Undiagnosed HIV infection in a population of MSM from six European cities: results from the Sialon project
Undiagnosed HIV infection in a population of MSM from six European cities: results from the Sialon project
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DOI：
10.1093/eurpub/cku139
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发表时间：
2015-06-01
影响因子：
4.4
通讯作者：
Mirandola, Massimo
中科院分区：
文献类型：
--
作者：
Ferrer, Laia;Furegato, Martina;Mirandola, Massimo
目的：本文的目的是评估南欧和东欧国家男男性行为者 (MSM) 未确诊 HIV 感染的分布情况，描述未确诊、确诊 HIV 阳性和 HIV 阴性 MSM 之间流行病学和行为的差异，并确定研究人群中与未确诊 HIV 感染相关的因素。方法：2008年进行了一项多中心生物学和行为横断面研究。采用时间-地点抽样方法招募不同地点的男性。完成自填问卷并收集口腔液样本以估计艾滋病毒感染率。结果：巴塞罗那的艾滋病毒感染率为 17%，维罗纳为 12%，布拉迪斯拉发为 6%，卢布尔雅那为 5%，布加勒斯特为 5%，布拉格为 3%，而未确诊的艾滋病毒感染率分别为 47%、62%、67%、83%、85% 和 57%。确诊的 HIV 阳性男性比 HIV 阴性 MSM 拥有更多的临时伴侣（平均值：分别为 19 和 9）（P < 0.001），并且与未确诊的 HIV 阳性和 HIV 阴性男性相比，他们在去年自我报告患有尖锐湿疣的可能性更高（分别为 15%、1% 和 3%）（P < 0.001）。与未确诊的 HIV 感染相关的因素包括去过性场所（OR = 2.49）、过去 12 个月报告梅毒（OR = 2.56）、最后一次性交时使用 Poppers（OR = 3.36）以及去年进行过 HIV 检测（OR = 2.00）。结论：许多 HIV 感染仍未得到诊断，并且有证据表明，尽管了解 HIV 阳性状况，但频繁的危险行为和性传播感染 (STI) 仍然持续存在，这强调需要采取多维方法来预防 HIV/STI。在针对 MSM 的预防计划中，尤其是在东欧，应将获得艾滋病毒检测视为优先事项。
Objectives: The purpose of this article is to assess the distribution of undiagnosed HIV infection in men who have sex with men (MSM) in Southern and Eastern European countries, to describe the differences in epidemiology and behaviour between undiagnosed, diagnosed HIV-positive and HIV-negative MSM and to identify factors associated with undiagnosed HIV infection in the study population. Methods: A multi-centre biological and behavioural cross-sectional study was conducted in 2008. Time-location sampling was used to recruit men attending different venues. A self-administered questionnaire was completed and oral fluid samples were collected to estimate HIV prevalence. Results: HIV prevalence was 17% in Barcelona, 12% in Verona, 6% in Bratislava, 5% in Ljubljana, 5% in Bucharest and 3% in Prague while undiagnosed HIV infection was 47, 62, 67, 83, 85 and 57%, respectively. Diagnosed HIV-positive men reported more casual partners than HIV-negative MSM (mean: 19 and 9, respectively) (P < 0.001), and they were more likely to self-reported condyloma in the last year than undiagnosed HIV-positive and HIV-negative men (15, 1 and 3%, respectively) (P < 0.001). Factors associated with undiagnosed HIV infection included attending sex-focused venues (OR = 2.49), reporting syphilis in the previous 12 months (OR = 2.56), using poppers at last sexual intercourse (OR = 3.36) and having had an HIV test in the previous year (OR = 2.00). Conclusions: Many HIV infections remain undiagnosed, and there is evidence of the persistence of frequent risk behaviours and sexually transmitted infections (STI) despite knowledge of HIV-positive status, emphasising the need for a multidimensional approach to HIV/STI prevention. Access to HIV testing should be considered a priority in prevention programs targeted at MSM, especially in Eastern Europe.