The HIV Care Continuum among Men Who Have Sex with Men in Moscow, Russia: A Cross-Sectional Study of Infection Awareness & Engagement In Care
OBJECTIVES:
Early
diagnosis and treatment of HIV infection is critical to improving clinical
outcomes for HIV-infected individuals. We sought to characterise the HIV care
continuum and identify correlates of being unaware of one's HIV infection among
men who have sex with men (MSM) in Moscow, Russia.
METHODS:
Participants
(N=1376) were recruited via respondent-driven sampling and completed a
sociobehavioural survey and HIV testing from 2010 to 2013. Sample and
population estimates were calculated for key steps along the HIV care continuum
for HIV-infected MSM and logistic regression methods were used to examine
correlates of being unaware of one's HIV infection.
RESULTS:
15.6% of participants
were HIV infected. Of these, only 23.4% were previously aware of their infection, 8.7% were on antiretroviral therapy
(ART), and 4.4% reported
an undetectable viral load. Bisexual identity (reference: homosexual; adjusted
odds ratio, having ≥5 sexual partners in the
last 6 months, and employer
HIV testing requirements were associated with being unaware of one's HIV infection. HIV testing in a
specialised facility and
testing ≥2 times in the last 12 months were inversely associated with being unaware of HIV infection.
CONCLUSIONS:
There
is a steep gradient along the HIV care continuum for Moscow-based MSM beginning
with low awareness of HIV infection. Efforts that improve access to acceptable
HIV testing strategies, such as alternative testing facilities, and linkage to
care are needed for key populations.
- 1Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA Department of Emergency Medicine, Johns Hopkins Medical Institute, Baltimore, Maryland, USA.
- 2Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
- 3Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
- 4AIDS Infoshare, Moscow, Russian Federation.
- 5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA Department of Statistics, University of Haifa, Israel.
- 6Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
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