Sex Transm Infect 88:539-544 doi:10.1136/sextrans-2011-050374
  • Epidemiology

Prevalence of HIV and sexually transmitted infections and patterns of recent HIV testing among men who have sex with men in Zagreb, Croatia

  1. Josip Begovac2,5
  1. 1WHO Collaborating Centre for HIV Surveillance, School of Medicine, University of Zagreb, Zagreb, Croatia
  2. 2University Hospital for Infectious Diseases “Dr Fran Mihaljevic,” Zagreb, Croatia
  3. 3Non-governmental Organization Iskorak, Zagreb, Croatia
  4. 4School of Public Health and Tropical Medicine, Tulane University, USA
  5. 5School of Medicine, University of Zagreb, Zagreb, Croatia
  1. Correspondence to Dr Ivana Bozicevic, WHO Collaborating Centre for HIV Surveillance, School of Medicine, University of Zagreb, Rockefellerova 4, 10 000 Zagreb, Croatia; ivana.bozicevic{at}
  1. Contributors All authors participated in the planning and conception of the research questions and the study design. IB, PJ, ZD, DL and JB conceptualised the study design and coordinated the study implementation. ODR, IG and SZL did the laboratory analysis of the samples. IB was responsible for analysing the data. IB drafted the article, and all authors participated in interpreting the data and critically revising the manuscript. All authors read and approved the revised manuscript.

  • Accepted 22 April 2012
  • Published Online First 24 May 2012


Objective To determine the prevalence of HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) in Zagreb, Croatia, and assess correlates of testing for HIV in the past 12 months.

Methods The authors carried out a bio-behavioural survey using respondent-driven sampling (RDS) from September 2010 to February 2011. Participants completed a questionnaire and were asked to provide blood, urine, oropharyngeal and rectal swabs for the detection of infections. Data were analysed using RDS Analysis Tool 6.0.1 and STATA V.8.0.

Results A total of 387 MSM were recruited at the University Hospital for Infectious Diseases. The age range of recruited men was 18–57 years. HIV prevalence was 2.8% (95% CI 1.1% to 5.1%) (3.6%, unadjusted), lower than that found in the first RDS survey carried out in 2006 (4.5%, 95% 2.2% to 7.3%) (4.9%, unadjusted). The seroprevalence of herpes virus type 2 was 5.9% (6.9, unadjusted) and that of syphilis measured by Treponema pallidum haemagglutination assay was 7.6% (6.7%, unadjusted). The authors found urethral and/or rectal infections with Chlamydia trachomatis in 7.2% (8.5%, unadjusted) of men and gonoccocal in 2.7% (2.1%, unadjusted). HIV testing in the past 12 months was reported by 32.7% (38.9%, unadjusted). In the multivariate analysis, significant correlates of recent HIV testing were having more than three partners in the past 12 months and the knowledge of HIV status of a regular partner.

Conclusions The results indicate that there might have not been a progression of an HIV and STI epidemic in the past 5 years among MSM in Croatia. Prevention should expand by providing better uptake of HIV and STI testing services, thus enabling timely treatment.


  • Funding The core funding for the study was provided by the Netherlands Embassy in Zagreb. Molecular testing was funded by the Ministry of Health, Education and Sports, Republic of Croatia.

  • Competing interests None.

  • Ethics approval The study was approved by the Ethical Board of the University Hospital for Infectious Diseases in Zagreb, Croatia.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement We agree to share the data of this study.