Sexual risk behaviour trajectories among MSM at risk for HIV in Amsterdam, the Netherlands

Basten, Maartje; Heijne, Janneke C. M.; Geskus, Ronald B.; Daas, Chantal den; Kretzschmar, Mirjam; Matser, Amy

doi:10.1097/qad.0000000000001803

Cited by 27 publications

(40 citation statements)

References 24 publications

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“…The consistent associations between risk perception and numbers of casual AI partners or having condomless AI with a casual partner, which are well known risk factors for HIV [32], support the hypothesis that MSM have, overall, an adequate risk assessment. The finding that having condomless receptive AI with a partner living with HIV is no longer associated with higher perceived risk could also signify 'adequate' risk assessment, under the assumption that MSM only have unprotected sex with partners with an undetectable viral load.…”

Section: Discussionsupporting

confidence: 54%

The Rhythm of Risk: Sexual Behaviour, PrEP Use and HIV Risk Perception Between 1999 and 2018 Among Men Who Have Sex with Men in Amsterdam, The Netherlands

et al. 2020

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HIV risk perception plays a crucial role in the uptake of preventive strategies. We investigated how risk perception and its determinants changed between 1999 and 2018 in an open, prospective cohort of 1323 HIV-negative men who have sex with men (MSM). Risk perception, defined as the perceived likelihood of acquiring HIV in the past 6 months, changed over time: being relatively lower in 2008–2011, higher in 2012–2016, and again lower in 2017–2018. Irrespective of calendar year, condomless anal intercourse (AI) with casual partners and high numbers of partners were associated with higher risk perception. In 2017–2018, condomless receptive AI with a partner living with HIV was no longer associated with risk perception, while PrEP use and condomless AI with a steady partner were associated with lower risk perception. We showed that risk perception has fluctuated among MSM in the past 20 years. The Undetectable equals Untransmittable statement and PrEP coincided with lower perceived risk.

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Section: Discussionsupporting

confidence: 54%

The Rhythm of Risk: Sexual Behaviour, PrEP Use and HIV Risk Perception Between 1999 and 2018 Among Men Who Have Sex with Men in Amsterdam, The Netherlands

et al. 2020

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“…We also did not explicitly model the role of chemsex; which we simplified by assuming a factor increase in transmission risk, reflective of what is found in the literature (see Supplementary materials). MSM were also assumed to have similar risk behaviour over their entire lifetime [39] due to insufficient data to parameterise transitions between risk groups over time.…”

Section: Discussionmentioning

confidence: 99%

Scaling up screening and treatment for elimination of hepatitis C among men who have sex with men in the era of HIV pre-exposure prophylaxis

et al. 2020

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Background: Routine HIV pre-exposure prophylaxis (PrEP) and HIV care appointments provide opportunities for screening men who have sex with men (MSM) for hepatitis C virus infection (HCV). However, levels of screening required for achieving the WHO elimination target of reducing HCV incidence by 90% by 2030 among all MSM are unknown. Methods: An HCV/HIV transmission model was calibrated to UK prevalence of HIV among MSM (4¢7%) and chronic HCV infection among HIV-positive MSM (9¢9%) and HIV-negative MSM (1.2%). Assuming 12¢5% coverage of PrEP among HIV-negative MSM, we evaluated the relative reduction in overall HCV incidence by 2030 (compared to 2018 levels) of HCV screening every 12/6-months (alongside completing direct acting antiviral treatment within 6-months of diagnosis) in PrEP users and/or HIV-diagnosed MSM. We estimated the additional screening required among HIV-negative non-PrEP users to reduce overall incidence by 90% by 2030. The effect of 50% reduction in condom use among PrEP users (risk compensation) was estimated. Results: Screening and treating PrEP users for HCV every 12 or 6-months decreases HCV incidence by 67¢3% (uncertainty range 52¢7À79¢2%) or 70¢2% (57¢1À80¢8%), respectively, increasing to 75¢4% (59¢0À88¢6%) or 78¢8% (63¢9À90¢4%) if HIV-diagnosed MSM are also screened at same frequencies. Risk compensation reduces these latter projections by <10%. To reduce HCV incidence by 90% by 2030 without risk compensation, HIVnegative non-PrEP users require screening every 5¢6 (3¢8À9¢2) years if MSM on PrEP and HIV-diagnosed MSM are screened every 6-months, shortening to 4¢4 (3¢1À6¢6) years with risk compensation. For 25¢0% PrEP coverage, the HCV elimination target can be reached without screening HIV-negative MSM not on PrEP, irrespective of risk compensation. Interpretation: At low PrEP coverage, increased screening of all MSM is required to achieve the WHO HCVelimination targets for MSM in the UK, whereas at higher PrEP coverage this is possible through just screening HIV-diagnosed MSM and PrEP users.

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“…In the LCA, underlying dimensions (latent classes) of the dependent variables were inferred on the basis of patterns in the observed data. The number of latent classes was determined by a combination of fit indices, including the Akaike Information Criterion score and the Bayesian Information Criterion value (lower values indicating a better fit), entropy (>0.8 indicating good classification), the degrees of freedom (negative degrees of freedom indicating a lower number of latent classes needed), and interpretability of the classes (17). The uncertainty of the results was tested by comparing the LCA including the identified psychological predictors of chlamydia diagnosis to 1) an LCA with behavioral and psychological predictors of chlamydia diagnosis, 2) an LCA including behavioral variables that were not identified as predictors of chlamydia diagnosis, and 3) an LCA including psychological and behavioral variables selected using a swap-stepwise (backward) preselection method (28, 29).…”

Section: Methodsmentioning

confidence: 99%

A Multidimensional Approach to Assessing Infectious Disease Risk: Identifying Risk Classes Based on Psychological Characteristics

Wees

Heijne

Heijman

et al. 2019

American Journal of Epidemiology

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Prevention of infectious diseases depends on health-related behavior, which is often influenced by psychological characteristics. However, few studies assessing health-related behavior have examined psychological characteristics to identify risk groups, and this multidimensional approach might improve disease risk assessment. We aimed to characterize subgroups based on psychological characteristics and examine their influence on behavior and disease risk, using chlamydia as a case study. Selected participants (heterosexuals aged 18–24 years and females aged 18–24 years who had sex with both men and women) in a Dutch longitudinal cohort study (the Mathematical Models Incorporating Psychological Determinants: Control of Chlamydia Transmission (iMPaCT) Study) filled out a questionnaire and were tested for chlamydia (2016–2017). Latent class analysis was performed to identify risk classes using psychological predictors of chlamydia diagnosis. Two classes were identified: class 1 (n = 488; 9% chlamydia diagnosis) and class 2 (n = 325; 13% chlamydia diagnosis). The proportion of participants with high shame, high impulsiveness, and lower perceived importance of health was higher in class 2 than in class 1. Furthermore, persons in class 2 were more likely to be male and to report condomless sex compared with class 1, but the number of recent partners was comparable. Thus, risk classes might be distinguished from each other by psychological characteristics beyond sexual behavior. Therefore, the impact of the same intervention could differ, and tailoring interventions based on psychological characteristics might be necessary to reduce chlamydia prevalence most effectively.

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Sexual risk behaviour trajectories among MSM at risk for HIV in Amsterdam, the Netherlands

Abstract: MSM follow different trajectories of changing sexual risk behaviour over time. Early identification of MSM following a trajectory of falling or rising high-risk behaviour and adequate timing of individual-based preventive interventions may reduce HIV transmission.

Cited by 27 publications

References 24 publications

The Rhythm of Risk: Sexual Behaviour, PrEP Use and HIV Risk Perception Between 1999 and 2018 Among Men Who Have Sex with Men in Amsterdam, The Netherlands

The Rhythm of Risk: Sexual Behaviour, PrEP Use and HIV Risk Perception Between 1999 and 2018 Among Men Who Have Sex with Men in Amsterdam, The Netherlands

Scaling up screening and treatment for elimination of hepatitis C among men who have sex with men in the era of HIV pre-exposure prophylaxis

A Multidimensional Approach to Assessing Infectious Disease Risk: Identifying Risk Classes Based on Psychological Characteristics

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