High prevalence of undiagnosed HIV infection despite high levels of reported history of HIV testing among men who have sex with men (MSM) in Moscow, Russia

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High prevalence of undiagnosed HIV infection despite high levels of reported history of HIV testing among men who have sex with men (MSM) in Moscow, Russia

C.E. Zelaya1, A.L. Wirtz1, N. Galai1, A. Peryshkina2, K. Dyakonov2, C. Beyrer1

1Johns Hopkins Bloomberg School of Public Health, Epidemiology, Baltimore, United States, 2AIDS Infoshare, Moscow, Russian Federation

 

Background: Little is known about HIV infections among MSM in Russia. We investigated HIV testing history, risk, and correlates of HIV infection among MSM in Moscow, using enhanced respondent driven sampling (RDS) approach.

Methods: Participants completed a socio-behavioral survey and HIV testing. Socio-behavioral, HIV results, and sexual-identity characteristics were examined. HIV prevalence was adjusted for network size and homophily. The proportion of previously undiagnosed HIV infections was calculated and correlates of HIV infection (including undiagnosed) were investigated with logistic regression.

Results: A total of 567 MSM living in Moscow were enrolled. Participants were predominantly: Russian born (85.6%); young (mean 31yrs); and self-identified gay (49.7%) or bisexual (47.5%). Median age of first sex with a man was 18 years. Reported sexual risk (last 12m) was high: 43.8% reported >5 sexual partners; 16.7% offered and 17.8% received money/drugs in exchange for sex; 78.4% reported alcohol and/or drugs prior to sex. Sex in a public place (38.8%) and group sex (23.7%) were common. The majority of participants reported a history of HIV-testing (87.4%) and, of these, 94.5% had received the result. The adjusted HIV prevalence among participants providing blood samples (n=378) was 12.0% (CI: 7.1-19.3) and unadjusted prevalence was 14.8%. Of participants testing positive, 84.8% had a previously undiagnosed HIV infection. Factors correlated with positive HIV test results were: lower age at first-sex with man (OR:0.91,p=0.005); having received money/drugs for sex (OR:1.91,p=0.047); use of alcohol and drugs prior to sex (OR:2.13,p=0.055); and group sex (OR:1.88,p=0.04). Previously undiagnosed HIV infection was correlated with younger age of first sex with a man (OR:0.90;p=0.001) and group sex (OR:1.88,p=0.05).

Conclusions: Findings suggest this newly described population understands the importance of and utilizes HIV-testing services. Sexual risks and a high level of undetected/untreated HIV infection persist, however. These findings have implication for public health programming and clinical care.

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Posted on July 23, 2012, in Uncategorized. Bookmark the permalink. Comments Off on High prevalence of undiagnosed HIV infection despite high levels of reported history of HIV testing among men who have sex with men (MSM) in Moscow, Russia.

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