- Louise Logan1, Ibidun Fakoya2, Alison Howarth2, Gary Murphy3, Anne M Johnson2, Alison J Rodger2,4, Fiona Burns2,4, Anthony Nardone1
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View Affiliations Hide AffiliationsAffiliations: 1 HIV and STIs Department, Public Health England, London, United Kingdom 2 Institute for Global Health, University College London, United Kingdom 3 Laboratory Services, National Infections Service, Public Health England, London, United Kingdom 4 Royal Free London NHS Foundation Trust, London, United KingdomLouise Loganlouise.logan phe.gov.uk
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Citation style for this article: Logan Louise, Fakoya Ibidun, Howarth Alison, Murphy Gary, Johnson Anne M, Rodger Alison J, Burns Fiona, Nardone Anthony. Combination prevention and HIV: a cross-sectional community survey of gay and bisexual men in London, October to December 2016. Euro Surveill. 2019;24(25):pii=1800312. https://doi.org/10.2807/1560-7917.ES.2019.24.25.1800312 Received: 14 Jun 2018; Accepted: 09 Feb 2019
Combination prevention and HIV: a cross-sectional community survey of gay and bisexual men in London, October to December 2016
Abstract
Men who have sex with men (MSM) are at risk of HIV and are an important population to monitor and ameliorate combination prevention efforts.
To estimate HIV prevalence and identify factors associated with frequent HIV testing (≥ 2 HIV tests in the last year) and pre-exposure prophylaxis (PrEP) use among MSM in London.
For this cross-sectional study, MSM recruited from 22 social venues provided oral-fluid samples for anonymous HIV antibody (Ab) testing and completed a questionnaire. Factors associated with frequent HIV testing and PrEP use were identified through logistic regression.
Of 767 men recruited, 545 provided an eligible oral specimen. Among these, 38 MSM (7.0%) were anti-HIV positive including five (13.2%; 5/38) who reported their status as negative. Condomless anal sex within the previous 3 months was reported by 60.1% (412/685) men. Frequent HIV testing was associated with, in the past year, a reported sexually transmitted infection (adjusted odds ratio (AOR): 5.05; 95% confidence interval (CI): 2.66–9.58) or ≥ 2 casual condomless partners (AOR 2–4 partners: 3.65 (95% CI: 1.87–7.10); AOR 5–10 partners: 3.34(95% CI: 1.32–8.49). Age ≥ 35 years was related to less frequent HIV testing (AOR 35–44 years: 0.34 (95% CI: 0.16–0.72); AOR ≥ 45 years: 0.29 (95% CI: 0.12–0.69). PrEP use in the past year was reported by 6.2% (46/744) of MSM and associated with ≥ 2 casual condomless sex partners (AOR: 2.86; 95% CI: 1.17–6.98) or chemsex (AOR: 2.31; 95% CI: 1.09–4.91).
This bio-behavioural study of MSM found high rates of behaviours associated with increased risk of HIV transmission. Combination prevention, including frequent HIV testing and use of PrEP, remains crucial in London.

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