Abstract
BackgroundIn Europe, men who have sex with men (MSM) are disproportionately affected by STI/HIV. Sex between men is the predominant mode of HIV and syphilis transmission and contributes to a third of gonorrhoea cases in 2011. The main goal of this evidence-based review was to gather and critically appraise the scientific evidence for and to inform European guidance on a comprehensive approach for HIV, STI and hepatitis prevention among MSM.MethodsRelevant data bases were searched for publications related to disease prevention and health promotion among MSM. All kinds of reviews were included but gave presence to systematic reviews, when no reviews were found individual studies were included. A critical appraisal of the quality of each study was performed before inclusion in the targeted review. The Highest Attainable Standard of Evidence (HASTE) was used for grading as the basis for recommendations as HASTE was specifically developed to evaluate evidence regarding HIV/STI interventions among key populations. HASTE takes into account three categories with equal weight: efficacy data; implementation science data; biological and public health plausibility.ResultsSeven interventions were identified to be strongly recommended for prevention of HIV, STI and/or hepatitis, and 15 interventions for probable or possible recommendation. Consistent condom use, HIV treatment as prevention, peer outreach and support groups for men testing HIV negative as well as for HIV positive men, together with HSV-2 suppression therapy with acyclovir to prevent genital ulcer disease and hepatitis B vaccination, were all strongly recommended according to the HASTE grading.ConclusionsIn general, studies of acceptable quality from the European context were few and made the assessment of context-specific effectiveness difficult. Additionally, effectiveness studies looking into real-life effectiveness of biomedical interventions were very few. Future research would be able to contribute with more information from the specific European settings including (cost-) effectiveness studies.
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