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Abstract

Background

Men who have sex with men (MSM) are at risk of HIV and are an important population to monitor and ameliorate combination prevention efforts.

Aim

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.

Methods

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.

Results

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).

Conclusion

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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/content/10.2807/1560-7917.ES.2019.24.25.1800312
2019-06-20
2020-04-07
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.25.1800312
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References

  1. Hankins CA, de Zalduondo BO. Combination prevention: a deeper understanding of effective HIV prevention. AIDS. 2010;24(Suppl 4):S70-80.  https://doi.org/10.1097/01.aids.0000390709.04255.fd  PMID: 21042055 
  2. Kurth AE, Celum C, Baeten JM, Vermund SH, Wasserheit JN. Combination HIV prevention: significance, challenges, and opportunities. Curr HIV/AIDS Rep. 2011;8(1):62-72.  https://doi.org/10.1007/s11904-010-0063-3  PMID: 20941553 
  3. Cremin I, Alsallaq R, Dybul M, Piot P, Garnett G, Hallett TB. The new role of antiretrovirals in combination HIV prevention: a mathematical modelling analysis. AIDS. 2013;27(3):447-58.  https://doi.org/10.1097/QAD.0b013e32835ca2dd  PMID: 23296196 
  4. Public Health England (PHE). National HIV Surveillance Data Tables. 2017. London: PHE; October 2017.
  5. Kirwan PDCC, Brown AE, Gill ON. Delpech VC and contributors. HIV in the UK - 2016 report. London: Public Health England; 2017.
  6. Skingsley AYZ, Kirwan P, Croxford S, Chau C, Conti S, Presanis ANA, et al. HIV in the UK – Situation Report 2015: data to end 2014. London: Public Health England; 2015.
  7. Brown AEHM, Mohammed H, Ogaz D, Kirwan PD, Yung M, Nash SG, et al. Fall in new HIV diagnoses among men who have sex with men (MSM) at selected London sexual health clinics since early 2015: testing or treatment or pre-exposure prophylaxis (PrEP)? Euro Surveill. 2017;22(25):30553.  https://doi.org/10.2807/1560-7917.ES.2017.22.25.30553  PMID: 28662762 
  8. Public Health England (PHE). HIV in the United Kingdom: decline in new HIV diagnoses in gay and bisexual men in London, 2017 report. Health Protection Report Advanced Access report. London: PHE; 3 October 2017.
  9. Aghaizu A, Wayal S, Nardone A, Parsons V, Copas A, Mercey D, et al. Sexual behaviours, HIV testing, and the proportion of men at risk of transmitting and acquiring HIV in London, UK, 2000-13: a serial cross-sectional study. Lancet HIV. 2016;3(9):e431-40.  https://doi.org/10.1016/S2352-3018(16)30037-6  PMID: 27562744 
  10. BHIVA, BASHH, BIS. UK National Guidelines for HIV Testing. 2008. [Accessed 4 Apr 2018]. Available from: https://www.bhiva.org/HIV-testing-guidelines
  11. McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016;387(10013):53-60.  https://doi.org/10.1016/S0140-6736(15)00056-2  PMID: 26364263 
  12. Molina JM, Capitant C, Spire B, Pialoux G, Cotte L, Charreau I, et al. ANRS IPERGAY Study Group. On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. N Engl J Med. 2015;373(23):2237-46.  https://doi.org/10.1056/NEJMoa1506273  PMID: 26624850 
  13. PrEP Impact Trial. A pragmatic health technology assessment of PrEP and implementation 2018. Available from: https://www.prepimpacttrial.org.uk/
  14. Dodds JP, Mercey DE, Parry JV, Johnson AM. Increasing risk behaviour and high levels of undiagnosed HIV infection in a community sample of homosexual men. Sex Transm Infect. 2004;80(3):236-40.  https://doi.org/10.1136/sti.2003.007286  PMID: 15170012 
  15. Curlin ME, Gvetadze R, Leelawiwat W, Martin M, Rose C, Niska RW, et al. OraQuick Study Group. Analysis of False-Negative Human Immunodeficiency Virus Rapid Tests Performed on Oral Fluid in 3 International Clinical Research Studies. Clin Infect Dis. 2017;64(12):1663-9.  https://doi.org/10.1093/cid/cix228  PMID: 28369309 
  16. Bourne A, Reid D, Hickson F, Torres-Rueda S, Steinberg P, Weatherburn P. "Chemsex" and harm reduction need among gay men in South London. Int J Drug Policy. 2015;26(12):1171-6.  https://doi.org/10.1016/j.drugpo.2015.07.013  PMID: 26298332 
  17. Schmidt AJ, Bourne A, Weatherburn P, Reid D, Marcus U, Hickson FEMIS Network. Illicit drug use among gay and bisexual men in 44 cities: Findings from the European MSM Internet Survey (EMIS). Int J Drug Policy. 2016;38:4-12.  https://doi.org/10.1016/j.drugpo.2016.09.007  PMID: 27788450 
  18. Sewell J, Miltz A, Lampe FC, Cambiano V, Speakman A, Phillips AN, et al. Attitudes to and Understanding of Risk of Acquisition of HIV (AURAH) Study Group. Poly drug use, chemsex drug use, and associations with sexual risk behaviour in HIV-negative men who have sex with men attending sexual health clinics. Int J Drug Policy. 2017;43:33-43.  https://doi.org/10.1016/j.drugpo.2017.01.001  PMID: 28189979 
  19. Tomkins A, Ahmad S, Cannon L, Higgins SP, Kliner M, Kolyva A, et al. Prevalence of recreational drug use reported by men who have sex with men attending sexual health clinics in Manchester, UK. Int J STD AIDS. 2018;29(4):350-6. https://doi.org/10.1177/0956462417725638  PMID: 28835196 
  20. Aghaizu ABA, Nardone A, Gill ON. Delpech VC & contributors. HIV in the United Kingdom: 2013 Report. Public Health England; November 2013. Available from: http://www.unaids.org/sites/default/files/country/documents/GBR_narrative_report_2014.pdf
  21. McDaid LM, Aghaizu A, Frankis J, Riddell J, Nardone A, Mercey D, et al. Frequency of HIV testing among gay and bisexual men in the UK: implications for HIV prevention. HIV Med. 2016;17(9):683-93.  https://doi.org/10.1111/hiv.12373  PMID: 26991460 
  22. Aghaizu A, Mercey D, Copas A, Johnson AM, Hart G, Nardone A. Who would use PrEP? Factors associated with intention to use among MSM in London: a community survey. Sex Transm Infect. 2013;89(3):207-11.  https://doi.org/10.1136/sextrans-2012-050648  PMID: 23015689 
  23. Bull L, Dimitrijevic P, Beverley S, Scarborough A, Mandalia S, Dosekun O, et al. Perceived need of, and interest in, HIV pre-exposure prophylaxis amongst men who have sex with men attending three sexual health clinics in London, UK. Int J STD AIDS. 2018;29(5):435-42.  https://doi.org/10.1177/0956462417730259  PMID: 28927341 
  24. Hoornenborg E, Prins M, Achterbergh RCA, Schim van der Loeff MF, Davidovich U, Hogewoning A, et al. High prevalence of hepatitis C virus among HIV negative MSM in the Amsterdam PrEP project. In: Conference on Retroviruses and Opportunistic Infections (CROI); 2017 February 13-17; Seattle, Washington.
  25. BHIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP). 2018. [Accessed 14 Jun 2018] Available from: https://www.bhiva.org/file/5b729cd592060/2018-PrEP-Guidelines.pdf
  26. Prah P, Hickson F, Bonell C, McDaid LM, Johnson AM, Wayal S, et al. Men who have sex with men in Great Britain: comparing methods and estimates from probability and convenience sample surveys. Sex Transm Infect. 2016;92(6):455-63.  https://doi.org/10.1136/sextrans-2015-052389  PMID: 26965869 
Combination prevention and HIV: a cross-sectional community survey of gay and bisexual men in London, October to December 2016
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Louise+Logan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Logan Louise</a>, <a href="/search?value1=Ibidun+Fakoya&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fakoya Ibidun</a>, <a href="/search?value1=Alison+Howarth&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Howarth Alison</a>, <a href="/search?value1=Gary+Murphy&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Murphy Gary</a>, <a href="/search?value1=Anne+M+Johnson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Johnson Anne M</a>, <a href="/search?value1=Alison+J+Rodger&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rodger Alison J</a>, <a href="/search?value1=Fiona+Burns&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Burns Fiona</a>, <a href="/search?value1=Anthony+Nardone&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nardone Anthony</a></span>. Combination prevention and HIV: a cross-sectional community survey of gay and bisexual men in London, October to December 2016. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(25):pii=1800312. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.25.1800312" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.25.1800312</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 14 Jun 2018;&nbsp;&nbsp; <span class="generated">Accepted</span>: 09 Feb 2019 </span> </p>
/content/10.2807/1560-7917.ES.2019.24.25.1800312
/content/10.2807/1560-7917.ES.2019.24.25.1800312
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