Abstract
BackgroundMen who have sex with men (MSM) are at risk of HIV and are an important population to monitor and ameliorate combination prevention efforts.AimTo estimate HIV prevalence and identify factors associated with frequent HIV testing (≥ 2 HIV tests in the last year) and pre-exposure prophylaxis (PrEP) use among MSM in London.MethodsFor this cross-sectional study, MSM recruited from 22 social venues provided oral-fluid samples for anonymous HIV antibody (Ab) testing and completed a questionnaire. Factors associated with frequent HIV testing and PrEP use were identified through logistic regression.ResultsOf 767 men recruited, 545 provided an eligible oral specimen. Among these, 38 MSM (7.0%) were anti-HIV positive including five (13.2%; 5/38) who reported their status as negative. Condomless anal sex within the previous 3 months was reported by 60.1% (412/685) men. Frequent HIV testing was associated with, in the past year, a reported sexually transmitted infection (adjusted odds ratio (AOR): 5.05; 95% confidence interval (CI): 2.66–9.58) or ≥ 2 casual condomless partners (AOR 2–4 partners: 3.65 (95% CI: 1.87–7.10); AOR 5–10 partners: 3.34(95% CI: 1.32–8.49). Age ≥ 35 years was related to less frequent HIV testing (AOR 35–44 years: 0.34 (95% CI: 0.16–0.72); AOR ≥ 45 years: 0.29 (95% CI: 0.12–0.69). PrEP use in the past year was reported by 6.2% (46/744) of MSM and associated with ≥ 2 casual condomless sex partners (AOR: 2.86; 95% CI: 1.17–6.98) or chemsex (AOR: 2.31; 95% CI: 1.09–4.91).ConclusionThis bio-behavioural study of MSM found high rates of behaviours associated with increased risk of HIV transmission. Combination prevention, including frequent HIV testing and use of PrEP, remains crucial in London.
Highlights
Combination prevention is an effective approach to address the HIV epidemic, but requires implementation of a range of interventions including condom use, high levels of HIV testing, early initiation of antiretroviral therapy (ART) and, more recently, appropriate pre-exposure prophylaxis (PrEP) use in populations at higher risk of HIV [1,2,3].In the United Kingdom (UK), men who have sex with men (MSM) remain the population at highest risk of acquiring HIV
Questionnaires were collected from 767 men of whom 23 were excluded either because they did not self-identify as Men who have sex with men (MSM) (n = 18) or had already participated in the survey (n = 5); the remaining 744 men were included in the following analyses
In the multivariate analysis men reporting two or more casual condomless partners (AOR: 2.86) or chemsex in the last year (AOR: 2.31) were significantly more likely to have used PrEP. Those who reported having one or more sexually transmitted infection (STI) diagnoses in the previous 12 months were more likely to report using PrEP (21/143; 14.7%) than those who had not been diagnosed with an STI (25/588; 4.3%) (OR: 3.88); but the association did not remain in the multivariate model (AOR: 1.58; 95% confidence intervals (CI): 0.72–3.45)
Summary
Men who have sex with men (MSM) are at risk of HIV and are an important population to monitor and ameliorate combination prevention efforts. Aim: To estimate HIV prevalence and identify factors associated with frequent HIV testing (≥ 2 HIV tests in the last year) and pre-exposure prophylaxis (PrEP) use among. Factors associated with frequent HIV testing and PrEP use were identified through logistic regression. Frequent HIV testing was associated with, in the past year, a reported sexually transmitted infection (adjusted odds ratio (AOR): 5.05; 95% confidence interval (CI): 2.66–9.58) or ≥ 2 casual condomless partners (AOR 2–4 partners: 3.65 (95% CI: 1.87–7.10); AOR. PrEP use in the past year was reported by 6.2% (46/744) of MSM and associated with ≥ 2 casual condomless sex partners (AOR: 2.86; 95% CI: 1.17–6.98) or chemsex (AOR: 2.31; 95% CI: 1.09–4.91). Combination prevention, including frequent HIV testing and use of PrEP, remains crucial in London
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