Community-based voluntary counselling and testing (VCT) for men having sex with men (MSM) in Geneva, Switzerland: 2005 – 2008 monitoring
C. Gumy1, T. Huissoud1, H. Balthasar2, V. Jobin3, M. Häusermann3, H. Crevoisier3, P. Sudre4, A. Jeannin1, F. Dubois-Arber1
1Institute of Social and Preventive Medicine (IUMSP), University Hospital Center and University of Lausanne, Lausanne, Switzerland, 2Committee for Evaluation of Public Policies (CEPP), Geneva, Switzerland, 3Dialogai, Geneva, Switzerland, 4Direction Générale de la Santé, Département des Affaires Régionales, de l’Economie et de la Santé (DARES), Geneva, Switzerland
Background: We present results from monitoring of the activities and clientele of the community-based VCT "Checkpoint" facility in Geneva. The facility, opened in 2005 and operated by a local gay NGO, offers rapid HIV tests and MSM-specific counselling, available 8 hours weekly.
Methods: Analysis of data from the self-administered computerized questionnaire filled in by clients at entry, and routine facility data. Change was ascertained using Stata´s nptrend.
Results: The annual number of tests increased from 249 in 2005 to 480 in 2008 (2006: 282, 2007: 328). The proportion of positive tests was stable (2005: 2.4%, 2006: 2.1%, 2007: 3.0%, 2008: 2.1%). Each year, most clients were MSM (78% to 93%); median age was between 32 and 34.
Among MSM, the proportion having already been tested at least once for HIV increased from 86% in 2005 (n=159) to 91% in 2008 (n=332) (2006: 86%, n=204, 2007: 90%, n=271) (p=.015). The percentage of returning MSM clients increased from 21% (2006) to 37% (2008) (p< .001). In 2007/2008, main reasons for consultation were deliberate sexual risk exposure (37%/44%) and routine screening (31%/35%). No significant trend was observed regarding risk-taking behaviors: non-systematic condom use for anal intercourse with a stable partner was 73% in 2005, 55% in 2006, 57% in 2007, and 62% in 2008; with anonymous occasional partners, the range was 25% (2006) to 17% (2007); each year, 28% to 33% of MSM had had unprotected anal intercourse at least once with a partner of different or unknown HIV status.
Conclusions: The population attending this community-based VCT is more exposed to potential HIV transmission than the general MSM population in Geneva. As people attending the facility increased each year and many used the facility for routine repeated testing, this VCT seems to be well accepted, useful for clients and is reaching the intended population.