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Massimo Mirandola 1,2 , Jean Pierre Foschia 2 , Michele Breveglieri 2 , Ruth Joana Davis 1 , Martina Furegato 2 , Enrica Castellani 2 , Lorenzo Gios 1 , Dunia Ramarli 4 , Paola Coato 4 & The SIALON network
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Massimo Mirandola 1,2, Jean Pierre Foschia 2, Michele Breveglieri2, Ruth Joana Davis 1, Martina Furegato2, Enrica Castellani 2, Lorenzo Gios1, Dunia Ramarli 4, Paola Coato4 & The SIALON network 1 Dept. ofHealth - Office for International Health and Social Affairs - Veneto Region - Italy 2 RegionalCentreforHealth Promotion (CRRPS) – ULSS 20 Verona – Veneto Region – Italy 3Verona University Hospital – ClinicalImmunology - Verona – Italy 4Verona University Hospital – Microbiology - Verona – Italy Project co-funded by the European Commission under the Public Health Programme2003-2008 The SIALON Project (2008-2010): HIV prevalence, undiagnosed HIV infections and testing seeking behaviour among MSM attending gay venues in six European cities Lisbon, Portugal, 28 - 29 March 2011
Objectives • To estimate HIV among MSM based on oral fluid test • To study sexual behaviour risk patterns and the determinants of VCT (Voluntary Counselling and Testing) access in the MSM population • To model the relationship between risk behaviour, socio-ecological factors, real and self reported sero-status
Project Methodology • QUESTIONNAIRE • GENSCREEN HIV 1 / 2 version 2, BIO-RAD • EIA Test – Validation on 504 pos. and neg. samples
Questionnaire flow-chart 12 months period Last time 6 months period
mapping Advertisements Gay guides Venues opening Gay venues time identification At least 10 VDT? SIALON TLSSAMPLING Venues mapping Gay venues Internet search Key informants review OpeningTime mapping Attendance Special events Owners - patrons patterns identification cross validation identification Further info NO Need of Potential VDTs list furhter info ? YES Observation at excluded venues Safety check and final VDTs list YES YES Safety for FILL IN Eligible VDTs list MSM per data THE EXCEL FILE collectors? NO NO
HIV TESTING PRACTICE, HIV PREVALENCE AND PERCENTAGE OF HIV UNDIAGNOSED MSM BY CITY Confidence Intervals 95% * Provided only for reference
Testingseekingbehaviourpredictedprobabilitybyage,city and sexualorientation
Testingseekingbehaviourpredictedprobabilitybyageand sexualorientation
Conclusions • HIV prevalence was higher in Southern European cities than elsewhere. • Data seems to indicate that quite a number of infections was recently acquired over the last 12 months. • Outreach prevention programmes promoting HIV testing are needed in order to promote HIV testing and detect undiagnosed infections. • Testing seeking behaviour is influenced by age, education, living conditions, perceived homonegativity at micro-meso level and sexual orientation/identity. • In relation to the study cities Sexual orientation/identity plays an important role in predicting testing seeking behaviour • TLS increases the possibility of involving a variety of participants who probably do not attend health services and of obtaining more valid results. • TLS is easily applicable in cities with a considerable number of eligible gay venues. It is more difficult to implement in cities where the gay community is poorly organised and where there are few easily accessible venues. • TLS does not take into account other ways of recruiting, such as the internet, gay magazines, chat room, therefore the estimate of HIV and risk behaviour prevalence may be biased.