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

Abstract

1R e s e a r c h a r t i c l e s H I V b I o -b e H aV I o u r a l s u r V e y a m o n g m e n w H o H aV e s e x w I t H m e n I n b a r c e l o n a , b r at I s l aVa , b u c H a r e s t , l j u b l j a n a , P r a g u e a n d V e r o n a , 2 0 0 8 -2 0 0 9 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 selfidentity. 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.

Prevalence of HIV among MSM in Europe: comparison of self-reported diagnoses from a large scale internet survey and existing national estimates

“…For others, detailed information on methodology was not always available. For six countries data were based on a collaborative European study (SIALON I) using time location sampling in six cities (Barcelona, Bratislava, Bucharest, Ljubljana, Prague, and Verona [7]), the other estimates are based on respondent driven sampling, snowball sampling, or other less formalized venue based sampling methods. The correlation between the prevalence study estimates and the EMIS prevalence estimates was high (R 2 =0.70; see Figure 3).…”

“…from different, not too distinct time points or different areas) a median value was calculated. For the six city SIALON study, which used time location sampling in larger cities of six Mediterranean and Central European countries [7], comparable regions were selected for the EMIS prevalence estimates.…”

“…[7] in gay venues or Respondent Driven Sampling [8] may be more representative of MSM attending such settings than seroprevalence studies without such formalized sampling frames, but still the claim to reach representative samples of the whole MSM population with these methods is unfounded, particularly because the absolute size and composition of the MSM population (which critically depends on the definition of MSM) remains unknown. This is underlined by the observation that repeated seroprevalence studies using such methods, e.g.…”

BCN Checkpoint, a community‐based centre for men who have sex with men in Barcelona, Catalonia, Spain, shows high efficiency in HIV detection and linkage to care

“…Peer support is fundamental in helping HIV‐infected persons to deal with the emotional impact of receiving such a diagnosis, as well as in helping them to seek medical care and adhere to treatment. This CBC is dedicated to MSM because Barcelona has a significant MSM community with a high prevalence of HIV infection (17%) . Awareness of serostatus also results in a reduction in the risk of transmission of HIV to sex partners, as a substantial proportion of PLWHIV reduce sexual behaviours likely to transmit HIV after discovering that they have HIV infection .…”

The emerging and re-emerging human immunodeficiency virus epidemics in Europe

“…. The HIV prevalence among MSM was 2.2% according to sentinel surveillance and 5.1% in a survey using time–location sampling, both conducted in 2009 .…”