High prevalence and incidence of HIV infection among men who have sex with men recruited in commercial gay venues in Paris, France: PREVAGAY 2009 Survey
A. Velter1, F. Barin2, A. Bouyssou1, J. Guinard3, S. Le Vu1, J. Pillonel1, A. Alexandre4, C. Semaille1
1Institut de Veille Sanitaire, Département des Maladies Infectieuses, Saint-Maurice, France, 2Centre National de Reference du VIH, Tours, France, 3Centre National de Reference du VIH, TOURS, France, 4Syndicat National des Entreprises Gay, Prevention, Paris, France
Background: In France, nearly half of new HIV cases among men are attributed to sexual contact among men who have sex with men (MSM). Until now, behavioural surveys provided a self-reported HIV prevalence among MSM ranging from 12 to 17%. In 2009, a survey was set up in order to estimate HIV prevalence and incidence based on biological results.
Methods: An anonymous cross-sectional survey was conducted in 14 Paris gay commercial venues with or without sex (saunas, backrooms and bars), during 6 weeks. MSM were invited to self-collect a fingerprick blood sample on blotting paper, then to self-complete a behavioural questionnaire.
Blood samples were screened using the Genscreen-ultra-HIV-Ag-Ab (Biorad) assay and confirmed by Western Blot. The enzyme immunoassay for recent HIV-1 infections (EIA-RI) was used to estimate cross-sectional incidence (180 days window-period, false recent rate of 1.6%).
Results: Of the 1578 men approached, 886 (56%) provided both blood specimen and completed the questionnaire. Participants’ median age was 38 years; 63% of them reported at least one HIV screening, and 51% over 10 sexual partners during the last 12 months. The estimated HIV sero-prevalence was 17.7% [95%CI: 15.3-20.4]. This prevalence increased with age: 8.9% [5.4-14.3] for 30 year-olds and under, 22.0% [15.5-30.4] for those above 50. The annual HIV incidence estimate was 7.5% person-years [95%CI: 4.5-10.5]. The highest incidence estimate was among the 40-49 age group: 9.4% [1.7-17.8].
Among the 157 HIV-positive men, 20% were unaware of their positive status, 69% reported over 10 sexual partners, 38% unprotected anal intercourse with partners of negative or unknown HIV status in the last 12 months.
Conclusions: This first French MSM community based survey provides both HIV sero-prevalence and incidence; it reveals an important HIV transmission in this highly infected population. These data call for effective emergency prevention programs targeting MSM.
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