HIV infections and STI co-infections in men who have sex with men in Belgium: sustained increase in HIV diagnoses

Abstract

w w w. e u ro s u rve i ll an c e . o rg 1 S u r v e i ll a n c e a n d o u t b r e a k r e p o r t s H I V I n f e c t I o n s a n d s t I c o -I n f e c t I o n s I n m e n w H o H aV e s e x w I t H m e n I n B e l g I u m : s u s ta I n e d I n c r e a s e I n H I V d I a g n o s e s Belgium is currently experiencing an upward trend in the number of new HIV diagnoses characterised by a continuous increase in the number of cases among men who have sex with men (MSM). Based on surveillance data, in the past decade the yearly number of newly diagnosed HIV cases in MSM increased more than threefold, from 101 cases diagnosed in 1999 to 332 cases in 2008. During this period, the majority of new HIV infections in MSM were diagnosed among Belgians citizens (72%), followed by other European nationalities (13%). The increase in HIV diagnoses does not reflect an increase in HIV testing since the number of tests performed nationwide remained remarkably stable over time. The steady increase in the number of newly diagnosed HIV cases among MSM, and the high proportion of MSM among HIV-positive patients co-infected with other sexually transmitted infections (STI) (95.6% in 2008) indicate increases in unsafe sex practices in this group. Development of behavioural surveillance and more qualitative research on reasons for unsafe sex are needed in order to develop more effective prevention strategies.

The “3 in 1” Study: Pooling Self-Taken Pharyngeal, Urethral, and Rectal Samples into a Single Sample for Analysis for Detection of Neisseria gonorrhoeae and Chlamydia trachomatis in Men Who Have Sex with Men

“…Coinfection with an STI and HIV has been shown to increase HIV transmission in epidemiological studies (5)(6)(7). Concomitant genital infections have been shown to increase shedding of HIV in the genital tract, in both vaginal secretions and seminal fluid (8,9).…”

HIV/AIDS and other STI in men who have sex with men – a continuous challenge for public health

“…It is of concern that many HIV diagnoses take place during STI consultation (11% of the new HIV diagnoses in Belgium). The Belgian authors suggest implementing behavioural surveillance and qualitative research to improve effective prevention campaigns [20]. Similar conditions are described in the paper from Spain which shows high HIV prevalence rates among syphilis patients, highlighting the importance of the availability of information on HIV and STI co-infections, as this is usually not covered by the national surveillance system for HIV and STI [22].…”

“…Increasing trends in HIV among MSM are reported by Sasse and Defraye for Belgium [20], Semaille et al for France [21], and by Diaz et al for Spain [22]. Although this could be due to increased HIV testing, it is shown in Belgium that the number of tests has remained stable over time [20].…”

“…Although this could be due to increased HIV testing, it is shown in Belgium that the number of tests has remained stable over time [20]. In France, about 50% of the newly diagnosed HIV infections in MSM in 2003-2008 were recently infected and high rates of co-infection with syphilis and LGV were reported [21].…”

Re-Emergence of HIV Infection and Syphilis Among Men Who Have Sex with Men

“…Belgium is currently experiencing an alarming upward trend among MSM in the number of new HIV diagnoses that, in the past decade, increased by 228% ( from 101 cases diagnosed in 1999 to 332 cases in 2008). The majority of new HIV infections were diagnosed among Belgians citizens (72%), followed by other European nationalities, sub-Saharan Africa and other/unknown nationality ( Sasse & Defraye, 2009). …”