HIV/STI co-infection among men who have sex with men in Spain

Asunción Díaz ,C De Armas,C Colomo,F Gual,J Belda,J Boronat,M C Landa,J.m Pérez Trullen ,Pierre Gomez ,F J Bru ,Isabel Abad Sanz ,Martí Vall ,Elisa Fernández ,Mikel Azpiri ,J A Varela ,Ignacio Alastrué ,María Eugenia Lezaun ,J Ginart Suárez ,J Balaguer ,Juan R Ordoñana ,Luisa Fernanda Gómez ,José Manuel Marín Ureña ,María Luisa Junquera ,Maria Clara Coelho Câmara ,Jorge Del Romero ,Blanca Olivares Martínez ,Josefina López De Munain ,Isabel Casasús Pueyo ,Valentín Esteban ,Mercedes Díez

doi:10.2807/ese.14.48.19426-en

Abstract

In Spain, neither the HIV nor the STI national surveillance systems collect information on HIV/STI co-infection. However, there are two networks based on HIV/STI clinics which gather this data. We describe HIV prevalence in men who have sex with men (MSM) diagnosed with infectious syphilis and/or gonorrhoea in 15 STI clinics; and concurrent diagnoses of STI in MSM newly diagnosed with HIV in 19 HIV/STI clinics. In total, 572 MSM were diagnosed with infectious syphilis and 580 with gonorrhoea during 2005-2007. HIV prevalence among syphilis and gonorrhoea cases was 29.8% and 15.2% respectively. In the multivariate analysis, HIV/syphilis co-infection was associated with being Latin American; having a history of STI; reporting exclusively anal intercourse; and having sex with casual or several types of partners. HIV and gonorrhoea co-infection was associated with age older than 45 years; having no education or only primary education completed; and having a history of STI. In total, 1,462 HIV infections were newly diagnosed among MSM during 2003-2007. Of these, 31.0% were diagnosed with other STI at the same time. Factors associated with STI co-infection among new HIV cases in MSM were being Latin American; and having sex with casual partners or with both steady and casual partners. In Spain, a considerable proportion of MSM are co-infected with HIV and STI.

Highlights

HIV infection continues to disproportionately affect men who have sex with men (MSM) in the European Union [1], and many countries have reported an increase of the number of new HIV diagnoses in MSM since the early 2000s [2,3]
We describe HIV prevalence in men who have sex with men (MSM) diagnosed with infectious syphilis and/or gonorrhoea in 15 sexually transmitted infections (STI) clinics; and concurrent diagnoses of STI in MSM newly diagnosed with HIV in 19 HIV/STI clinics
HIV prevalence among MSM with infectious syphilis and/or gonorrhoea A total of 1,152 MSM with infectious syphilis and/or gonorrhoea were identified during the study period: 572 were diagnosed with

Summary

Introduction

HIV infection continues to disproportionately affect men who have sex with men (MSM) in the European Union [1], and many countries have reported an increase of the number of new HIV diagnoses in MSM since the early 2000s [2,3]. It is known that the presence of other STI may increase the likelihood of transmitting or contracting HIV [6]. While information on new HIV diagnoses is not yet available on a national basis in Spain, data collected in eight autonomous regions, covering 32% of the total Spanish population, show that the number of MSM newly diagnosed with HIV has been increasing among Spaniards as well as foreign-born population (Figure) [7]. Nationwide surveillance data on gonorrhoea and syphilis show an increase in the number of reported cases of both diseases since 2002 [8], and syphilis outbreaks affecting MSM have been reported recently [9]. At the moment, neither the HIV nor the STI national surveillance systems collect information on co-infection

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Results

Conclusion