Regional disparity of HIV incidence and prevalence among men who have sex with men

Abstract

Background HIV incidence can be estimated with cross-sectional studies using clinical, serological, and molecular data. Worldwide, HIV incidence data in only men who have sex with men (MSM) are scarce and principally focus on those with healthcare or under treatment. However, better estimates can be obtained through studies with national representativeness. The objective was to estimate the prevalence, incidence, and factors associated with acquiring HIV in a national sample of MSM who attend meeting places, considering geographical regions. Methods A nationally representative survey of MSM attending meeting places was performed in Mexico. Participants answered a questionnaire, and a dried blood spot (DBS) was collected. Samples were classified as recent infections using an algorithm with HIV status, antiretroviral therapy, and the result of BED-EIA assay. Parameters were analysed considering regions and demographic and sexual behaviour characteristics. Results The national HIV prevalence was 17.4% with regional differences; the highest prevalence (20.7%) was found in Mexico City, and the lowest prevalence was found in the West region (11.5%). The incidence was 9.4 per 100 p/y, with regional values from 6.2 to 13.2 for the Northeast and the Centre regions, respectively. Age, age at sexual debut, low wealth index, and rewarded sex were associated with HIV prevalence. Centre region, use of private clinics as health services, and having sex exclusively with men were associated with recent HIV infections. Conclusions The incidence and prevalence showed regional differences, suggesting a difference in the dynamics of HIV transmission; some regions have a greater case accumulation, and others have a greater rate of new infections. Understanding this dynamic will allow developing health programs focused on HIV prevention or treating people already living with HIV.

Sustained high HIV incidence among men who have sex with men in Jiangsu province, China: based on the limiting-antigen avidity EIA method and six consecutive surveys, 2016–2021

“…However, it suggested that HIV incidence among MSM in Jiangsu province still maintained a high level. Compared with HIV incidence among MSM in other countries, the result in our study was higher than that in Manila in the Philippines ( 20 ) and lower than those in Mexico ( 21 ) and in a study of Myanmar ( 22 ). Compared with those in other provinces and cities in China, our result was similar to that of Tang et al's study in 20 cities of China ( 23 ) and higher than those in Shandong province ( 24 ) and Yunnan province ( 25 ).…”

Examining Geographical Differences in the HIV Care Continuum Among Men Who Have Sex with Men in Mexico

“…Based on reported state of residence, participants were stratified into the following 6 geographical regions: Noroeste (Baja California, Baja California Sur, Sonora, Sinaloa, Chihuahua, and Durango); Noreste (Coahuila, Nuevo León, Tamaulipas, San Luis Potosí, and Zacatecas); CDMX/EdoMex (Ciudad de México and Estado de México); Centro (Hidalgo, Puebla, Tlaxcala, Morelos, Guerrero, and Veracruz); Bajío/Occidente (Aguascalientes, Nayarit, Jalisco, Colima, Guanajuato, Michoacán, and Querétaro); and Sur/Sureste (Oaxaca, Tabasco, Chiapas, Campeche, Yucatán, and Quintana Roo). As there is no national consensus for categorizing states into regions to assess HIV-related outcomes in Mexico, [ 3 – 5 ] we developed these categorizations based on previous literature by Bautista-Arredondo et al (2013) [ 4 ] and applied modifications informed by consultations with representatives from the National Center of HIV/AIDS Control and Prevention in Mexico (CENSIDA; the governmental institution responsible for preventing and monitoring sexual, blood, and perinatal transmission of HIV in Mexico) and other subject matter experts.…”

“…[ 3 ] HIV prevalence among MSM is disproportionately higher than that of the general population in Mexico (17.4% vs. 0.26%). [ 3 , 4 , 5 , 6 ] Yet, minimal research has reported on regional HIV prevalence, testing, and care continuum outcomes specifically among MSM (HIV prevalence estimates, [ 3 – 6 ] yearly HIV tests used, [ 3 , 7 ] HIV testing within the past 12 months [ 8 ]). To reach the Joint United Nations Programme on HIV/AIDS’s (UNAIDS) 90/90/90 goal, [ 9 ] it remains important to examine care continuum outcomes and identify regions where resources may be needed to improve these outcomes and achieve national goals.…”

Metrics of sexual behavior stigma among cisgender men who have sex with men in Mexico: exploratory and confirmatory factor analyses

“…MSM in Mexico experience a disproportionate burden of HIV, with an estimated prevalence of 12-17% [23][24][25] compared to < 0.3% in the general population [26]. HIV testing and status awareness remain low at 40%, while roughly 1 in 3 do not use condoms [25].…”