26 research outputs found
Process evaluation of a bio-behavioural HIV research combined with prevention among GBMSM in 13 European countries
Quantifying unmet prevention needs among MSM in Europe through a multi-site bio-behavioural survey
Introduction
The HIV epidemic represents an important public health issue in Europe particularly among men who have sex with men (MSM). Global AIDS Monitoring indicators (GAM) have been widely and jointly promoted as a set of crucial standardised items to be adopted for monitoring and responding to the epidemic.
Methods
The Sialon II study, implemented in 13 European cities (2013-14), was a complex multi-centre integrated bio-behavioural cross-sectional survey targeted at MSM, with a concomitant collection of behavioural and biological (oral fluid or blood specimens) data. Rigorous sampling approaches for hard-to-reach populations were used (time-location sampling and respondent-driven sampling) and GAM indicators were calculated; sampling frames were adapted to allow weighted estimates of GAM indicators.
Results
4,901 MSM were enrolled. HIV prevalence estimates ranged from 2.4% in Stockholm to 18.0% in Bucharest. When exploring city-level correlations between GAM indicators, prevention campaigns significantly correlated with levels of condom use and level of HIV testing among MSM.
Conclusion
The Sialon II project has made an important contribution to the monitoring and evaluation of the HIV epidemic across Europe, integrating the use of GAM indicators within a second generation HIV surveillance systems approach and in participatory collaboration with MSM communities. It influenced the harmonisation of European data collection procedures and indicators via GAM country reporting and contributed essential knowledge informing the development and implementation of strategic, evidence-based HIV prevention campaigns for MSM.Peer Reviewe
Quantifying Unmet Prevention Needs Among MSM in Europe Through a Multi-site Bio-behavioural Survey
The HIV epidemic represents an important
public health issue in Europe particularly among
men who have sex with men (MSM). Global AIDS
Monitoring indicators (GAM) have been widely and
jointly promoted as a set of crucial standardised items
to be adopted for monitoring and responding to the
epidemic. Methods: The Sialon II study, implemented
in 13 European cities (2013-14), was a complex multicentre
integrated bio-behavioural cross-sectional
survey targeted at MSM, with a concomitant collection
of behavioural and biological (oral fluid or blood
specimens) data. Rigorous sampling approaches for
hard-to-reach populations were used (time-location
sampling and respondent-driven sampling) and GAM
indicators were calculated; sampling frames were
adapted to allow weighted estimates of GAM indicators.
Results: 4,901 MSM were enrolled. HIV prevalence
estimates ranged from 2.4% in Stockholm to
18.0% in Bucharest. When exploring city-level correlations
between GAM indicators, prevention campaigns significantly correlated with levels of condom use
and level of HIV testing among MSM. Conclusion: The
Sialon II project has made an important contribution
to the monitoring and evaluation of the HIV epidemic
across Europe, integrating the use of GAM indicators
within a second generation HIV surveillance systems
approach and in participatory collaboration with
MSM communities. It influenced the harmonisation of
European data collection procedures and indicators
via GAM country reporting and contributed essential
knowledge informing the development and implementation
of strategic, evidence-based HIV prevention
campaigns for MSM
HIV-1 Infection in Cyprus, the Eastern Mediterranean European Frontier: A Densely Sampled Transmission Dynamics Analysis from 1986 to 2012
Since HIV-1 treatment is increasingly considered an effective preventionstrategy, it is important to study local HIV-1 epidemics to formulate tailored preventionpolicies. The prevalence of HIV-1 in Cyprus was historically low until 2005. To investigatethe shift in epidemiological trends, we studied the transmission dynamics of HIV-1 in Cyprususing a densely sampled Cypriot HIV-1 transmission cohort that included 85 percent ofHIV-1-infected individuals linked to clinical care between 1986 and 2012 based on detailedclinical, epidemiological, behavioral and HIV-1 genetic information. Subtyping andtransmission cluster reconstruction were performed using maximum likelihood and Bayesianmethods, and the transmission chain network was linked to the clinical, epidemiological andbehavioral data. The results reveal that for the main HIV-1 subtype A1 and B sub-epidemics,young and drug-naïve HIV-1-infected individuals in Cyprus are driving the dynamics of thelocal HIV-1 epidemic. The results of this study provide a better understanding of thedynamics of the HIV-1 infection in Cyprus, which may impact the development of preventionstrategies. Furthermore, this methodology for analyzing densely sampled transmissiondynamics is applicable to other geographic regions to implement effective HIV-1 preventionstrategies in local settings
Increase in transmitted resistance to non-nucleoside reverse transcriptase inhibitors among newly diagnosed HIV-1 infections in Europe
Background: One out of ten newly diagnosed patients in Europe was infected with a virus carrying a drug resistant mutation. We analysed the patterns over time for transmitted drug resistance mutations (TDRM) using data from the European Spread program.Methods: Clinical, epidemiological and virological data from 4317 patients newly diagnosed with HIV-1 infection between 2002 and 2007 were analysed. Patients were enrolled using a pre-defined sampling strategy.Results: The overall prevalence of TDRM in this period was 8.9% (95% CI: 8.1-9.8). Interestingly, significant changes over time in TDRM caused by the different drug classes were found. Whereas nucleoside resistance mutations remained constant at 5%, a significant decline in protease inhibitors resistance mutations was observed, from 3.9% in 2002 to 1.6% in 2007 (p = 0.001). In contrast, resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) doubled from 2.0% in 2002 to 4.1% in 2007 (p = 0.004) with 58% of viral strains carrying a K103N mutation. Phylogenetic analysis showed that these temporal changes could not be explained by large clusters of TDRM.Conclusion: During the years 2002 to 2007 transmitted resistance to NNRTI has doubled to 4% in Europe. The frequent use of NNRTI in first-line regimens and the clinical impact of NNRTI mutations warrants continued monitoring
Increase in transmitted resistance to non-nucleoside reverse transcriptase inhibitors among newly diagnosed HIV-1 infections in Europe
Limited cross-border infections in patients newly diagnosed with HIV in Europe
Matti Ristola ja Jussi Sutinen kuuluvat työryhmään SPREAD ProgrammePeer reviewe
Treatment-associated polymorphisms in protease are significantly associated with higher viral load and lower CD4 count in newly diagnosed drug-naive HIV-1 infected patients
Peer reviewe