Sex Transm Infect 92:70-75 doi:10.1136/sextrans-2015-052042
  • Epidemiology
  • Original article

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

  1. Jordi Casabona1,2,3,5
  1. 1Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain
  2. 2Institut d'Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain
  3. 3CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain
  4. 4Projecte dels Noms-Hispanosida, BCN Checkpoint, Barcelona, Spain
  5. 5Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Bellaterra (Cerdanyola), Spain
  1. 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; jcasabona{at}
  • 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.