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Waetjen M, Papadopoulou M, Flores R, Sypsa V, Roussos S, Chanos S, Dedes N, Liao C, Paraskevis D, Hatzakis A, Schneider J, Psichogiou M. Pre-exposure Prophylaxis Persistence Among Greek Sexual Minority Men: Results from PrEP for Greece (P4G) Study. AIDS Behav 2022; 26:1039-1046. [PMID: 34494178 DOI: 10.1007/s10461-021-03459-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 01/24/2023]
Abstract
Nearly half the new HIV infections in Greece occur in sexual minority men, yet pre-exposure prophylaxis is not currently supported in the national HIV program. We examined factors associated with PrEP persistence among Greek SMM in PrEP for Greece, the first PrEP study in Greece. Participants (n = 100) were recruited from 2016 to 2018 through respondent-driven sampling among SMM in Athens, receiving supplies for daily PrEP at interval visits over 12-months. PrEP persistence, operationalized as Total PrEP Time, was high, 74% of participants achieving perfect persistence. Higher alcohol risk scores (OR 1.27, 95% CI 1.08-1.49) and adherence to HIV testing guidelines (OR 1.23, 95% CI 1.00-1.51) were associated with persistence. Housing impermanence (OR 0.14, 95% CI 0.04-0.48) and serostatus disclosure concerns (OR 0.77, 95% CI 0.60-0.97) were associated with limited PrEP persistence. While PrEP persistence among Greek SMM is high, socioeconomic factors and societal attitudes may challenge prevention efforts.
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2
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Bowman B, Psichogyiou M, Papadopoulou M, Sypsa V, Khanna A, Paraskevis D, Chanos S, Friedman SR, Hatzakis A, Schneider J. Sexual Mixing and HIV Transmission Potential Among Greek Men Who have Sex with Men: Results from SOPHOCLES. AIDS Behav 2021; 25:1935-1945. [PMID: 33555414 PMCID: PMC8081711 DOI: 10.1007/s10461-020-03123-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 11/29/2022]
Abstract
HIV incidence among men who have sex with men (MSM) in Greece remains unchanged despite effective response to a recent outbreak among people who inject drugs (PWID). Network factors are increasingly understood to drive transmission in epidemics. The primary objective of the study was to characterize MSM in Greece, their sexual behaviors, and sexual network mixing patterns. We investigated the relationship between serostatus, sexual behaviors, and self-reported sex networks in a sample of MSM in Athens, Greece, generated using respondent driven sampling. We estimated mixing coefficients (r) based on survey-generated egonets. Additionally, multiple logistic regression was used to estimate adjusted odds ratios (AOR) and to assess relationships between serostatus, sexual behaviors, and sociodemographic indicators. A sample of 1,520 MSM participants included study respondents (n = 308) and their network members (n = 1,212). Mixing based on serostatus (r = 0.12, σr = 0.09–0.15) and condomless sex (r = 0.11, σr = 0.07–0.14) was random. However, mixing based on sex-drug use was highly assortative (r = 0.37, σr = 0.32–0.42). This study represents the first analysis of Greek MSM sexual networks. Our findings highlight protective behavior in two distinct network typologies. The first typology mixed assortatively based on serostatus and sex-drug use and was less likely to engage in condomless sex. The second typology mixed randomly based on condomless sex but was less likely to engage in sex-drug use. These findings support the potential benefit of HIV prevention program scale-up for this population including but not limited to PrEP.
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Affiliation(s)
- Benjamin Bowman
- Pritzker School of Medicine, University of Chicago, Chicago, IL USA
| | - Mina Psichogyiou
- First Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Martha Papadopoulou
- Department of Hygiene, Epidemiology & Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Vana Sypsa
- First Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Aditya Khanna
- Department of Medicine, Infectious Diseases, University of Chicago, Chicago, IL USA
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology & Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Samuel R. Friedman
- Institute for Infectious Disease Research, National Development & Research Institutes, New York, NY USA
- Department of Population Health, New York University Langone Medical School, New York, NY USA
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology & Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - John Schneider
- Pritzker School of Medicine, University of Chicago, Chicago, IL USA
- Department of Medicine, Infectious Diseases, University of Chicago, Chicago, IL USA
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Hoyos J, Maté T, Guerras JM, Donat M, Agustí C, Kuske M, Fuertes R, Chanos S, Pichon F, Sordo L, Pulido J, Belza MJ. Preference towards HIV Self-Testing above Other Testing Options in a Sample of Men Who Have Sex with Men from Five European Countries. Int J Environ Res Public Health 2021; 18:ijerph18094804. [PMID: 33946300 PMCID: PMC8125199 DOI: 10.3390/ijerph18094804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 12/24/2022]
Abstract
We analyzed men who have sex with men (MSM) from Denmark, Germany, Greece, Portugal and Spain to identify who would choose HIV self-testing as their preferred testing method and assessed their preferred setting to acquire a self-testing kit and to confirm a reactive result. In 2016, we recruited an online sample of 3725 HIV-negative MSM. We used Poisson regression to identify factors associated with choosing self-testing as the preferred testing option. For those choosing it as their preferred option, we assessed the preferred settings to acquire a self-testing kit and to confirm a reactive result. Not being open about one's sexual behaviors with men was associated with choosing self-testing as the preferred option, except in Greece; older age in Greece and Spain; reporting condomless anal intercourses (CAI) in Germany and Portugal; reporting one previous test in Greece; between 2 and 5 in Spain and with having been tested ≥ 12 months ago in Germany, Portugal and Spain. The internet (32.8%) was the preferred place to acquire a self-testing kit and primary care (34.0%) for confirmation purposes. Self-testing was highly valued, especially among individuals who were not open about their sexual behaviors with men. In certain countries, it was also associated with older age, CAI and being undertested.
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Affiliation(s)
- Juan Hoyos
- Departamento de Salud Pública y Materno-Infantil, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.H.); (L.S.); (J.P.)
| | - Tomás Maté
- Gerencia de Atención Primaria de Valladolid Este, Gerencia Regional de Salud de Castilla y León (SACYL), 47010 Valladolid, Spain
- Correspondence:
| | - Juan-Miguel Guerras
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (J.-M.G.); (C.A.); (M.-J.B.)
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marta Donat
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Cristina Agustí
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (J.-M.G.); (C.A.); (M.-J.B.)
- Departament de Salut, Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, 08005 Badalona, Spain
| | | | - Ricardo Fuertes
- GAT-Grupo de Ativistas em Tratamentos, 1000-228 Lisboa, Portugal;
| | | | | | - Luis Sordo
- Departamento de Salud Pública y Materno-Infantil, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.H.); (L.S.); (J.P.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (J.-M.G.); (C.A.); (M.-J.B.)
| | - José Pulido
- Departamento de Salud Pública y Materno-Infantil, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.H.); (L.S.); (J.P.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (J.-M.G.); (C.A.); (M.-J.B.)
| | - María-José Belza
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (J.-M.G.); (C.A.); (M.-J.B.)
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, 28029 Madrid, Spain;
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Delabre RM, Bernier A, Sánchez F, Vilotitch A, Chanos S, Cosmaro ML, Langanke H, Mey C, James C, Duken SB, Schlegel V, Stranz R, Jonas KJ, Spire B, Rojas Castro D. "Yes, I'm interested in taking PrEP!": PrEP interest among women respondents to the European community-based survey "Flash! PrEP in Europe". PLoS One 2021; 16:e0246037. [PMID: 33596225 PMCID: PMC7888674 DOI: 10.1371/journal.pone.0246037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/12/2021] [Indexed: 01/29/2023] Open
Abstract
The World Health Organization recommends pre-exposure prophylaxis (PrEP) for all populations at substantial risk of HIV infection, including women. However, data regarding PrEP interest among women is lacking, particularly in Europe. Factors associated with interest in using PrEP were assessed among women respondents to the Flash! PrEP in Europe (FPIE) survey. This community-based cross-sectional study, conducted in 12 European countries, aimed to assess PrEP knowledge and interest. “High objective risk” (HOR) was assessed using established risk criteria following EACS and CDC guidelines. Factors associated with interest in using PrEP were assessed in univariable and multivariable logistic regression models. Among 678 women, 12.5% (n = 85) were considered at HOR, 46.8% (n = 317) indicated prior PrEP knowledge and 18.0% (n = 122) reported interest in using PrEP. Among women at HOR, 40.0% (n = 34) were interested in PrEP. Factors significantly associated with PrEP interest in the final multivariable model were: younger age (18–29 years) (aOR 1.91[95CI: 1.07; 3.41]), bad self-perceived financial status (1.84[1.09; 3.11]), migrant status (south to north) (2.87[1.05; 7.89]), single or dating relationship status (1.93[1.23; 3.03]), sexual abuse history (1.86[1.17; 2.97]), “rather high”/ “high” self-perceived HIV risk (3.21[1.32; 7.81]), and HOR (2.49[1.42; 4.35]). These results show that women at HOR and those who perceived themselves to be at high risk are interested in using PrEP. There is a critical need for targeted information and improved access to PrEP to increase uptake of this HIV prevention tool to meet PrEP interest among women.
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Affiliation(s)
- Rosemary M. Delabre
- Coalition PLUS, Community-Based Research Laboratory, Pantin, France
- * E-mail:
| | - Adeline Bernier
- Coalition PLUS, Community-Based Research Laboratory, Pantin, France
| | - Flor Sánchez
- Department of Social Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Antoine Vilotitch
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | | | | | - Harriet Langanke
- GSSG–Gemeinnützige Stiftung Sexualität und Gesundheit, Cologne, Germany
| | | | - Cary James
- Terrence Higgins Trust, London, United Kingdom
| | | | | | | | - Kai J. Jonas
- Maastricht University, Maastricht, The Netherlands
| | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- AIDES, Pantin, France
| | - Daniela Rojas Castro
- Coalition PLUS, Community-Based Research Laboratory, Pantin, France
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
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Guerras JM, Hoyos Miller J, Agustí C, Chanos S, Pichon F, Kuske M, Cigan B, Fuertes R, Stefanescu R, Ooms L, Casabona J, de la Fuente L, Belza MJ. Association of Sexualized Drug Use Patterns with HIV/STI Transmission Risk in an Internet Sample of Men Who Have Sex with Men from Seven European Countries. Arch Sex Behav 2021; 50:461-477. [PMID: 32875382 DOI: 10.1007/s10508-020-01801-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 06/11/2023]
Abstract
We estimated the prevalence of overall sexualized drug use (SDU) and of chemsex in particular, assessed patterns of drug use, and identified subpopulations of men who have sex with men (MSM) where SDU and chemsex are more frequent. Using data from an online survey of 9407 MSM recruited during 2016 in 7 European countries, we calculated the proportion of participants who reported SDU and chemsex (mephedrone, methamphetamine, and/or GHB/GBL) in the last 12 months. We grouped the different drug-use combinations in patterns and described sexual risk behaviors, sexually transmitted infections (STI), and HIV seropositivity for each one of them. Factors associated with SDU and chemsex were assessed with two logistic regression models. SDU was reported by 17.7% and chemsex by 5.2%. Risk indicators increased through the different SDU patterns but were higher within those including chemsex drugs. In the multivariate analysis, chemsex was independently associated with living in Slovenia. Both SDU and chemsex were independently associated with living in Spain; being < 50 years old; living in cities of > 500,000 inhabitants; being open about their sex life; reporting transactional sex; condomless anal intercourse; having received an STI diagnosis and with being HIV positive or having been tested ≤ 12 months ago. Magnitude of associations was higher in the chemsex model. One in five participants reported SDU, but prevalence of chemsex was notably lower. However, the risk profiles and higher prevalence of HIV/STIs among those involved in chemsex suggest the existence of a subpopulation of MSM that could be playing a relevant role in the HIV and STI epidemics, especially in very large cities of some countries.
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Affiliation(s)
- Juan-Miguel Guerras
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Hoyos Miller
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.
- Departamento de Salud Pública y Materno-Infantil, Universidad Complutense de Madrid, Madrid, Spain.
| | - Cristina Agustí
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Salut, Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Badalona, Spain
| | | | | | | | | | | | | | - Lieselot Ooms
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Jordi Casabona
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Salut, Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Badalona, Spain
| | - Luis de la Fuente
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - María-José Belza
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain
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6
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Maté T, Hoyos J, Guerras JM, Agustí C, Chanos S, Kuske M, Fuertes R, Stefanescu R, Pulido J, Sordo L, de la Fuente L, Belza MJ. Potential of HIV Self-Sampling to Increase Testing Frequency Among Gay, Bisexual, and Other Men Who Have Sex With Men, and the Role of Online Result Communication: Online Cross-Sectional Study. J Med Internet Res 2020; 22:e21268. [PMID: 33252346 PMCID: PMC7735895 DOI: 10.2196/21268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/28/2020] [Accepted: 10/13/2020] [Indexed: 11/13/2022] Open
Abstract
Background Late HIV diagnosis remains frequent among the gay, bisexual, and other men who have sex with men (GBMSM) population across Europe. HIV self-sampling could help remove barriers and facilitate access to testing for this high-risk population. Objective We assessed the capacity of HIV self-sampling to increase the testing frequency among GBMSM living in Denmark, Germany, Greece, Portugal, Romania, and Spain, and evaluated the role of new technologies in the result communication phase. Methods We analyzed a convenience sample of 5019 GBMSM with prior HIV testing experience who were recruited during 2016 through gay dating websites. We estimated the proportion of GBMSM who reported that the availability of self-sampling would result in an increase of their current testing frequency. We constructed a Poisson regression model for each country to calculate prevalence ratios and 95% CIs of factors associated with an increase of testing frequency as a result of self-sampling availability. Results Overall, 59% (between country range 54.2%-77.2%) of the participants considered that they would test more frequently for HIV if self-sampling was available in their country. In the multivariate analysis, the increase of testing frequency as a result of self-sampling availability was independently associated with reporting a higher number of unprotected anal intercourse events in all countries except for Greece. Independent associations were also observed among GBMSM who were not open about their sex life in Germany, Greece, Portugal, and Spain; those with a lower number of previous HIV tests in Denmark, Greece, Portugal, and Spain; and for those that took their last test more than 3 months previously in Germany, Portugal, Romania, and Spain. In addition, 58.4% (range 40.5%-73.6%) of the participants indicated a preference for learning their result through one-way interaction methods, mainly via email (25.6%, range 16.8%-35.2%) and through a secure website (20.3%, range 7.3%-23.7%). Almost two thirds (65%) of GBMSM indicated preferring one of these methods even if the result was reactive. Conclusions Availability of HIV self-sampling kits as an additional testing methodology would lead to a much-needed increase of testing frequency, especially for the hidden, high-risk, and undertested GBMSM population. Online-based technologies without any personal interaction were preferred for the communication of the results, even for reactive results.
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Affiliation(s)
- Tomás Maté
- Gerencia Regional de Salud de Castilla y León, Valladolid, Spain
| | - Juan Hoyos
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Departamento de Salud Pública y Materno-Infantil, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan Miguel Guerras
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Agustí
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Departament de Salut, Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Badalona, Spain
| | | | | | | | | | - Jose Pulido
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Departamento de Salud Pública y Materno-Infantil, Universidad Complutense de Madrid, Madrid, Spain
| | - Luis Sordo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Departamento de Salud Pública y Materno-Infantil, Universidad Complutense de Madrid, Madrid, Spain
| | - Luis de la Fuente
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - María José Belza
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain
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7
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Hoyos J, Maté T, Indave BI, Agustí C, Chanos S, Pichon F, Kuske M, Cigan B, Fuertes R, Ooms L, Stefanescu R, Cabeza de Vaca C, Arranz B, de la Fuente L, Belza MJ. Knowledge, actual and potential use of HIV self-sampling testing kits among MSM recruited in eight European countries. HIV Med 2019; 19 Suppl 1:27-33. [PMID: 29488699 DOI: 10.1111/hiv.12593] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 11/28/2022]
Abstract
AIM To describe the knowledge as well as current and potential use of self-sampling kits among men who have sex with men (MSM) and to analyse their preferred biological sample and result communication method. METHODS We analyse data of MSM of HIV negative or unknown serostatus from an online survey conducted in eight countries (Belgium, Denmark, Germany, Greece, Portugal, Romania, Slovenia and Spain) between April and December 2016. It was advertised mainly in gay dating websites. We conduct a descriptive analysis of the main characteristics of the participants, and present data on indicators of knowledge, use and potential use of HIV self-sampling as well as their preferences regarding blood or saliva sample and face or non-face-to-face result communication by country of residence. RESULTS A total of 8.226 participants of HIV negative or unknown serostatus were included in the analysis. Overall, 25.5% of participants knew about self-sampling (range: 18.8-47.2%) and 1.1% had used it in the past (range: 0.3-8.9%). Potential use was high, with 66.6% of all participants reporting that they would have already used it if available in the past (range: 62.1-82.1%). Most (78.6%) reported that they would prefer using a blood-based kit, and receiving the result of the test through a non-face-to-face-method (70.8%), even in the case of receiving a reactive result. CONCLUSION The high potential use reported by MSM recruited in eight different European countries suggests that self-sampling kits are a highly acceptable testing methodology that could contribute to the promotion of HIV testing in this population.
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Affiliation(s)
- J Hoyos
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain
| | - T Maté
- Primary Health Care Management of East Valladolid, Valladolid, Spain
| | - B I Indave
- Institute of Health Carlos III, Centro Nacional de Epidemiología, Madrid, Spain
| | - C Agustí
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Departament de Salut, Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Badalona, Spain
| | - S Chanos
- Checkpoint Athens, Athens, Greece
| | - F Pichon
- AIDS Fondet, Copenhaguen, Denmark
| | - M Kuske
- AIDS Hilfe NRW e.V., Berlin, Germany
| | - B Cigan
- Legebitra, Ljubljana, Slovenia
| | - R Fuertes
- GAT-Grupo de Ativistas em Tratamentos, Lisboa, Portugal
| | - L Ooms
- Institute of Tropical Medicine, Antwerp, Belgium
| | - R Stefanescu
- ARAS-Asociatia Romana Anti-SIDA, Bucharest, Romania
| | - C Cabeza de Vaca
- Institute of Health Carlos III, Escuela Nacional de Sanidad, Madrid, Spain
| | - B Arranz
- Institute of Health Carlos III, Centro Nacional de Epidemiología, Madrid, Spain
| | - L de la Fuente
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Institute of Health Carlos III, Centro Nacional de Epidemiología, Madrid, Spain
| | - M J Belza
- CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.,Institute of Health Carlos III, Escuela Nacional de Sanidad, Madrid, Spain
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8
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Nikolopoulos GK, Chanos S, Tsioptsias E, Hodges-Mameletzis I, Paraskeva D, Dedes N. HIV incidence among men who have sex with men at a community-based facility in Greece. Cent Eur J Public Health 2019; 27:54-57. [PMID: 30927398 DOI: 10.21101/cejph.a4856] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Men who have sex with men (MSM) are disproportionately affected by HIV in Greece. However, research on HIV incidence in this group is lacking. This study aimed at estimating HIV incidence among MSM in Athens, Greece. METHODS The analysis included routinely collected data between January 2013-June 2015 from adult MSM who visited a community-based facility (Ath Checkpoint) at least twice and were non-reactive to the rapid INSTITM HIV-1/HIV-2 assay at baseline. HIV conversion rates were calculated by dividing the number of clients who became reactive by the person-years of observation. All statistical analyses including Poisson regression models were conducted in STATA 14. RESULTS A total of 1,243 MSM contributed 1,102.50 person-years (py). The overall (per 100 py) conversion rate was 3.99 (95% CI: 2.97-5.36). In multivariable analyses, age less than 30 years was associated with an increased risk of HIV conversion (rate ratio: 2.01; 95% CI: 1.08-3.76). CONCLUSIONS This analysis shows high rates of HIV conversion among MSM who repeatedly visit a community-based testing site. Ath Checkpoint could contribute to HIV surveillance and identify a high-risk group that could benefit from essential health interventions.
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Affiliation(s)
| | | | | | | | - Dimitra Paraskeva
- Hellenic Centre for Disease Control and Prevention, Amarousio, Greece
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9
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Perelman J, Rosado R, Amri O, Morel S, Rojas Castro D, Chanos S, Cigan B, Lobnik M, Fuertes R, Pichon F, Kaye PS, Agustí C, Fernàndez-López L, Lorente N, Casabona J. Economic evaluation of HIV testing for men who have sex with men in community-based organizations - results from six European cities. AIDS Care 2016; 29:985-989. [PMID: 28027661 DOI: 10.1080/09540121.2016.1271392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The non-decreasing incidence of HIV among men who have sex with men (MSM) has motivated the emergence of Community Based Voluntary Counselling and Testing (CBVCT) services specifically addressed to MSM. The CBVCT services are characterized by facilitated access and linkage to care, a staff largely constituted by voluntary peers, and private not-for-profit structures outside the formal health system institutions. Encouraging results have been measured about their effectiveness, but these favourable results may have been obtained at high costs, questioning the opportunity to expand the experience. We performed an economic evaluation of HIV testing for MSM at CBVCT services, and compared them across six European cities. We collected retrospective data for six CBVCT services from six cities (Copenhagen, Paris, Lyon, Athens, Lisbon, and Ljubljana), for the year 2014, on the number of HIV tests and HIV reactive tests, and on all expenditures to perform the testing activities. The total costs of CBVCTs varied from 54,390€ per year (Ljubljana) to 245,803€ per year (Athens). The cost per HIV test varied from to 41€ (Athens) to 113€ (Ljubljana). The cost per HIV reactive test varied from 1966€ (Athens) to 9065€ (Ljubljana). Our results show that the benefits of CBVCT services are obtained at an acceptable cost, in comparison with the literature (values, mostly from the USA, range from 1600$ to 16,985$ per HIV reactive test in clinical and non-clinical settings). This result was transversal to several European cities, highlighting that there is a common CBVCT model, the cost of which is comparable regardless of the epidemiological context and prices. The CBVCT services represent an effective and "worth it" experience, to be continued and expanded in future public health strategies towards HIV.
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Affiliation(s)
- Julian Perelman
- a Escola Nacional de Saúde Pública , Universidade NOVA de Lisboa , Lisbon , Portugal.,b Centro de Investigação em Saúde Pública , Lisbon , Portugal
| | - Ricardo Rosado
- a Escola Nacional de Saúde Pública , Universidade NOVA de Lisboa , Lisbon , Portugal
| | | | | | | | | | - Bojan Cigan
- e Drustvo informacijski center Legebitra , Ljubljana , Slovenia
| | - Miha Lobnik
- e Drustvo informacijski center Legebitra , Ljubljana , Slovenia
| | | | | | | | - Cristina Agustí
- h Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT) , Departament de Salut, Generalitat de Catalunya , Badalona , Spain.,i Hospital Germans trias i Pujol , Barcelona , Spain.,j The Institute for Health Science Research Germans Trias i Pujol (IGTP) , Badalona , Spain.,k CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | - Laura Fernàndez-López
- h Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT) , Departament de Salut, Generalitat de Catalunya , Badalona , Spain.,i Hospital Germans trias i Pujol , Barcelona , Spain.,j The Institute for Health Science Research Germans Trias i Pujol (IGTP) , Badalona , Spain.,k CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | - Nicolas Lorente
- h Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT) , Departament de Salut, Generalitat de Catalunya , Badalona , Spain.,i Hospital Germans trias i Pujol , Barcelona , Spain.,j The Institute for Health Science Research Germans Trias i Pujol (IGTP) , Badalona , Spain
| | - Jordi Casabona
- h Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT) , Departament de Salut, Generalitat de Catalunya , Badalona , Spain.,i Hospital Germans trias i Pujol , Barcelona , Spain.,j The Institute for Health Science Research Germans Trias i Pujol (IGTP) , Badalona , Spain.,k CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
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Lorente N, Fernàndez-López L, Fuertes R, Rojas Castro D, Pichon F, Cigan B, Chanos S, Meireles P, Lucas R, Morel S, Slaaen Kaye P, Agustí C, Klavs I, Platteau T, Casabona J. COBA-Cohort: a prospective cohort of HIV-negative men who have sex with men, attending community-based HIV testing services in five European countries (a study protocol). BMJ Open 2016; 6:e011314. [PMID: 27412103 PMCID: PMC4947773 DOI: 10.1136/bmjopen-2016-011314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Community-based voluntary counselling and testing (CBVCT) services for men who have sex with men (MSM) can reach those most-at-risk and provide an environment for gay men that is likely to be non-stigmatising. Longitudinal data on the behaviour of HIV-negative MSM are scarce in Europe. The aim of this protocol, developed during the Euro HIV Early Diagnosis And Treatment (EDAT) project, is to implement a multicentre community-based cohort of HIV-negative MSM attending 15 CBVCT services in 5 European countries. RESEARCH OBJECTIVES (1) To describe the patterns of CBVCT use, (2) to estimate HIV incidence, and to identify determinants of (3) HIV seroconversion and (4) HIV and/or sexually transmitted infection (STI) test-seeking behaviour. METHODS AND ANALYSIS All MSM aged 18 years or over and who had a negative HIV test result are invited to participate in the COmmunity-BAsed Cohort (COBA-Cohort). Study enrolment started in February 2015, and is due to continue for at least 12 months at each study site. Follow-up frequency depends on the testing recommendations in each country (at least 1 test per year). Sociodemographic data are collected at baseline; baseline and follow-up questionnaires both gather data on attitudes and perceptions, discrimination, HIV/STI testing history, sexual behaviour, condom use, and pre- and post-exposure prophylaxis. Descriptive, exploratory and multivariate analyses will be performed to address the main research objectives of this study, using appropriate statistical tests and models. These analyses will be performed on the whole cohort data and stratified by study site or country. ETHICS AND DISSEMINATION The study was approved by the Public Health authorities of each country where the study is being implemented. Findings from the COBA-Cohort study will be summarised in a report to the European Commission, and in leaflets to be distributed to study participants. Articles and conference abstracts will be submitted to peer-reviewed journals and conferences.
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Affiliation(s)
- Nicolas Lorente
- Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain
- The Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Laura Fernàndez-López
- Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain
- The Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Daniela Rojas Castro
- AIDES (MIRE-Mission Innovation Recherche Expérimentation), Pantin, France
- Groupe de Recherche en Psychologie Sociale (GRePS) EA4163, Université de Lyon 2, Bron, France
| | | | | | | | - Paula Meireles
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Raquel Lucas
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Stéphane Morel
- AIDES (MIRE-Mission Innovation Recherche Expérimentation), Pantin, France
| | | | - Cristina Agustí
- Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain
- The Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Irena Klavs
- National Institute of Public Health, Ljubljana, Slovenia
| | - Tom Platteau
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Jordi Casabona
- Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain
- The Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Univ Autonoma Barcelona, Badalona, Spain
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