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Original article
Identifying recently acquired HIV infections among newly diagnosed men who have sex with men attending STI clinics in The Netherlands
  1. Jussi Sane1,2,
  2. Titia Heijman3,
  3. Boris Hogema4,
  4. Maarten Koot4,
  5. Maaike van Veen3,
  6. Hannelore Götz5,
  7. Johan Fennema3,
  8. Eline Op de Coul1
  1. 1Unit of Epidemiology and Surveillance, National Institute for Public Health and Environment (RIVM), Centre for Infectious Disease Control, The Netherlands
  2. 2European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
  3. 3Public Health Service of Amsterdam, Amsterdam, The Netherlands
  4. 4Virus Diagnostic Services, Sanquin Blood Supply, Amsterdam, The Netherlands
  5. 5Department of Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
  1. Correspondence to Dr Eline LM Op de Coul, Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and the Environment, PO Box 1, Bilthoven 3720 BA, The Netherlands;{at}


Objectives The current surveillance system in The Netherlands cannot differentiate recent HIV infections from established infections, which is crucial for estimating the HIV incidence; this information is needed for assessing trends of the HIV epidemic and the impact of prevention interventions. We determined the proportion of recent HIV infections (RI) and estimated HIV incidence using a recent infection testing algorithm (RITA) among men who have sex with men (MSM) newly diagnosed as having HIV attending sexually transmitted infection (STI) clinics.

Methods Plasma samples collected between 2009 and 2011 were tested for RI with the Architect HIV Ag/Ab Combo immunoassay. Data on viral load, CD4 count and previous HIV testing were incorporated into the RITA. HIV incidence and 95% CIs were estimated. Logistic regression was used to identify factors associated with RI.

Results Of the 251 samples tested for RI, 78/251 (31%) infections were determined as recent by the RITA. No significant change over time was observed. The estimated HIV incidence in this high-risk MSM population was 3.3 per 100 person-years (95% CI 2.5 to 4.1). The only factor associated with RI in the multivariable model was being tested for HIV ≥3 times in the past (aOR=7.4; 95% CI 2.0 to 27.8).

Conclusions The proportion of RIs was comparable to studies in similar settings in Europe. Implementation of the RITA for routine surveillance in The Netherlands to assess trends in RIs over time, to study the infections in other groups and to inform public health actions, is being planned.

  • HIV
  • HIV Testing
  • Surveillance
  • Epidemiology (General)
  • Gay Men

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