Abstract
To assess trends in HIV-1 incidence and risk factors for seroconversion among men who have sex with men (MSM) resident in Rome, Italy, a retrospective longitudinal cohort study was conducted over 25 years. Incidence rates and trends were modelled using Poisson regression and risk factors were assessed by multivariate Cox models. Of 1,862 HIV-1-negative individuals, 347 seroconverted during follow-up. HIV-1 incidence rates increased from 5.2/100 persons/year (p/y) in 1986 (95% confidence interval (CI): 2.3–11.5) to 9.2/00 p/y in 1992 (95% CI: 6.4–13.0), decreased to 1.3/100 p/y in 2001 and increased until 2009 (11.7/100 p/y; 95% CI: 7.4–18.6). The risk of HIV-1 seroconversion increased during the study period in younger MSM (incidence rate ratio (IRR) = 17.18; 95% CI: 9.74–30.32 in 16–32 year-olds and IRR = 5.09; 95% CI: 2.92–8.87 in 33–41 year-olds) and in those who acquired syphilis (IRR = 7.71; 95% CI: 5.00–11.88). In contrast, the risk of seroconversion decreased among highly educated MSM (IRR = 0.54; 95% CI: 0.35–0.82) and those without Italian citizenship (IRR = 0.45; 95% CI: 0.28–0.71). The HIV epidemic in MSM living in Rome continues to expand. Targeted prevention programmes against sexually transmitted infections to enhance knowledge transfer and behavioural skills are urgently required.
Highlights
In Europe, human immunodeficiency virus (HIV) incidence declined among men who have sex with men (MSM) after the first phase of the epidemic because of a decrease in risky sexual practices [1]
Our longitudinal study on MSM living in Rome has provided valuable insights about the dynamics and the characteristics of the HIV epidemic in this urban population over the last 25 years
This is consistent with other studies which suggest that the HIV epidemic among MSM in southern Europe started later than in northern Europe and the United States (US)
Summary
In Europe, human immunodeficiency virus (HIV) incidence declined among men who have sex with men (MSM) after the first phase of the epidemic because of a decrease in risky sexual practices [1]. This decline continued until the mid-1990s when the introduction of combination antiretroviral therapy (cART) dramatically changed the quality of life and survival of infected individuals and boosted the re-emergence of sexual risk behaviour which exposed MSM to sexually transmitted infections (STI) in general and HIV-1 in particular [2,3,4,5]. The proportion of HIV infections attributable to sex with a same-sex male partner almost doubled from 2000 to 2011 [10,11]
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Schedule a callMore From: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
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