual risk assessment of sexual behaviours. The aim of this study was to evaluate the impact of this change in donor screening criteria on the human immunodeficiency virus epidemic among blood donors in Italy. MATERIALS AND METHODS We used the data obtained from the Italian blood donor epidemiological surveillance system. We compared data collected in 2009 and 2010, when the individual risk assessment policy was applied, with data collected in 1999 when permanent deferral was applied for men who have sex with men based on a declaration of sexual orientation. We evaluated the change over time in the relative proportion of HIV antibody-positive donors who likely acquired the infection from men who have sex with men vs heterosexual sexual exposure; the relative risk was calculated using 1999 as the reference year. RESULTS In all 3 years, the majority of HIV antibody-positive donors reported sexual exposure as a risk factor for HIV infection; this proportion increased over time, although not statistically significantly. Heterosexuals always accounted for at least 40% of all HIV antibody-positive cases. The rate of HIV antibody-positive donors increased similarly in men who have sex with men and heterosexuals; specifically, the rate of HIV antibody-positive cases per 100,000 donors was more than 2-fold higher among men who have sex with men in 2009-2010 than in 1999 (2009-2010 vs 1999, RR =2.8; P =0.06), and that among heterosexuals was 1.5 fold higher (P =0.18). DISCUSSION When comparing the period before (1999) and after (2009-2010), the implementation of the individual risk assessment policy in 2001, no significant increase in the proportion of men who have sex with men compared to heterosexuals was observed among HIV antibody-positive blood donors, suggesting that the change in donor deferral policy did not lead to a disproportionate increase of HIV-seropositive men who have sex with men.
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HIV prevalence and sexual risk behaviors associated with awareness of HIV status among men who have sex with men in Paris, France. AIDS Behav 2013; 17:1266-78. [PMID: 22968398 DOI: 10.1007/s10461-012-0303-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A cross-sectional survey, using self-sampled finger-prick blood on blotting paper and anonymous behavioral self-administrated questionnaires was conducted in Paris in 2009 among MSM attending gay venues. Paired biological results and questionnaires were available for 886 participants. HIV seroprevalence was 17.7 % (95 % CI: 15.3-20.4). Four groups were identified according to their knowledge of their HIV biological status. Among the 157 found to be seropositive, 31 (19.7 %) were unaware of their status and reported high levels of sexual risk behaviors and frequent HIV testing in the previous 12 months. Among the 729 MSM diagnosed HIV-negative, 183 were no longer sure whether they were still HIV-negative, or had never been tested despite the fact that they engaged in at-risk sexual behaviors. This study provides the first estimate of HIV seroprevalence among MSM in Paris and underlines the specific need for combined prevention of HIV infection in this MSM population.
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Marcus U, Hickson F, Weatherburn P, Schmidt AJ. Prevalence of HIV among MSM in Europe: comparison of self-reported diagnoses from a large scale internet survey and existing national estimates. BMC Public Health 2012; 12:978. [PMID: 23151263 PMCID: PMC3526585 DOI: 10.1186/1471-2458-12-978] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 10/19/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Country level comparisons of HIV prevalence among men having sex with men (MSM) is challenging for a variety of reasons, including differences in the definition and measurement of the denominator group, recruitment strategies and the HIV detection methods. To assess their comparability, self-reported data on HIV diagnoses in a 2010 pan-European MSM internet survey (EMIS) were compared with pre-existing estimates of HIV prevalence in MSM from a variety of European countries. METHODS The first pan-European survey of MSM recruited more than 180,000 men from 38 countries across Europe and included questions on the year and result of last HIV test. HIV prevalence as measured in EMIS was compared with national estimates of HIV prevalence based on studies using biological measurements or modelling approaches to explore the degree of agreement between different methods. Existing estimates were taken from Dublin Declaration Monitoring Reports or UNAIDS country fact sheets, and were verified by contacting the nominated contact points for HIV surveillance in EU/EEA countries. RESULTS The EMIS self-reported measurements of HIV prevalence were strongly correlated with existing estimates based on biological measurement and modelling studies using surveillance data (R(2)=0.70 resp. 0.72). In most countries HIV positive MSM appeared disproportionately likely to participate in EMIS, and prevalences as measured in EMIS are approximately twice the estimates based on existing estimates. CONCLUSIONS Comparison of diagnosed HIV prevalence as measured in EMIS with pre-existing estimates based on biological measurements using varied sampling frames (e.g. Respondent Driven Sampling, Time and Location Sampling) demonstrates a high correlation and suggests similar selection biases from both types of studies. For comparison with modelled estimates the self-selection bias of the Internet survey with increased participation of men diagnosed with HIV has to be taken into account. For most countries self-reported EMIS prevalence is higher than measured prevalence, which is likely due to a combination of different time points of measurement, measurement errors for small sample sizes, different sampling methods, and an indicator-inherent overestimate of prevalence among the untested fraction of MSM.
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Affiliation(s)
- Ulrich Marcus
- Department of Infectious Disease Epidemiology, Robert Koch Institute, P.O. Box 650261, Berlin 13302, Germany.
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Pedrana AE, Hellard ME, Guy R, Wilson K, Stoove M. The difference in self-reported and biological measured HIV prevalence: implications for HIV prevention. AIDS Behav 2012; 16:1454-63. [PMID: 22205325 DOI: 10.1007/s10461-011-0116-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In Australia, HIV prevalence estimates among gay men have been mainly based on self-reported HIV status collected in annual behavioural surveys. We measured biological HIV prevalence among gay men in Melbourne, Australia, using a facility based sampling method. We calculated HIV prevalence and used logistic regression to assess correlates of a positive HIV test. A total of 639 gay men were recruited completed a survey and provided oral fluid for HIV testing from seven venues in 2008. The median age of the participants was 35 years (range 18-75 years). Overall biological HIV prevalence was 9.5% (95% CI 7.5-12.0%) compared with 6.3% (95% CI 4.5-8.4%) for self-reported HIV positive status. We found a significant discrepancy between test detected biological and self-report HIV status in our study, with 19 men (31.1%) unaware of their HIV infection. These results highlight the importance of repeatable biological estimates to inform and evaluate HIV prevention strategies.
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Affiliation(s)
- Alisa E Pedrana
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.
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Fernández de Mosteyrín S, Acebrón V, Fernández Guerrero ML. Las conmemoraciones del sida: oportunidades perdidas. Enferm Infecc Microbiol Clin 2012; 30:49-51. [DOI: 10.1016/j.eimc.2011.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 07/26/2011] [Accepted: 08/04/2011] [Indexed: 10/15/2022]
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Bozicevic I, Begovac J. The emerging HIV epidemic among men who have sex with men in southeastern Europe. Expert Rev Anti Infect Ther 2011; 8:1351-8. [PMID: 21133661 DOI: 10.1586/eri.10.131] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Patterns of HIV transmission in the seven countries of southeastern Europe (Albania, Bosnia and Herzegovina, Croatia, Montenegro, former Yugoslav Republic of Macedonia, Serbia and Slovenia) indicate that men who have sex with men (MSM) bear the highest burden of HIV. In 2008, MSM represented 56% of all HIV cases reported in Serbia, and 71 and 76% in Slovenia and Croatia, respectively. In other countries the number of reported HIV cases attributed to MSM remains low, which is likely due to under reporting. HIV prevalence measured in surveys was the highest among MSM compared with other at-risk groups, ranging from 0.7% in Bosnia and Herzegovina to 6.1% in Serbia. Data on sexual behaviors and HIV testing uptake indicate an urgent need to increase coverage with prevention services.
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Affiliation(s)
- Ivana Bozicevic
- WHO Collaborating Centre for Capacity Development in HIV Surveillance, Andrija Stampar School of Public Health, School of Medicine, Rockefellerova 4, 10000 Zagreb, Croatia
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