AIDS and Behavior

, Volume 17, Issue 4, pp 1266–1278 | Cite as

HIV Prevalence and Sexual Risk Behaviors Associated with Awareness of HIV Status Among Men Who Have Sex with Men in Paris, France

  • Annie Velter
  • Francis Barin
  • Alice Bouyssou
  • Jérôme Guinard
  • Lucie Léon
  • Stéphane Le Vu
  • Josiane Pillonel
  • Bruno Spire
  • Caroline Semaille
Original Paper

Abstract

A cross-sectional survey, using self-sampled finger-prick blood on blotting paper and anonymous behavioral self-administrated questionnaires was conducted in Paris in 2009 among MSM attending gay venues. Paired biological results and questionnaires were available for 886 participants. HIV seroprevalence was 17.7 % (95 % CI: 15.3–20.4). Four groups were identified according to their knowledge of their HIV biological status. Among the 157 found to be seropositive, 31 (19.7 %) were unaware of their status and reported high levels of sexual risk behaviors and frequent HIV testing in the previous 12 months. Among the 729 MSM diagnosed HIV-negative, 183 were no longer sure whether they were still HIV-negative, or had never been tested despite the fact that they engaged in at-risk sexual behaviors. This study provides the first estimate of HIV seroprevalence among MSM in Paris and underlines the specific need for combined prevention of HIV infection in this MSM population.

Keywords

MSM HIV prevalence Genetic diversity Sexual behavior HIV status awareness 

Resumen

Se realizó un estudio transversal en hombres que tienen sexo con hombres (HSH) reclutados en establecimientos de ambiente gay en Paris en 2009. Los datos se obtuvieron a partir de un cuestionario anónimo y autocumplimentado, y de muestras de sangre autoextraídas posteriormente analizadas. Un total de 886 participantes con cuestionario y resultado diagnóstico fueron incluidos. La seroprevalencia del VIH fue de 17.7 % (IC95 % 15.3–20.4 %). Entre los 157 HSH VIH-positivos, 31 (19.7 %) desconocían su estatus serológico y declararon mantener conductas de riesgo y haber realizado frecuentemente la prueba del VIH en los 12 meses previos. Entre los 729 HSH VIH-negativos, 183 declararon no estar más seguros de su estatus serológico, o no haber realizado nunca el test diagnóstico a pesar de practicar conductas de riesgo. Este es el primer estudio de seroprevalencia realizado en HSH en Paris, y enfatiza la necesidad de una prevención integral del VIH en este colectivo.

Notes

Acknowledgments

The authors would like to acknowledge the owners of the bars, backrooms and saunas, the survey team from the Union of Gay Businesses (Antonio Alexandre, Rémi Calmon, Stéphane Calvarin, Sébastien Cambeau, Philippe Couteau, Richard De Wewer, Jérôme Derrien, Julien Escolano, Matthieu Folléa, David Friboulet, Sylvain Guillet, Roberto Labuthie, Patrice Louvet, Mathieu Panel, Jérôme Rivon, Christophe Robert, Gérard Siad), and men who agreed to participate in the Prevagay study. The authors thank Audrey Renaud for her excellent technical assistance, Sylvie Brunet and Damien Thierry for their help in serotyping and genotyping, and Marie-Laure Chaix for exchanged information on viral sequences, Christine Saura for her critical review of the manuscript and Jude Sweeney for his revision and editing of the English manuscript and Francisco Nogareda Moreno for his translation of the Spanish abstract. Our thanks to the ANRS scientific COPIL members: Stéphane Chevalier, Véronique Doré, Gabriel Girard, Isabelle Grémy. The PREVAGAY study was funded by InVS and ANRS (Agence Nationale de Recherche sur le Sida et les Hépatites Virales).

Conflict of interest

The authors have no conflicts of interest to report.

References

  1. 1.
    Sullivan PS, Hamouda O, Delpech V, et al. Reemergence of the HIV epidemic among men who have sex with men in North America, Western Europe, and Australia, 1996–2005. Ann Epidemiol. 2009;19(6):423–31.PubMedCrossRefGoogle Scholar
  2. 2.
    Likatavicius G, van de LM. HIV infection and AIDS in the European Union and European Economic Area, 2010. Euro Surveill. 2011;16(48). http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20030. Accessed 30 June 2012.
  3. 3.
    Dougan S, Evans BG, Elford J. Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. Sex Transm Dis. 2007;34(10):783–90.PubMedGoogle Scholar
  4. 4.
    Savage EJ, Hughes G, Ison C, Lowndes CM. Syphilis and gonorrhoea in men who have sex with men: a European overview. Euro Surveill. 2009;14(47). http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19417. Accessed 30 June 2012.
  5. 5.
    Cazein F, Le Strat Y, Pillonel J, et al. Dépistage du VIH et découvertes de séropositivité, France, 2003–2010. Bull Epidemiol Hebd. 2011;43–44. http://www.invs.sante.fr/Publications-et-outils/BEH-Bulletin-epidemiologique-hebdomadaire/Derniers-numeros-et-archives/Archives/2011/BEH-n-43-44-2011. Accessed 30 June 2012.
  6. 6.
    Le Vu S, Le Strat Y, Barin F, et al. Population-based HIV-1 incidence in France, 2003–08: a modelling analysis. Lancet Infect Dis. 2010;10(10):682–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Herida M, Michel A, Goulet V, et al. Epidemiology of sexually transmitted infections in France. Med Mal Infect. 2005;35(5):281–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Velter A, Michel A, Pillonel J, Jacquier G, Semaille C. Baromètre gay 2005: enquête auprès des hommes fréquentant les lieux de rencontre gay franciliens. Bull Epidemiol Hebd. 2006;25:178–80.Google Scholar
  9. 9.
    Velter A. Rapport enquete presse gay 2004 (ANRS-EN17-presse gay 2004). Saint-Maurice: Institut de Veille Sanitaire; 2007.Google Scholar
  10. 10.
    Likatavicius G, Klavs I, Devaux I, Alix J, Nardone A. An increase in newly diagnosed HIV cases reported among men who have sex with men in Europe, 2000–6: implications for a European public health strategy. Sex Transm Infect. 2008;84(6):499–505.PubMedCrossRefGoogle Scholar
  11. 11.
    Semaille C, Cazein F, Lot F, et al. Recently acquired HIV infection in men who have sex with men (MSM) in France, 2003–2008. Euro Surveill. 2009;14(48). http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19425. Accessed 30 June 2012.
  12. 12.
    Williamson LM, Hart GJ. HIV prevalence and undiagnosed infection among a community sample of gay men in Scotland. J Acquir Immune Defic Syndr. 2007;45(2):224–30.PubMedCrossRefGoogle Scholar
  13. 13.
    Dodds JP, Johnson AM, Parry JV, Mercey DE. A tale of three cities: persisting high HIV prevalence, risk behaviour and undiagnosed infection in community samples of men who have sex with men. Sex Transm Infect. 2007;83(5):392–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Barin F, Meyer L, Lancar R, et al. Development and validation of an immunoassay for identification of recent human immunodeficiency virus type 1 infections and its use on dried serum spots. J Clin Microbiol. 2005;43(9):4441–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Barin F, Plantier JC, Brand D, et al. Human immunodeficiency virus serotyping on dried serum spots as a screening tool for the surveillance of the AIDS epidemic. J Med Virol. 2006;78(Suppl 1):S13–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Brand D, Beby-Defaux A, Mace M, et al. First identification of HIV-1 groups M and O dual infections in Europe. AIDS. 2004;18(18):2425–8.PubMedGoogle Scholar
  17. 17.
    Semaille C, Barin F, Cazein F, et al. Monitoring the dynamics of the HIV epidemic using assays for recent infection and serotyping among new HIV diagnoses: experience after 2 years in France. J Infect Dis. 2007;196(3):377–83.PubMedCrossRefGoogle Scholar
  18. 18.
    Dachraoui R, Brand D, Brunet S, Barin F, Plantier JC. RNA amplification of the HIV-1 Pol and env regions on dried serum and plasma spots. HIV Med. 2008;9(7):557–61.PubMedCrossRefGoogle Scholar
  19. 19.
    Agresti A, Coull BA. Approximate is better than “exact” for interval estimation of binomial proportions. Am Stat. 1998;52(2):119–26.Google Scholar
  20. 20.
    Scott Long J, Freese J. Regression models for categorial dependent variables using stata. College Station: Stata Press; 2006.Google Scholar
  21. 21.
    Jauffret-Roustide M, Le Strat Y, Couturier E, et al. A national cross-sectional study among drug-users in France: epidemiology of HCV and highlight on practical and statistical aspects of the design. BMC Infect Dis. 2009;9:113.PubMedCrossRefGoogle Scholar
  22. 22.
    Folch C, Munoz R, Zaragoza K, Casabona J. Sexual risk behaviour and its determinants among men who have sex with men in Catalonia, Spain. Euro Surveill. 2009;14(47). http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19415. Accessed 30 June 2012.
  23. 23.
    Pedrana AE, Hellard ME, Wilson K, Guy R, Stoove M. High rates of undiagnosed HIV infections in a community sample of gay men in Melbourne, Australia. J Acquir Immune Defic Syndr. 2012;59(1):94–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Vanden BW, Nostlinger C, Buve A, et al. A venue-based HIV prevalence and behavioural study among men who have sex with men in Antwerp and Ghent, Flanders, Belgium, October 2009 to March 2010. Euro Surveill. 2011;16(28). http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19914. Accessed 30 June 2012.
  25. 25.
    Dodds JP, Mercer CH, Mercey DE, Copas AJ, Johnson AM. Men who have sex with men: a comparison of a probability sample survey and a community based study. Sex Transm Infect. 2006;82(1):86–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Williamson LM, Dodds JP, Mercey DE, Hart GJ, Johnson AM. Sexual risk behaviour and knowledge of HIV status among community samples of gay men in the UK. AIDS. 2008;22(9):1063–70.PubMedCrossRefGoogle Scholar
  27. 27.
    MacKellar D, Valleroy L, Karon J, Lemp G, Janssen R. The Young Men’s Survey: methods for estimating HIV seroprevalence and risk factors among young men who have sex with men. Public Health Rep. 1996;111(Suppl 1):138–44.PubMedGoogle Scholar
  28. 28.
    Paquette D, De Wit J. Sampling methods used in developed countries for behavioural surveillance among men who have sex with men. AIDS Behav. 2010;14(6):1252–64.PubMedCrossRefGoogle Scholar
  29. 29.
    Schwarcz S, Spindler H, Scheer S, Valleroy L, Lansky A. Assessing representativeness of sampling methods for reaching men who have sex with men: a direct comparison of results obtained from convenience and probability samples. AIDS Behav. 2007;11(4):596–602.PubMedCrossRefGoogle Scholar
  30. 30.
    Raymond HF, Rebchook G, Curotto A, et al. Comparing internet-based and venue-based methods to sample MSM in the San Francisco Bay Area. AIDS Behav. 2010;14(1):218–24.PubMedCrossRefGoogle Scholar
  31. 31.
    Folch C, Marks G, Esteve A, et al. Factors associated with unprotected sexual intercourse with steady male, casual male, and female partners among men who have sex with men in Barcelona, Spain. AIDS Educ Prev. 2006;18(3):227–42.PubMedCrossRefGoogle Scholar
  32. 32.
    Mirandola M, Folch TC, Krampac I, et al. HIV bio-behavioural survey among men who have sex with men in Barcelona, Bratislava, Bucharest, Ljubljana, Prague and Verona, 2008–2009. Euro Surveill. 2009;14(48). http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19427. Accessed 30 June 2012.
  33. 33.
    Yeni P. Prise en charge médicale des personnes infectées par le VIH. Rapport 2010. Recommandations du groupe d’experts. Paris: Médecine-Sciences Flammarion; 2010. p. 2010.Google Scholar
  34. 34.
    Barin F, Courouce AM, Pillonel J, Buzelay L. Increasing diversity of HIV-1M serotypes in French blood donors over a 10-year period (1985–1995). Retrovirus Study Group of the French Society of Blood Transfusion. AIDS. 1997;11(12):1503–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Cuevas M, Fernandez-Garcia A, Sanchez-Garcia A, et al. Incidence of non-B subtypes of HIV-1 in Galicia, Spain: high frequency and diversity of HIV-1 among men who have sex with men. Euro Surveill. 2009;14(47). http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19413. Accessed 30 June 2012.
  36. 36.
    Fox J, Castro H, Kaye S, et al. Epidemiology of non-B clade forms of HIV-1 in men who have sex with men in the UK. AIDS. 2010;24(15):2397–401.PubMedGoogle Scholar
  37. 37.
    Giuliani M, Montieri S, Palamara G, et al. Non-B HIV type 1 subtypes among men who have sex with men in Rome, Italy. AIDS Res Hum Retroviruses. 2009;25(2):157–64.PubMedCrossRefGoogle Scholar
  38. 38.
    Couturier E, Damond F, Roques P, et al. HIV-1 diversity in France, 1996–1998. The AC 11 laboratory network. AIDS. 2000;14(3):289–96.PubMedCrossRefGoogle Scholar
  39. 39.
    MacKellar DA, Valleroy LA, Secura GM, et al. Unrecognized HIV infection, risk behaviors, and perceptions of risk among young men who have sex with men: opportunities for advancing HIV prevention in the third decade of HIV/AIDS. J Acquir Immune Defic Syndr. 2005;38(5):603–14.PubMedCrossRefGoogle Scholar
  40. 40.
    Velter A, Bouyssou-Michel A, Arnaud A, Semaille C. Do men who have sex with men use serosorting with casual partners in France? Results of a nationwide survey (ANRS-EN17-Presse Gay 2004). Euro Surveill. 2009;14(47). http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19416. Accessed 30 June 2012.
  41. 41.
    Butler DM, Smith DM. Serosorting can potentially increase HIV transmissions. AIDS. 2007;21(9):1218–20.PubMedCrossRefGoogle Scholar
  42. 42.
    Golden MR, Stekler J, Hughes JP, Wood RW. HIV serosorting in men who have sex with men: is it safe? J Acquir Immune Defic Syndr. 2008;49(2):212–8.PubMedCrossRefGoogle Scholar
  43. 43.
    Le Vu S, Velter A, Meyer L, et al. Biomarker-based HIV incidence in a community sample of men who have sex with men in Paris, France. PLoS One. 2012;7(6):e39872.PubMedCrossRefGoogle Scholar
  44. 44.
    Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS. 2006;20(10):1447–50.PubMedCrossRefGoogle Scholar
  45. 45.
    Champenois K, Le Gall JM, Jacquemin C, et al. ANRS-COM’TEST: description of a community-based HIV testing intervention in non-medical settings for men who have sex with men. BMJ Open. 2012;2(2):e000693.PubMedCrossRefGoogle Scholar
  46. 46.
    Das M, Chu PL, Santos GM, et al. Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco. PLoS One. 2010;5(6):e11068.PubMedCrossRefGoogle Scholar
  47. 47.
    Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373(9657):48–57.PubMedCrossRefGoogle Scholar
  48. 48.
    Elford J. Changing patterns of sexual behaviour in the era of highly active antiretroviral therapy. Curr Opin Infect Dis. 2006;19(1):26–32.PubMedCrossRefGoogle Scholar
  49. 49.
    Zablotska IB, Crawford J, Imrie J, et al. Increases in unprotected anal intercourse with serodiscordant casual partners among HIV-negative gay men in Sydney. AIDS Behav. 2009;13(4):638–44.PubMedCrossRefGoogle Scholar
  50. 50.
    Kippax S, Campbell D, Van de Ven P, et al. Cultures of sexual adventurism as markers of HIV seroconversion: a case control study in a cohort of Sydney gaymen. AIDS Care. 1998;10(6):677–88.PubMedCrossRefGoogle Scholar
  51. 51.
    Buchbinder SP, Liu A. Pre-exposure prophylaxis and the promise of combination prevention approaches. AIDS Behav. 2011;15(Suppl 1):S72–9.PubMedCrossRefGoogle Scholar
  52. 52.
    Lorente N, Fugon L, Carrieri MP, et al. Acceptability of an “on-demand” pre-exposure HIV prophylaxis trial among men who have sex with men living in France. AIDS Care. 2012;24(4):468–77.PubMedGoogle Scholar
  53. 53.
    Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr. 2005;39(4):446–53.PubMedCrossRefGoogle Scholar
  54. 54.
    Coates TJ, Richter L, Caceres C. Behavioural strategies to reduce HIV transmission: how to make them work better. Lancet. 2008;372(9639):669–84.PubMedCrossRefGoogle Scholar
  55. 55.
    McDaid LM, Hart GJ. Sexual risk behaviour for transmission of HIV in men who have sex with men: recent findings and potential interventions. Curr Opin HIV AIDS. 2010;5(4):311–5.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Annie Velter
    • 1
  • Francis Barin
    • 2
  • Alice Bouyssou
    • 1
  • Jérôme Guinard
    • 2
  • Lucie Léon
    • 1
  • Stéphane Le Vu
    • 1
  • Josiane Pillonel
    • 1
  • Bruno Spire
    • 3
  • Caroline Semaille
    • 1
  1. 1.Institut de Veille SanitaireSaint-Maurice cedexFrance
  2. 2.Centre national de référence du VIH, Inserm U966Université François-Rabelais and CHU BretonneauToursFrance
  3. 3.INSERM, U912 (SE4S)MarseilleFrance

Personalised recommendations