Behavioural and demographic correlates of undiagnosed HIV infection in a MSM sample recruited in 13 European cities

The Sialon II Network

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Reducing the number of people with undiagnosed HIV infection is a major goal of HIV control and prevention efforts in Europe and elsewhere. We analysed data from a large multi-city European bio-behavioural survey conducted among Men who have Sex with Men (MSM) for previously undiagnosed HIV infections, and aimed to characterise undiagnosed MSM who test less frequently than recommended. Methods: Data on sexual behaviours and social characteristics of MSM with undiagnosed HIV infection from Sialon II, a bio-behavioural cross-sectional survey conducted in 13 European cities in 2013/2014, were compared with HIV-negative MSM. Based on reported HIV-testing patterns, we distinguished two subgroups: MSM with a negative HIV test result within 12 months prior to the study, i.e. undiagnosed incident infection, and HIV positive MSM with unknown onset of infection. Bivariate and multivariate associations of explanatory variables were analysed. Distinct multivariate multi-level random-intercept models were estimated for the entire group and both subgroups. Results: Among 497 participants with HIV-reactive specimens, 234 (47.1%) were classified as previously diagnosed, 106 (21.3%) as incident, and 58 (11.7%) as unknown onset based on self-reported status and testing history. MSM with incident HIV infection were twice as likely (odds ratio (OR) = 2.22, 95% confidence interval (95%CI): 1.17-4.21) to have used recreational substances during their last anal sex encounter and four times more likely (OR = 3.94, 95%CI: 2.14-7.27) not to discuss their HIV status with the last anal sex partner(s). MSM with unknown onset of HIV infection were 3.6 times more likely (OR = 3.61, 95%CI: 1.74-7.50) to report testing for a sexually transmitted infection (STI) during the last 12 months. Conclusions: Approximately one third of the study participants who are living with HIV were unaware of their infection. Almost two-third (65%) of those with undiagnosed HIV appeared to have acquired the infection recently, emphasizing a need for more frequent testing. Men with the identified behavioural characteristics could be considered as primary target group for HIV Pre-Exposure Prophylaxis (PrEP) to avoid HIV infection. The increased odds of those with unknown onset of HIV infection to have had an STI test in the past year strongly suggests a lost opportunity to offer HIV testing.

Original languageEnglish
Article number368
JournalBMC Infectious Diseases
Volume18
Issue number1
DOIs
Publication statusPublished - Aug 6 2018

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HIV Infections
Demography
HIV
Sexual Behavior
Odds Ratio
Confidence Intervals
Sexually Transmitted Diseases
Infection
Cross-Sectional Studies
History

Keywords

  • Biobehavioural survey
  • Europe
  • HIV
  • Men having sex with men
  • Undiagnosed HIV infection

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Behavioural and demographic correlates of undiagnosed HIV infection in a MSM sample recruited in 13 European cities. / The Sialon II Network.

In: BMC Infectious Diseases, Vol. 18, No. 1, 368, 06.08.2018.

Research output: Contribution to journalArticle

@article{56a21aac4a8341328ebd8d5b934176a0,
title = "Behavioural and demographic correlates of undiagnosed HIV infection in a MSM sample recruited in 13 European cities",
abstract = "Background: Reducing the number of people with undiagnosed HIV infection is a major goal of HIV control and prevention efforts in Europe and elsewhere. We analysed data from a large multi-city European bio-behavioural survey conducted among Men who have Sex with Men (MSM) for previously undiagnosed HIV infections, and aimed to characterise undiagnosed MSM who test less frequently than recommended. Methods: Data on sexual behaviours and social characteristics of MSM with undiagnosed HIV infection from Sialon II, a bio-behavioural cross-sectional survey conducted in 13 European cities in 2013/2014, were compared with HIV-negative MSM. Based on reported HIV-testing patterns, we distinguished two subgroups: MSM with a negative HIV test result within 12 months prior to the study, i.e. undiagnosed incident infection, and HIV positive MSM with unknown onset of infection. Bivariate and multivariate associations of explanatory variables were analysed. Distinct multivariate multi-level random-intercept models were estimated for the entire group and both subgroups. Results: Among 497 participants with HIV-reactive specimens, 234 (47.1{\%}) were classified as previously diagnosed, 106 (21.3{\%}) as incident, and 58 (11.7{\%}) as unknown onset based on self-reported status and testing history. MSM with incident HIV infection were twice as likely (odds ratio (OR) = 2.22, 95{\%} confidence interval (95{\%}CI): 1.17-4.21) to have used recreational substances during their last anal sex encounter and four times more likely (OR = 3.94, 95{\%}CI: 2.14-7.27) not to discuss their HIV status with the last anal sex partner(s). MSM with unknown onset of HIV infection were 3.6 times more likely (OR = 3.61, 95{\%}CI: 1.74-7.50) to report testing for a sexually transmitted infection (STI) during the last 12 months. Conclusions: Approximately one third of the study participants who are living with HIV were unaware of their infection. Almost two-third (65{\%}) of those with undiagnosed HIV appeared to have acquired the infection recently, emphasizing a need for more frequent testing. Men with the identified behavioural characteristics could be considered as primary target group for HIV Pre-Exposure Prophylaxis (PrEP) to avoid HIV infection. The increased odds of those with unknown onset of HIV infection to have had an STI test in the past year strongly suggests a lost opportunity to offer HIV testing.",
keywords = "Biobehavioural survey, Europe, HIV, Men having sex with men, Undiagnosed HIV infection",
author = "{The Sialon II Network} and Ulrich Marcus and Christiana N{\"o}stlinger and Magdalena Rosińska and Nigel Sherriff and Lorenzo Gios and Dias, {Sonia F.} and Gama, {Ana F.} and Igor Toskin and Ivailo Alexiev and Emilia Naseva and Schink, {Susanne Barbara} and Massimo Mirandola and Massimo Mirandola and Lorenzo Gios and Stefano Benvenuti and Davis, {Ruth Joanna} and Silvana Menichelli and Michele Breveglieri and Berghe, {Wim Vanden} and {de Groot}, Peter and Christiana N{\"o}stlinger and {van Wijk}, Veronica and Katrien Fransen and Tine Vermoesen and Michiel Vanackere and Fourat Benchikha and {Van den Eynde}, Sandra and Boris Cruyssaert and Mark Sergeant and Karel Blondeel and Pieter Damen and Fran{\cc}ois Massoz and Erwin Carlier and Michael Fran{\cc}ois and Stephen Karon and Safia Soltani and Thierry Martin and {De Bruyne}, Alan and Francoise Bocken and Myriam Dieleman and Ivailo Alexiev and Reneta Dimitrova and Anna Gancheva and Dobromira Bogeva and Maria Nikolova and Mariya Muhtarova and Maria Rocca and Barbara Suligoi and Vincenza Regine and Lucia Pugliese",
year = "2018",
month = "8",
day = "6",
doi = "10.1186/s12879-018-3249-8",
language = "English",
volume = "18",
journal = "BMC Infectious Diseases",
issn = "1471-2334",
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T1 - Behavioural and demographic correlates of undiagnosed HIV infection in a MSM sample recruited in 13 European cities

AU - The Sialon II Network

AU - Marcus, Ulrich

AU - Nöstlinger, Christiana

AU - Rosińska, Magdalena

AU - Sherriff, Nigel

AU - Gios, Lorenzo

AU - Dias, Sonia F.

AU - Gama, Ana F.

AU - Toskin, Igor

AU - Alexiev, Ivailo

AU - Naseva, Emilia

AU - Schink, Susanne Barbara

AU - Mirandola, Massimo

AU - Mirandola, Massimo

AU - Gios, Lorenzo

AU - Benvenuti, Stefano

AU - Davis, Ruth Joanna

AU - Menichelli, Silvana

AU - Breveglieri, Michele

AU - Berghe, Wim Vanden

AU - de Groot, Peter

AU - Nöstlinger, Christiana

AU - van Wijk, Veronica

AU - Fransen, Katrien

AU - Vermoesen, Tine

AU - Vanackere, Michiel

AU - Benchikha, Fourat

AU - Van den Eynde, Sandra

AU - Cruyssaert, Boris

AU - Sergeant, Mark

AU - Blondeel, Karel

AU - Damen, Pieter

AU - Massoz, François

AU - Carlier, Erwin

AU - François, Michael

AU - Karon, Stephen

AU - Soltani, Safia

AU - Martin, Thierry

AU - De Bruyne, Alan

AU - Bocken, Francoise

AU - Dieleman, Myriam

AU - Alexiev, Ivailo

AU - Dimitrova, Reneta

AU - Gancheva, Anna

AU - Bogeva, Dobromira

AU - Nikolova, Maria

AU - Muhtarova, Mariya

AU - Rocca, Maria

AU - Suligoi, Barbara

AU - Regine, Vincenza

AU - Pugliese, Lucia

PY - 2018/8/6

Y1 - 2018/8/6

N2 - Background: Reducing the number of people with undiagnosed HIV infection is a major goal of HIV control and prevention efforts in Europe and elsewhere. We analysed data from a large multi-city European bio-behavioural survey conducted among Men who have Sex with Men (MSM) for previously undiagnosed HIV infections, and aimed to characterise undiagnosed MSM who test less frequently than recommended. Methods: Data on sexual behaviours and social characteristics of MSM with undiagnosed HIV infection from Sialon II, a bio-behavioural cross-sectional survey conducted in 13 European cities in 2013/2014, were compared with HIV-negative MSM. Based on reported HIV-testing patterns, we distinguished two subgroups: MSM with a negative HIV test result within 12 months prior to the study, i.e. undiagnosed incident infection, and HIV positive MSM with unknown onset of infection. Bivariate and multivariate associations of explanatory variables were analysed. Distinct multivariate multi-level random-intercept models were estimated for the entire group and both subgroups. Results: Among 497 participants with HIV-reactive specimens, 234 (47.1%) were classified as previously diagnosed, 106 (21.3%) as incident, and 58 (11.7%) as unknown onset based on self-reported status and testing history. MSM with incident HIV infection were twice as likely (odds ratio (OR) = 2.22, 95% confidence interval (95%CI): 1.17-4.21) to have used recreational substances during their last anal sex encounter and four times more likely (OR = 3.94, 95%CI: 2.14-7.27) not to discuss their HIV status with the last anal sex partner(s). MSM with unknown onset of HIV infection were 3.6 times more likely (OR = 3.61, 95%CI: 1.74-7.50) to report testing for a sexually transmitted infection (STI) during the last 12 months. Conclusions: Approximately one third of the study participants who are living with HIV were unaware of their infection. Almost two-third (65%) of those with undiagnosed HIV appeared to have acquired the infection recently, emphasizing a need for more frequent testing. Men with the identified behavioural characteristics could be considered as primary target group for HIV Pre-Exposure Prophylaxis (PrEP) to avoid HIV infection. The increased odds of those with unknown onset of HIV infection to have had an STI test in the past year strongly suggests a lost opportunity to offer HIV testing.

AB - Background: Reducing the number of people with undiagnosed HIV infection is a major goal of HIV control and prevention efforts in Europe and elsewhere. We analysed data from a large multi-city European bio-behavioural survey conducted among Men who have Sex with Men (MSM) for previously undiagnosed HIV infections, and aimed to characterise undiagnosed MSM who test less frequently than recommended. Methods: Data on sexual behaviours and social characteristics of MSM with undiagnosed HIV infection from Sialon II, a bio-behavioural cross-sectional survey conducted in 13 European cities in 2013/2014, were compared with HIV-negative MSM. Based on reported HIV-testing patterns, we distinguished two subgroups: MSM with a negative HIV test result within 12 months prior to the study, i.e. undiagnosed incident infection, and HIV positive MSM with unknown onset of infection. Bivariate and multivariate associations of explanatory variables were analysed. Distinct multivariate multi-level random-intercept models were estimated for the entire group and both subgroups. Results: Among 497 participants with HIV-reactive specimens, 234 (47.1%) were classified as previously diagnosed, 106 (21.3%) as incident, and 58 (11.7%) as unknown onset based on self-reported status and testing history. MSM with incident HIV infection were twice as likely (odds ratio (OR) = 2.22, 95% confidence interval (95%CI): 1.17-4.21) to have used recreational substances during their last anal sex encounter and four times more likely (OR = 3.94, 95%CI: 2.14-7.27) not to discuss their HIV status with the last anal sex partner(s). MSM with unknown onset of HIV infection were 3.6 times more likely (OR = 3.61, 95%CI: 1.74-7.50) to report testing for a sexually transmitted infection (STI) during the last 12 months. Conclusions: Approximately one third of the study participants who are living with HIV were unaware of their infection. Almost two-third (65%) of those with undiagnosed HIV appeared to have acquired the infection recently, emphasizing a need for more frequent testing. Men with the identified behavioural characteristics could be considered as primary target group for HIV Pre-Exposure Prophylaxis (PrEP) to avoid HIV infection. The increased odds of those with unknown onset of HIV infection to have had an STI test in the past year strongly suggests a lost opportunity to offer HIV testing.

KW - Biobehavioural survey

KW - Europe

KW - HIV

KW - Men having sex with men

KW - Undiagnosed HIV infection

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