HIV bio-behavioural survey among men who have sex with men in Barcelona, Bratislava, Bucharest, Ljubljana, Prague and Verona, 2008-2009

M Mirandola,L Gios,M Breveglieri,M Furegato,I Toskin,D Stehlikova,D Stanekova,C Folch Toda,E Castellani,I Nita,I Krampac,M G Bonavina,J P Foschia,The Sialon Network The Sialon Network

doi:10.2807/ese.14.48.19427-en

Abstract

Data from 23 European countries show that the annual number of HIV diagnoses in men who have sex with men (MSM) increased by 86% between 2000 and 2006. This paper reports the main preliminary results of a bio-behavioural survey in MSM with a specific focus on HIV prevalence and use of United Nations General Assembly Special Session (UNGASS) indicators in six cities in Southern and Eastern Europe. Time-location sampling (TLS) was used. A total number of 2,356 questionnaires and 2,241 oral fluid samples were collected (invalid samples 4.1%). The data show different socio-demographic patterns across countries regarding age, level of education, living conditions, living area and self-identity. Southern European cities had the highest percentage of people who had tested for HIV and collected the result. More than 50% of respondents in the sample from Barcelona reported having used a condom last time they had anal sex (57.2%), whilst in all other cities this proportion was below 50%. The cities with the highest HIV prevalence in MSM were Barcelona (17.0%) and Verona (11.8%) whilst lower percentages were reported in Bratislava (6.1%), Bucharest (4.6%), Ljubljana (5.1%) and Prague (2.6%). The low prevalence in Eastern European cities is encouraging. However, with the level of high-risk sexual behaviour documented and the lower frequency of HIV test seeking behaviour, there is a clear risk of an increase in HIV transmission.

Highlights

HIV infection remains an important public health issue in Europe, with evidence of continuing transmission in many countries
In order to respond to this limitation, the SIALON project, used three key elements of behavioural and prevalence studies among men who have sex with men (MSM) for improving data comparability: time and location sampling (TLS) method, oral fluid testing in outreach settings and United Nations General Assembly Special Session (UNGASS) indicators
As previous studies among MSM have shown, Time-location sampling (TLS) increases the possibility of involving a variety of participants, producing more valid results [15]

Summary

Introduction

HIV infection remains an important public health issue in Europe, with evidence of continuing transmission in many countries. In addition to the spread of HIV, an increase of high risk sexual behaviour among MSM is reported throughout Europe [1,2]. In this context, HIV testing has become a key surveillance activity for monitoring the HIV epidemic especially in hard-to-reach MSM. Since the introduction of highly active antiretroviral therapy (HAART), AIDS has become less indicative of the underlying trends in HIV infection. Another important factor linked to risk behaviour and risk of HIV transmission is the use of alcohol and other psychoactive drugs. Alcohol and illicit drug consumption significantly increase the odds of having sex and have a significant positive association with the sexual risk

Methods

Results

Conclusion