BCN checkpoint: implementation of a community based center of HIV detection for men who have sex with men (MSM) in Barcelona, Spain
Issues: HIV Prevalence and Incidence; Men who have Sex with Men; Early HIV detection; Peer Counseling, Cohort Study.
Description: Data in the Barcelona area show that HIV prevalence in MSM is about 20% and almost 50% of the men newly diagnosed are MSM. Although in the Autonomous Community of Catalonia alternative HIV testing sites (anonymous) and seroprevalence surveys work since 1994, little data are available on changes in HIV incidence. In 2006, Projecte dels NOMS-HISPANOSIDA created in Barcelona’s gay area a community-based center for MSM, BCN Checkpoint, in order to: 1) give peer counseling about HIV transmission and risk perception, 2) promote an early detection of HIV infections, and 3) introduce the rapid HIV test. Men with major number of sex partners or with identified risk behaviors were suggested to do an HIV test every 6 or 12 months. During 2007 BCN Checkpoint has performed 1.098 HIV tests to 941 different persons – with a fourfold increase in the number of tests performed in regard of 2006 – and 37 HIV infections were detected (equal to ± 10% of all new HIV diagnosis in Barcelona).
Lessons learned: BCN Checkpoint as a concept has been well accepted by the Barcelona MSM community and will permit to obtain more insight into HIV incidence. The changes in testing practices within MSM suggest that a community approach for voluntary testing and counseling gives better results and is more cost/effective than an approach to general public.
Next steps: To extend our experience to other urban areas in Spain with significant MSM community, and to run a prospective cohort study among seronegative MSM to measure the incidence and the shifts in HIV transmission and to assess the effects of voluntary peer counseling and HIV testing on risk behaviors.
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