Good knowledge and frequent testing but high risk behaviour in recently HIV-infected men who have sex with men. First results from a KABP-survey as part of the German HIV-incidence study
R. Zimmermann1, U. Marcus1, J. Bätzing-Feigenbaum2, S. Gohlke-Micknis1, S. Loschen3, C. Kücherer3, O. Hamouda1, B. Gunsenheimer-Bartmeyer4
1Robert Koch-Institute, Infectious Disease Epidemiology, Berlin, Germany, 2State Office for Health and Social Welfare, Infectious Disease Protection and Epidemiology Unit, Berlin, Germany, 3Robert Koch-Institute, HIV Variability and Molecular Virology, Berlin, Germany, 4Robert Koch-Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
Background: Data on knowledge, attitudes, behaviour and practices (KABP) of persons with recent HIV-infections in comparison to matched controls with negative HIV test result provide information on current risk patterns and can help to re-focus prevention strategies.
Methods: From 03/2008 through 11/2009 clinical and socio-demographic data and dried blood spots (DBS) of persons newly diagnosed with HIV (=cases) and HIV negative controls, matched for age, gender, and transmission risk were collected by physicians in six sentinel regions in Germany. Cases and controls completed a KABP-questionnaire. To distinguish recent (< 5 months) from longstanding (>5m) infection the BED-IgG-capture-ELISA was performed on DBS. Reported risk behaviour of cases with recent infection was compared with controls.
Results: By November 2009, 348 cases and 320 controls had been recruited. 88% of cases were male, and men having sex with men (MSM;72%). The proportion of recent infections in MSM was 41% (n=106/256). MSM cases with recent infection and controls did not differ in terms of knowledge on transmission risks, HIV-testing frequency, partnership status (45% single), or for the frequency of any unprotected sex practice with partners known to be HIV-positive or assumed to be HIV-negative. Unprotected sex with persons of unknown HIV-serostatus within the last 6 months was reported by 71% of recently infected MSM (n=70) compared to 53% of controls (n=66;OR=2.2; 95%CI[1.1;4.5]). In addition, cases indicated higher frequencies of unprotected receptive anal (n=37;OR=3;95%CI[1.2;7.5]) and oral sex (n=42;OR=3;95%CI[1.1;8.6]) with persons of unknown serostatus. Primary partnerships of recently infected MSM (n=41) more often had a shorter duration (46% < 6months) than partnerships of controls (n=44;21%,OR=3.4; 95%CI[1.3;8.7]).
Conclusions: Recently HIV-infected MSM report shorter duration of their current primary partnership, and indicate unprotected receptive sex with persons of unknown serostatus more often than HIV-negative controls. They do not differ in terms of knowledge on HIV transmission risks and frequency of HIV-testing.