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Politi J, Donat M, Guerras JM, Ayerdi O, Palma D, García JN, Barrio G, Belza MJ. Gaps in HIV and Hepatitis C Testing Among 3486 HIV-Negative Men Who have Sex with Men in Spain in the Era of Highly Effective Antiviral Therapies. J Community Health 2024; 49:139-155. [PMID: 37561245 DOI: 10.1007/s10900-023-01259-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/11/2023]
Abstract
High uptake of HIV and hepatitis C (HCV) testing in Gay, bisexual, and other men who have sex with men (GBMSM) is needed to interrupt transmission. The objective was to identify subgroups with increased probability of lack of testing among HIV-negative GBMSM in Spain. Cross-sectional study including 3486 HIV-negative GBMSM attending prevention facilities in Madrid and Barcelona, 2018-2020. Data came from self-administered online sociodemographic, health, and risk behaviors questionnaires. Outcomes were lack of HCV (lifetime) and HIV (lifetime, last year) testing. Crude and adjusted prevalences and prevalence ratios were assessed for each outcome using negative binomial regression models. Lifetime lack of HIV and HCV testing prevalence was 6.3% and 35.8%, respectively, while lack of HIV testing in the last year was 22.4%. Prevalences were also substantial in GBMSM with high-risk behaviors. After sociodemographic adjustment, the highest probability of lack of HCV testing (lifetime) and HIV (last year) was among GBMSM with insufficient viral hepatitis knowledge, no history of STI, or HCV (or HIV) testing, aged < 25, non-outness about sex life with men, and less high-risk behaviors. Lack of HCV (lifetime) and HIV testing (last year) among HIV-negative GBMSM in Spain is still high, despite high-risk behaviors.
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Affiliation(s)
- Julieta Politi
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Marta Donat
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan Miguel Guerras
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Oskar Ayerdi
- Centro Sanitario Sandoval, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, Spain
| | - David Palma
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Servicio de Epidemiología, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Jorge Néstor García
- Unidad de ITS de Vall d'Hebron-Drassanes, Hospital Vall d'Hebron, Barcelona, Spain
| | - Gregorio Barrio
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María José Belza
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Wang H, Daas CD, de Coul EO, Jonas KJ. MSM with HIV: Improving prevalence and risk estimates by a Bayesian small area estimation modelling approach for public health service areas in the Netherlands. Spat Spatiotemporal Epidemiol 2023. [DOI: 10.1016/j.sste.2023.100577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Ivey K, Bernstein KT, Kirkcaldy RD, Kissinger P, Edwards OW, Sanchez T, Abara WE. Chemsex Drug Use among a National Sample of Sexually Active Men who have Sex with Men, - American Men's Internet Survey, 2017-2020. Subst Use Misuse 2023; 58:728-734. [PMID: 36872623 PMCID: PMC10167950 DOI: 10.1080/10826084.2023.2184207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Background: Chemsex is the intentional use of drugs to enhance sexual activity. Chemsex drug use among men who have sex with men (MSM) is associated with sexual behaviors that increase sexually transmitted infection (STI) risks and adverse mental health outcomes. However, published data are largely based on MSM recruited from STI clinics. There are limited data about use of chemsex drugs among national samples of MSM in the United States. Using data from the American Men's Internet Survey (AMIS), we assessed the prevalence and correlates of use of chemsex drugs among sexually active MSM in the United States. Methods: We used data from the 2017 to 2020 AMIS cycles to examine the prevalence of chemsex drug use in the past 12 months among MSM. We calculated prevalence ratios (PR) and 95% confidence intervals (CI) to compare chemsex drug use across demographic, behavioral, and mental health factors. Results: Of 30,294 MSM, 3,113 (10.3%) reported chemsex drug use in the past 12 months. Of the 3,113 MSM who reported chemsex drug use, 65.1% reported ecstasy use, 42.5% reported crystal methamphetamine use, and 21.7% reported GHB use. Factors associated with chemsex drug use included condomless anal sex (PR = 1.93, 95%=1.69-2.20), problem drinking (PR = 2.36, 95% = 2.13-2.61), bacterial STI test (1.84, 95% CI = 1.68-2.02) and probable serious mental illness (PR = 1.92, 95% = 1.76-2.09). Conclusion: Chemsex drug use is associated with behaviors that increase STI risk and mental distress among MSM. Health programs that serve MSM can consider screening for chemsex drug use and offering sexual and mental health promotion and risk reduction interventions when necessary.
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Affiliation(s)
- Kaitlyn Ivey
- School of Public Health, Tulane University, New Orleans, Louisiana, USA
| | - Kyle T Bernstein
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robert D Kirkcaldy
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - O Winslow Edwards
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Travis Sanchez
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Winston E Abara
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Slurink I, van Aar F, Parkkali S, Heijman T, Götz H, Kampman K, van Weert Y, van Benthem B, van de Laar T, Op de Coul E. Recently acquired HIV infections and associated factors among men who have sex with men diagnosed at Dutch sexual health centres. Int J STD AIDS 2021; 32:946-956. [PMID: 33910415 DOI: 10.1177/09564624211008071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Surveillance for recent HIV infections was implemented at Dutch sexual health centres (SHCs) for planning and evaluation of HIV prevention initiatives. The study objective is twofold: (1) to explore trends in recent HIV infections and associated socio-demographic and behavioural risk factors among men who have sex with men (MSM )attending SHCs, to gain insight into subgroups at risk for acquiring HIV and(2) to illustrate how comparison with different reference groups affect associations with these risk factors. METHODS Residual plasma or serum samples from MSM newly HIV diagnosed at SHCs in 2014-2017 were tested with an avidity assay. Multinomial regression was used to analyse risk factors for recent HIV infections among MSM with established HIV infections among MSM and with HIV-negative MSM as reference groups. RESULTS Of newly diagnosed MSM, 33% were classified as recent HIV infection with avidity testing. Combining HIV-negative test results with avidity outcomes resulted in 54% recent infections. Recent infection was associated with having an STI in the past, multiple partners and condom use for both reference groups of MSM. Additionally, relative to the HIV-negative MSM, recent infection was associated with education and having a non-Western origin. In contrast, relative to MSM with established HIV infections, recent infection was associated with Western origin. CONCLUSION Our results suggest ongoing but declining transmission of HIV and high uptake of HIV testing among MSM visiting SHCs. The identification of risk factors for recent infections can help healthcare professionals to target subgroups eligible for PrEP or condom use promotion. Differentiation by the reference group in explanatory models for recent infections is important as different risk factors were identified. Likely, associations relative to HIV-negative MSM follow those of acquiring HIV infection in general, whereas the comparison with the established HIV infection reference rather reflects the frequent testing behaviour of subgroups of MSM.
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Affiliation(s)
- Isabel Slurink
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Fleur van Aar
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Saara Parkkali
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Titia Heijman
- Department of Infectious Diseases, 1221Public Health Service (GGD), Amsterdam, The Netherlands
| | - Hannelore Götz
- Department of Infectious Disease Control, 6993Public Health Service, Rotterdam-Rijnmond, The Netherlands
| | - Karlijn Kampman
- 26095Public Health Service Twente, Enschede, The Netherlands
| | - Yolanda van Weert
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Birgit van Benthem
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | - Eline Op de Coul
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Hofstraat SH, Götz HM, van Dam AP, van der Sande MA, van Benthem BH. Trends and determinants of antimicrobial susceptibility of Neisseria gonorrhoeae in the Netherlands, 2007 to 2015. ACTA ACUST UNITED AC 2019; 23. [PMID: 30205870 PMCID: PMC6134804 DOI: 10.2807/1560-7917.es.2018.23.36.1700565] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Neisseria gonorrhoeae antibiotic resistance surveillance is important to maintain adequate treatment. We analysed 2007–15 data from the Gonococcal Resistance to Antimicrobials Surveillance (GRAS), which currently includes 19 of 25 sexually transmitted infection (STI) centres in the Netherlands. Methods: From each patient with a gonorrhoea culture, the minimum inhibitory concentration (MIC) for several antibiotics was determined. Time trends were assessed by geometric means and linear regression of logarithmic MIC. Determinants for decreased susceptibility to ceftriaxone (MIC > 0.032 mg/L) and resistance to cefotaxime (MIC > 0.125 mg/L) and azithromycin (MIC > 0.5 mg/L) were assessed using stratified logistic regression. Results: 11,768 isolates were analysed. No ceftriaxone resistance was found. In 2015, 27 of 1,425 isolates (1.9%) were resistant to cefotaxime and 176 of 1,623 (10.9%) to azithromycin. Ceftriaxone susceptibility showed no trend (p = 0.96) during the study period, but cefotaxime MIC decreased (p < 0.0001) and azithromycin MIC increased (p < 0.0001) significantly. Concerning ceftriaxone, isolates of men who have sex with men (MSM) from 2013 (p = 0.0005) and 2014 (p = 0.0004) were significantly associated with decreased susceptibility. Significant determinants for cefotaxime resistance were having ≥ 6 partners for women (p = 0.0006). For azithromycin,isolates from MSM collected in 2012 (p = 0.0035), 2013 (p = 0.012), and 2014 (p = 0.013), or from non-Dutch (p < 0.0001) or older (≥ 35 years; p = 0.01) MSM were significantly associated with susceptibility. Resistance in heterosexual men was significantly associated with being ≥ 25 years-old (p = 0.0049) or having 3–5 partners (p = 0.01). Conclusions: No ceftriaxone resistance was found, but azithromycin MIC increased in 2007–15. Resistance determinants could help with focused intervention strategies.
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Affiliation(s)
- Sanne Hi Hofstraat
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Hannelore M Götz
- Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands.,National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Alje P van Dam
- Public Health Laboratory, Amsterdam Health Service, Amsterdam, the Netherlands
| | - Marianne Ab van der Sande
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, the Netherlands.,National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Birgit Hb van Benthem
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, the Netherlands
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Alberts CJ, Boyd A, Bruisten SM, Heijman T, Hogewoning A, Rooijen MV, Siedenburg E, Sonder GJB. Hepatitis A incidence, seroprevalence, and vaccination decision among MSM in Amsterdam, the Netherlands. Vaccine 2019; 37:2849-2856. [PMID: 30992222 DOI: 10.1016/j.vaccine.2019.03.048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Several outbreaks of Hepatitis A virus (HAV) were recently documented among men who have sex with men (MSM) in Europe. We investigated the HAV incidence among MSM in Amsterdam, the Netherlands; and HAV seroprevalence and HAV vaccination decision among MSM visiting the Sexually Transmitted Infection (STI) clinic in Amsterdam. METHODS Using surveillance data from 1992 to 2017 of MSM with acute HAV in Amsterdam, we estimated the incidence by calendar year and age. We explored HAV seroprevalence by calendar year and age, determinants for HAV seropositivity, and opting-in/out for HAV vaccination using data collected among MSM that visited the STI clinic between 2006 and 2017 and were included in a nationwide Hepatitis B virus (HBV) vaccination programme. Offering HAV vaccination at the STI clinic differed over three consecutive periods: not offered, offered for free, or offered for 75 euros. Logistic regression analyses were used to explore determinants. RESULTS HAV incidence increased in 2016/17 after 4 years of absence and peaked in MSM around 35 years of age. Among MSM visiting the STI clinic, HAV seroprevalence was 37% (95%CI = 35-40%), which was constant over the period 2006-2017, and increased with age (p < 0.001). Determinants for HAV seropositivity in multivariable analysis were: older age (p < 0.001), originating from an HAV endemic country (p < 0.001), and being HBV seropositive (p = 0.001). MSM opted-in more frequently when HAV vaccination was offered for free versus paid (89% versus 11%, respectively; p < 0.001). Younger MSM were less inclined to vaccinate when payment was required (p = 0.010). Post-hoc analyses showed that 98% versus 46% of MSM visiting the Amsterdam STI clinic would be protected against HAV infection if HAV vaccination was offered for free or for 75 euros, respectively. CONCLUSIONS The MSM population of Amsterdam is vulnerable to a new HAV outbreak. We strongly recommend that MSM have access to free hepatitis A vaccination.
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Affiliation(s)
- Catharina J Alberts
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands
| | - Anders Boyd
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
| | - Sylvia M Bruisten
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Amsterdam Infection & Immunity Institute (AI&II), Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.
| | - Titia Heijman
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands.
| | - Arjan Hogewoning
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Amsterdam Infection & Immunity Institute (AI&II), Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.
| | - Martijn van Rooijen
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands.
| | - Evelien Siedenburg
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands.
| | - Gerard J B Sonder
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Amsterdam Infection & Immunity Institute (AI&II), Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.
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Ye M, Giri M. Prevalence and correlates of HIV infection among men who have sex with men: a multi-provincial cross-sectional study in the southwest of China. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2018; 10:167-175. [PMID: 30323685 PMCID: PMC6178892 DOI: 10.2147/hiv.s176826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective This study aims to assess the prevalence and correlates of HIV Infection among men who have sex with men (MSM) in two major provinces in southwest of China. Method We adopted the method of anonymous survey and HIV blood test on 1,245 MSM >18 years of age from Chongqing and Sichuan Province, China. Results The prevalence of HIV infection among MSM was 21.20%. Multiple logistic regression analysis revealed significant independent predictors of HIV infection among MSM as follows: lower level of education, preference to be receptive, lower frequency of condom use, drug usage, higher number of sexual partners in the past 1 month, and people suffering from sexually transmitted diseases. The distribution of HIV infection probability scores among HIV-negative MSM shows a positively skewed distribution, which will help to find persons at higher risk of HIV infection. Conclusion HIV prevalence in Chongqing and Sichuan Province is extremely high. We must find a way to identify people at high risk of HIV infection and employ different interventions among different risk levels of HIV infection in order to achieve maximum prevention and treatment benefit. Considering the relative shortage of resources, efforts to prevent HIV might be more effectively employed if they stratify men based on validated risk criteria.
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Affiliation(s)
- Mengliang Ye
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China,
| | - Mohan Giri
- Department of Respiratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Affiliation(s)
- Lewis Haddow
- Centre for Sexual Health and HIV Research, University College London, London, UK
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Abstract
OBJECTIVES Men who have sex with men (MSM) who are unaware of their HIV infection are more likely to infect others, and unable to receive treatment. Therefore, we aimed to identify the proportion and characteristics of Dutch MSM who never tested for HIV. METHODS In 2010, the European MSM Internet Survey (EMIS) recruited 174,209 men from 38 countries through an anonymous online questionnaire in 25 languages. We analysed data from participants living in the Netherlands (N=3787). The outcome we investigated was having never (lifetime) been tested for HIV. RESULTS A total of 770 MSM (20.4%) had never been tested for HIV. In multivariate regression analyses, not being from Amsterdam (adjusted OR, aOR 1.54, CI 1.17 to 2.03), with low education (aOR 1.28, CI 1.04 to 1.57) and low knowledge on HIV-testing (aOR 2.23, CI 1.37 to 3.64) were significantly associated with never having tested. Lower sexual risk (including having fewer sexual partners (aOR 2.19, CI 1.57 to 3.04) and no anal intercourse (aOR 5.99, CI 3.04 to 11.77)), and less social engagement (including being less out (aOR 1.93, CI 1.55 to 2.40)) were also associated with having never been tested. Additionally, 36.1% of MSM who never tested for HIV reported high-risk sexual behaviour that may have put them at HIV risk. CONCLUSIONS MSM make their own risk assessments that inform their choices about HIV-testing. Nevertheless, MSM who were never tested may have been at risk for HIV, and remain important to target for HIV interventions.
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Affiliation(s)
- Chantal den Daas
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Martine Doppen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Axel J Schmidt
- Sigma Research, Department of Social & Environmental Health Research, London School of Hygiene and Tropical Medicine, UK
| | - Eline Op de Coul
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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