Bio-behavioural HIV and STI surveillance among men who have sex with men in Europe: the Sialon II protocols

Abstract

BackgroundGlobally, the HIV epidemic continues to represent a pressing public health issue in Europe and elsewhere. There is an emerging and progressively urgent need to harmonise HIV and STI behavioural surveillance among MSM across European countries through the adoption of common indicators, as well as the development of trend analysis in order to monitor the HIV-STI epidemic over time. The Sialon II project protocols have been elaborated for the purpose of implementing a large-scale bio-behavioural survey among MSM in Europe in line with a Second Generation Surveillance System (SGSS) approach.Methods/DesignSialon II is a multi-centre biological and behavioural cross-sectional survey carried out across 13 European countries (Belgium, Bulgaria, Germany, Italy, Lithuania, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and the UK) in community settings. A total of 4,966 MSM were enrolled in the study (3,661 participants in the TLS survey, 1,305 participants in the RDS survey). Three distinct components are foreseen in the study protocols: first, a preliminary formative research in each participating country. Second, collection of primary data using two sampling methods designed specifically for ‘hard-to-reach’ populations, namely Time Location Sampling (TLS) and Respondent Driven Sampling (RDS). Third, implementation of a targeted HIV/STI prevention campaign in the broader context of the data collection.DiscussionThrough the implementation of combined and targeted prevention complemented by meaningful surveillance among MSM, Sialon II represents a unique opportunity to pilot a bio-behavioural survey in community settings in line with the SGSS approach in a large number of EU countries. Data generated through this survey will not only provide a valuable snapshot of the HIV epidemic in MSM but will also offer an important trend analysis of the epidemiology of HIV and other STIs over time across Europe. Therefore, the Sialon II protocol and findings are likely to contribute significantly to increasing the comparability of data in EU countries through the use of common indicators and in contributing to the development of effective public health strategies and policies in areas of high need.

Place and practice: Sexual risk behaviour while travelling abroad among Swedish men who have sex with men

“…Our findings strengthen the knowledge that MSM stand out not only when it comes to condom use (see figures 5 and 6) but also for HIV testing uptake. Swedish MSM surveys and other recent population surveys show that MSM are tested for HIV to greater extent than the general population and the MSM2013 estimates of HIV testing match other recent studies 42,43,94,146,162,163 .…”

“…The MSM2013 team also established a collaboration with an ongoing European TLS project, Sialon II 146 (Swedish partner was Public Health Agency of Sweden) and a respondent driven sampling (RDS) research project (led by Anna Thorson, Karolinska Institutet). The three different data collection methods provided a unique opportunity to compare the validity of Swedish MSM data since similar data were collected using different methods during the same time period.…”

“…Note: Purple denotes all genders, blue denotes MSM, yellow denotes men and green denotes women. About 25% of MSM report never having been HIV tested in every Swedish MSM survey over the past twenty years 2,42,43,94,146 . It has been possible to test for HIV since the mid-1980s 166 , and since the 1990s, studies on barriers to HIV testing have been conducted.…”

Field evaluation of two point-of-care tests for syphilis among men who have sex with men, Verona, Italy

“…Study participants were asymptomatic MSM, potentially exposed to syphilis as a result of risky behaviours, prospectively recruited from the Sialon II Respondent-Driven Sampling survey implemented in Verona, Italy,12 from 2013 to 2014 and MSM attending the Infectious Diseases Unit of the Verona University Hospital screening facility from 2015 to 2016. The prevalence of HIV, TPPA and dually TPPA/RPR seropositivity used for the evaluation of the performance of the POCTs was based on the results of an integrated bio-behavioural survey carried out among the Verona MSM population 5…”

Multiform spectrum of pulmonary disease in lethal HIV infection cases in Latvia (2012–2016)

“…Th e main HIV transmission routes in Latvia are heterosexual contacts (40%) and IVDU (25%), but in 35% of cases the route of transmission is not reported [18,37]. In Lithuania and Estonia, the situation is similar [5,10,20]. Practitioners, radiologists and pathologists in the 21 st century -35 years aft er the year 1982 when WHO accepted the word "AIDS" -are diagnosing very diff erent lung diseases in HIV-infected persons.…”