Abstract
IntroductionThe HIV epidemic represents an important public health issue in Europe particularly among men who have sex with men (MSM). Global AIDS Monitoring indicators (GAM) have been widely and jointly promoted as a set of crucial standardised items to be adopted for monitoring and responding to the epidemic.MethodsThe Sialon II study, implemented in 13 European cities (2013-14), was a complex multi-centre integrated bio-behavioural cross-sectional survey targeted at MSM, with a concomitant collection of behavioural and biological (oral fluid or blood specimens) data. Rigorous sampling approaches for hard-to-reach populations were used (time-location sampling and respondent-driven sampling) and GAM indicators were calculated; sampling frames were adapted to allow weighted estimates of GAM indicators.Results4,901 MSM were enrolled. HIV prevalence estimates ranged from 2.4% in Stockholm to 18.0% in Bucharest. When exploring city-level correlations between GAM indicators, prevention campaigns significantly correlated with levels of condom use and level of HIV testing among MSM.ConclusionThe Sialon II project has made an important contribution to the monitoring and evaluation of the HIV epidemic across Europe, integrating the use of GAM indicators within a second generation HIV surveillance systems approach and in participatory collaboration with MSM communities. It influenced the harmonisation of European data collection procedures and indicators via GAM country reporting and contributed essential knowledge informing the development and implementation of strategic, evidence-based HIV prevention campaigns for MSM.
Highlights
The HIV epidemic represents an important public health issue in Europe among men who have sex with men (MSM)
For the TLS survey, individual weights were assigned as the inverse of the product of the following: (i) the probability of the participant being at the sampled venue given he was at the sampled venue type; (ii) the length of the sampling time and (iii) the proportion of sampled individuals during the event in relation to the estimated number of visitors during the sampling event, a modification of the method proposed by Karon and Wejnert [17]
The sole exception was Warsaw where 28.8% of the participants had been reached by a prevention programme
Summary
The HIV epidemic represents an important public health issue in Europe among men who have sex with men (MSM). When exploring city-level correlations between GAM indicators, prevention campaigns significantly correlated with levels of condom use and level of HIV testing among MSM. Conclusion: The Sialon II project has made an important contribution to the monitoring and evaluation of the HIV epidemic across Europe, integrating the use of GAM indicators within a second generation HIV surveillance systems approach and in participatory collaboration with MSM communities. It influenced the harmonisation of European data collection procedures and indicators via GAM country reporting and contributed essential knowledge informing the development and implementation of strategic, evidence-based HIV prevention campaigns for MSM. Nominator Number of MSM who replied ‘yes’ to both questions related to the prevention programmes as per GAM guidelines (knowledge of HIV testing services and condoms received in the last 12 months in the context of broad prevention campaigns – outreach service)
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