High HIV incidence among men who have sex with men attending a community-based voluntary counselling and testing service in Barcelona, Spain: results from the ITACA cohort
- Laia Ferrer1,2,3,
- Eva Loureiro1,2,3,
- Michael Meulbroek4,
- Cinta Folch1,2,3,5,
- Felix Perez4,
- Anna Esteve1,2,3,5,
- Jorge Saz4,
- Hector Taboada4,
- Ferran Pujol4,
- Jordi Casabona1,2,3,5
- 1Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain
- 2Institut d'Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain
- 3CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain
- 4Projecte dels Noms-Hispanosida, BCN Checkpoint, Barcelona, Spain
- 5Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Bellaterra (Cerdanyola), Spain
- Correspondence to Dr Jordi Casabona, Centre for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Hospital Universitari Germans Trias i Pujol, Ctra de Canyet s/n, Badalona 08916, Spain;
- Received 5 February 2015
- Revised 20 May 2015
- Accepted 13 June 2015
- Published Online First 1 July 2015
Objectives To identify the HIV incidence and its associated factors (AFs) of the ITACA, a community-based cohort of HIV-negative men who have sex with men (MSM) established in Barcelona, Spain from 2008 to 2011.
Methods Participants were men aged 18 years or older, having a negative HIV test result at baseline and agreeing to participate. Bio-behavioural data were collected by peers in each visit. HIV incidence rates using person-time measures and 95% CIs were calculated. Cox logistic regression models were used to identify AFs to seroconversion.
Results Over the period, 3544 participants with at least one follow-up visit or those who had a first visit no longer than a year prior to the date of data censoring were included in the analysis contributing 3567.09 person-year (p-y) and 85 MSM seroconverted for an overall HIV incidence of 2.4 per 100 p-y (95% CI 1.9 to 2.9) ranging from 1.21/100 (2009) to 3.1/100 p-y (2011). Independent AF included: foreign origin, having more than five HIV tests at baseline, reporting in the preceding 6 months the following: condomless anal sex with the last steady partner of unknown serostatus, more than 10 casual partners, condomless anal sex with casual partner, self-reported gonorrhoea and entered in the cohort in 2010 or 2011.
Conclusions The ITACA cohort revealed a high and increasing HIV incidence among MSM, especially important among foreign-born men. The findings underscore the need to implement multilevel interventions for MSM taking into account different types of partners, cultural origins and the exposure to other sexually transmitted infections.