Abstract
BackgroundGlobally, 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/DesignSialon 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.DiscussionThrough 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.
Highlights
The HIV epidemic continues to represent a pressing public health issue in Europe and elsewhere
In terms of transmission, according to the 2013 data, the highest proportion of new HIV diagnoses was reported in men who have sex with men (MSM): this specific sub-population accounts for 42 % of all new infections in EU/EEA countries [2]
This paper describes the protocols of the Sialon II project, the aim of which has been the implementation of a largescale bio-behavioural survey among MSM in Europe using a Second Generation Surveillance System (SGSS) approach, as well as the carrying out of meaningful and targeted HIV/STI prevention
Summary
The HIV epidemic continues to represent a pressing public health issue in Europe and elsewhere. In younger MSM an increase of new diagnoses is dramatically reported for the EU/EEA area: between 2004 and 2013, the number of new HIV positive MSM aged 20-24 years almost doubled, whilst in adult MSM (30–39 years old) the estimates remain relatively stable. These high estimates (for the new diagnoses in particular) could be partially due to increasing HIV testing behaviours, but they could indicate onward transmission in this specific population. With regards the latter, according to the current scientific literature an increase of high risk sexual practices (such as unprotected anal intercourse) has been reported among MSM across Europe [1, 3]
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