HIV Infection Incidence among Men Who Have Sex with Men in Common Bathing Pool in Tianjin

OBJECTIVE:

To investigate incidence of HIV infection and identify associated risk factors among men who have sex with men (MSM) in common bathing pools in Tianjin.

METHODS:

A prospective cohort study was conducted among the MSM recruited in a common bathing pool in Tianjin from 2011 to 2013. A total of 733 MSM were surveyed to obtain the information about their sociodemographic characteristics, HIV-related knowledge awareness and sexual behaviors, and subsequent follow-up surveys were carried out every four months. Cox regression analysis was conducted to identify the risk factors for HIV infection.

RESULTS:

A total of 59 HIV infection cases were found in the 2.5-years follow-up survey. The cumulative follow-up time was 7 384.9 person months. The incidence rate of HIV infection was 9.59/100 person-year. The multivariate Cox regression analysis showed that young age, low score of HIV/AIDS knowledge awareness (HR=1.82, 95%CI:1.03-2.66), having two and more sexual partners during past 6 months (HR=1.74, 95%CI: 1.26-2.58) and syphilis (HR=2.36, 95%CI:1.31-3.27) were significantly associated with HIV infection in this MSM cohort.

CONCLUSIONS:

Low score of HIV/AIDS knowledge awareness, young age, having two and more sexual partners during past 6 months and syphilis were the risk factors for HIV infection in MSM in common bathing pools. It is necessary to strengthen the HIV surveillance and intervention in this population.

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By:   Yu MH1, Jiang GH1, Dou Z2, Li ZJ3, Guo Y1, Xu P1, Yang J4, Xu J2.

• 1Tianjin Center for Disease Control and Prevention, Tianjin 300011, China.
• 2National Center for STD/AIDS Control and Prevention, Chinese Center for Disease Control and Prevention Beijing 102206, China.
• 3United States Center of Disease Control Global AIDS Program, China Office, Beijing 100600, China.
• 4Shenlan Public Health Counsel Service Center, Tianjin 300121, China. 
• Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Mar 10;37(3):362-6. doi: 10.3760/cma.j.issn.0254-6450.2016.03.014.

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Bio-Behavioural HIV & STI Surveillance among Men Who Have Sex with Men in Europe: The Sialon II Protocols

Background

Globally, the HIV epidemic continues to represent a pressing public health issue in Europe and elsewhere. There is an emerging and progressively urgent need to harmonise HIV and STI behavioural surveillance among MSM across European countries through the adoption of common indicators, as well as the development of trend analysis in order to monitor the HIV-STI epidemic over time. The Sialon II project protocols have been elaborated for the purpose of implementing a large-scale bio-behavioural survey among MSM in Europe in line with a Second Generation Surveillance System (SGSS) approach.

Methods/Design

Sialon II is a multi-centre biological and behavioural cross-sectional survey carried out across 13 European countries (Belgium, Bulgaria, Germany, Italy, Lithuania, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and the UK) in community settings. A total of 4,966 MSM were enrolled in the study (3,661 participants in the TLS survey, 1,305 participants in the RDS survey). Three distinct components are foreseen in the study protocols: first, a preliminary formative research in each participating country. Second, collection of primary data using two sampling methods designed specifically for ‘hard-to-reach’ populations, namely Time Location Sampling (TLS) and Respondent Driven Sampling (RDS). Third, implementation of a targeted HIV/STI prevention campaign in the broader context of the data collection.

Discussion

Through the implementation of combined and targeted prevention complemented by meaningful surveillance among MSM, Sialon II represents a unique opportunity to pilot a bio-behavioural survey in community settings in line with the SGSS approach in a large number of EU countries. Data generated through this survey will not only provide a valuable snapshot of the HIV epidemic in MSM but will also offer an important trend analysis of the epidemiology of HIV and other STIs over time across Europe. Therefore, the Sialon II protocol and findings are likely to contribute significantly to increasing the comparability of data in EU countries through the use of common indicators and in contributing to the development of effective public health strategies and policies in areas of high need.

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By:  Lorenzo Gios, Massimo Mirandola, Igor Toskin, Ulrich Marcus, Sandra Dudareva-Vizule, Nigel Sherriff, Michele Breveglieri, Martina Furegato, Cinta Folch, Laia Ferrer, Alexandra Montoliu, Christiana Nöstlinger, Wim Vanden Berghe,Sharon Kühlmann-Berenzon, Inga Velicko, Sónia Dias, Barbara Suligoi, Vincenza Regine, Danica Stanekova,Magdalena Rosińska, Saulius Caplinskas, Irena Klavs, Ivailo Alexiev, and Alexandru Rafila

Veneto Region - Department of Health, CReMPE - Regional Coordination Centre for European Project Management, the Verona University Hospital, Verona, Italy

Department of Pathology, Infectious Diseases Section, the Verona University Hospital - Veneto Region, Verona, Italy

Department of Reproductive Health & Research, World Health Organization, Geneva, Switzerland

Department for Infectious Diseases Epidemiology, Robert Koch-Institute, Berlin, Germany

Centre for Health Research, University of Brighton, Brighton, UK

Institut Catala d’Oncologia (ICO), Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain

Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium

Department of Monitoring and Evaluation, Public Health Agency of Sweden, Solna, Sweden

Institute of Hygiene and Tropical Medicine & GHTM, Universidade Nova de Lisboa, Lisbon, Portugal

Centro Operativo AIDS, Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy

NRC for HIV/AIDS, Slovak Medical University, Bratislava, Slovak Republic

Department of Epidemiology, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland

Centre for Communicable Diseases and AIDS, Vilnius, Lithuania

National Institute of Public Health, Ljubljana, Slovenia

National Reference Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria

National Institute of Infectious Diseases Prof. Dr. Matei Bals, Bucharest, Romania

Lorenzo Gios, Email: moc.liamg@oznerol.soig, Email: ti.anorevinueladepso@soig.oznerol.

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A Method to Estimate the Size and Characteristics of HIV-Positive Populations Using an Individual-based Stochastic Simulation Model

It is important not only to collect epidemiologic data on HIV but to also fully utilize such information to understand the epidemic over time and to help inform and monitor the impact of policies and interventions. We describe and apply a novel method to estimate the size and characteristics of HIV-positive populations. The method was applied to data on men who have sex with men living in the UK and to a pseudo dataset to assess performance for different data availability. The individual-based simulation model was calibrated using an approximate Bayesian computation-based approach. In 2013, 48,310 (90% plausibility range: 39,900–45,560) men who have sex with men were estimated to be living with HIV in the UK, of whom 10,400 (6,160–17,350) were undiagnosed. There were an estimated 3,210 (1,730–5,350) infections per year on average between 2010 and 2013. Sixty-two percent of the total HIV-positive population are thought to have viral load <500 copies/ml. In the pseudo-epidemic example, HIV estimates have narrower plausibility ranges and are closer to the true number, the greater the data availability to calibrate the model. We demonstrate that our method can be applied to settings with less data, however plausibility ranges for estimates will be wider to reflect greater uncertainty of the data used to fit the model.

Below:  Calibrating the model to data on MSM in the UK. A, Number of HIV diagnoses, (B) number of AIDS diagnoses, (C) number of deaths, (D) proportion of diagnoses which were recent infections (defined here as an infection which took place within six months of an HIV diagnosis), (E) total number seen for care, (F) Median CD4 count at diagnosis. Diamonds represent surveillance data until 2012 supplied by Public Health England (PHE). Filled diamonds show data used to calibrate the model; open diamonds show data not used to calibrate the model. Model median (solid line), model 90% plausibility range (dotted lines) and model range (light grey band) also shown. RITA indicates recent infection testing algorithm; SOPHID, survey of prevalent HIV infections diagnosed; CD4 SS, CD4 surveillance scheme.

Below:  A, Estimated incidence (number of new HIV infections in a year) and the (B) estimated diagnosis rate (probability of being diagnosed in any given 3-month period) among MSM in the UK.

Below:  Estimates of the (A) total number of MSM living with HIV in the UK and (B) total number of MSM living with undiagnosed HIV, by calendar year. Columns and error bars: Modeled median and 90% plausibility range.

Below:  Estimated (A) treatment cascade and (B) population characteristics of all MSM living with HIV in the UK in 2013. Columns and error bars: Modeled median and 90% plausibility range. ART indicates antiretroviral therapy. “Resistance” is defined as at least one resistance mutation in majority virus. “In need of ART” includes people who are on ART and those who are ART-naïve with CD4 count <500 cells/mm³. ART indicates antiretroviral therapy.

By:  Fumiyo Nakagawa,a Ard van Sighem,b Rodolphe Thiebaut,c Colette Smith,a Oliver Ratmann,d Valentina Cambiano,aJan Albert,e,f Andrew Amato-Gauci,g Daniela Bezemer,b Colin Campbell,h Daniel Commenges,c Martin Donoghoe,iDeborah Ford,j Roger Kouyos,k Rebecca Lodwick,l Jens Lundgren,m Nikos Pantazis,n Anastasia Pharris,g Chantal Quinten,g Claire Thorne,o Giota Touloumi,n Valerie Delpech,p and Andrew Phillipsa, on behalf of the SSOPHIE project working group in EuroCoord

From the ^aResearch Department of Infection and Population Health, UCL, London, United Kingdom; ^bStichting HIV Monitoring, Amsterdam, The Netherlands; ^cINSERM, Centre INSERM U897, Bordeaux, France; ^dDepartment of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom; ^eDepartment of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden; ^fDepartment of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden; ^gEuropean Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; ^hCEEISCAT, Generalitat de Catalunya, Barcelona, Spain; ⁱWHO Regional Office for Europe, Copenhagen, Denmark; ^jInstitute of Clinical Trials and Methodology, UCL, London, United Kingdom; ^kDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland; ^lResearch Department of Primary Care and Population Health, UCL, London, United Kingdom; ^mCHIP @ Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; ⁿDepartment of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece; ^oUCL Institute of Child Health, UCL, London, United Kingdom; and^pPublic Health England, London, United Kingdom.

Corresponding author.

Correspondence: Fumiyo Nakagawa, Research Department of Infection and Population Health, UCL, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK. E-mail: ku.ca.lcu@awagakan.f.

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HIV Surveillance - Persons Who Inject Drugs

Via:   http://goo.gl/LkL7cC

HIV Surveillance by Race/Ethnicity - U.S.

Via:  http://goo.gl/gPBZwH