Assessment of HIV prevalence among MSM in Tokyo using self-collected dried blood spots delivered through the postal service

Misao Takano,Takuya Kinami,Yasuyo Nakayama,Toshiya Fukuhara,Kohta Iwahashi,Yuzuru Ikushima,Junko Araki,Yoshimi Kikuchi,Ikuo Satoh,Hiroo Obinata,Shinichi Oka

doi:10.1186/s12879-018-3491-0

Abstract

BackgroundMen who have sex with men (MSM) are at high risk of HIV infection. However, there are only few data on HIV prevalence in MSM in Japan. The objective of this study was to explore the HIV prevalence in MSM at Shinjuku 2-chome, a well known gay quarter in Tokyo.MethodsMSM directly collected the dried blood spot (DBS) self-collection HIV test kit from a drop-in center in Shinjuku 2-chome between August 2015 and December 2016. The participants collected their own blood by finger-prick and anonymously posted the kit to the laboratory. The participants accessed the study website and checked the results of their tests using unique ID and password. DBS was soaked in phosphate buffered saline overnight and the eluted sample was examined by the fourth generation HIV Ag/Ab test of LUMIPULSE (FUJIREBIO INC.), and followed by HISCL (Sysmex Corp.) when the first assay was positive. The result was defined provisionally positive if both were positive.ResultsA total of 1702 HIV test kits were distributed and 1403 DBS were returned (return rate: 82.4%). Since 20.2% of participants collected the test kit more than once, the estimated number of actual test kit users was 1120. Based on the results of the test kit, 34 cases were provisionally diagnosed with HIV. The estimated prevalence was 3.04% (95% confidence interval: 2.03–4.04). Of these 34, 24 (70.6%) were later confirmed to be HIV-positive in the hospital, while the remaining 10 were lost to follow-up. Among the participants, 34.5% received HIV test for the first time. Especially in those aged 20–29, 46.0% were first time HIV testers.ConclusionsThe prevalence of HIV infection in the study population was 3.04%. The high collection suggested a demand for this type of testing in MSM. The test should be expanded further to difficult-to-reach or hidden populations.Trial registrationThis study was registered with the University Hospital Medical Information Network Clinical Trial Registry in August 20th, 2015 (Registry number: UMIN000018699).

Highlights

Men who have sex with men (MSM) are at high risk of HIV infection
During the study period, a total of 1702 HIV testing kits were distributed to MSM
The samples provided by 11 cases were considered insufficient; the dried blood spot (DBS) was too small to be used for the HIV test

Summary

Introduction

Men who have sex with men (MSM) are at high risk of HIV infection. There are only few data on HIV prevalence in MSM in Japan. The objective of this study was to explore the HIV prevalence in MSM at Shinjuku 2-chome, a well known gay quarter in Tokyo. According to the current Japanese national surveillance data, about 1500 new cases of HIV infection are recorded every year during the current decade, and of these, approximately 30% are registered in Tokyo [1]. Over 450 public health centers provide the HIV test once a week or once a month at each site. One public HIV testing center (Minami Shinjuku Voluntary Counseling Testing center) opens every day throughout the year in Japan [2].

Objectives

Methods

Results

Discussion

Conclusion