Background
Methods
Study procedures
Measures
Statistical analysis
Results
Study sample
Missing values
Proportion with HIV serostatus disclosure at the last AI | Odds Ratio | 95% Confidence Interval | p-value^ | |||
---|---|---|---|---|---|---|
Age group [years] | 18–24 | 31.6% |
0.82
| 0.68 | 0.97 | 0.024 |
25–34 | 36.1% | ref. | ||||
35–44 | 39.5% | 1.15 | 0.98 | 1.36 | 0.092 | |
45–54 | 32.9% | 0.87 | 0.70 | 1.07 | 0.195 | |
55+ | 31.3% | 0.80 | 0.59 | 1.10 | 0.169 | |
Total
|
35.3%
|
0.0040
| ||||
Education | secondary school or lower | 28.1% |
0.66
| 0.49 | 0.90 | 0.01 |
high school diploma or post-secondary | 33.1% |
0.84
| 0.73 | 0.96 | 0.01 | |
university studies or higher | 37.1% | ref. | ||||
Total
|
35.1%
|
0.0035
| ||||
Migration status | native | 34.1% | ref. | |||
migrant | 41.0% |
1.34
| 1.13 | 1.59 | <0.001 | |
Total
|
35.2%
| |||||
City | Hamburg | 35.9% | ref. | |||
Barcelona | 37.0% | 1.05 | 0.77 | 1.43 | ||
Bratislava (RDS) | 26.4% | 0.64 | 0.46 | 0.89 | ||
Brighton | 46.9% | 1.57 | 1.15 | 2.15 | ||
Brussels | 43.4% | 1.37 | 1.00 | 1.87 | ||
Bucharest (RDS) | 22.8% | 0.53 | 0.34 | 0.82 | ||
Lisbon | 37.7% | 1.08 | 0.80 | 1.47 | ||
Ljubljana | 42.1% | 1.30 | 0.95 | 1.77 | ||
Sofia | 29.6% | 0.75 | 0.55 | 1.02 | ||
Stockholm | 39.0% | 1.14 | 0.81 | 1.60 | ||
Verona (RDS) | 29.6% | 0.75 | 0.55 | 1.03 | ||
Vilnius (RDS) | 33.4% | 0.90 | 0.65 | 1.24 | ||
Warsaw | 32.2% | 0.85 | 0.62 | 1.16 | ||
Total
|
35.3%
| |||||
Frequency of gay sex venue attendance in recent 3 months | no | 34.7% | ref. | |||
low (1–3 times) | 36.1% | 1.06 | 0.90 | 1.24 | 0.49 | |
high (>3 times) | 34.6% | 0.99 | 0.84 | 1.18 | 0.95 | |
Total
|
35.3%
| 0.67 | ||||
Perceived gay stigma | experienced positive attitudes (score points 11–15) | 40.7% | ref. | |||
experienced neutral attitudes (score points 8–10.5) | 32.7% |
0.70
| 0.61 | 0.81 | <0.001 | |
experienced negative attitudes (score points 1–7.5) | 26.4% |
0.53
| 0.43 | 0.64 | <0.001 | |
Total
|
35.3%
| <0.001 | ||||
Outness towards family, friends and co-workers | nobody/few | 27.1% | ref. | |||
less than half | 31.8% |
1.25
| 1.01 | 1.56 | 0.04 | |
more than half | 35.8% |
1.50
| 1.23 | 1.83 | <0.001 | |
all/almost all | 41.8% |
1.93
| 1.64 | 2.28 | <0.001 | |
Total
|
35.3%
| <0.001 | ||||
Number of CLAI partners in most recent 6 months | no partner | 28.9% | ref. | |||
1 partner | 48.4% |
2.31
| 1.96 | 2.72 | <0.001 | |
2–5 partners | 33.6% |
1.25
| 1.05 | 1.48 | 0.01 | |
6–10 partners | 26.5% | 0.89 | 0.64 | 1.24 | 0.49 | |
>10 partners | 32.4% | 1.18 | 0.82 | 1.70 | 0.37 | |
Total
|
35.6%
| <0.001 | ||||
Type of partner during most recent AI | steady | 54.1% | ref. | |||
non-steady | 17.2% |
0.18
| 0.15 | 0.20 | <0.001 | |
more than one | 21.0% |
0.23
| 0.16 | 0.31 | <0.001 | |
Total
|
35.3%
| <0.001 | ||||
Condom use during most recent AI | condom use during last AI | 26.6% | ref. | |||
no condom use | 47.8% |
2.52
| 2.19 | 2.91 | <0.001 | |
Total
|
35.6%
| <0.001 | ||||
HIV test during last 12 months | HIV test last 12 months | 40.8% | ref. | |||
never tested or tested >12 months ago | 26.9% |
0.53
| 0.47 | 0.61 | <0.001 | |
Total
|
34.9%
| <0.001 | ||||
Negative HIV test result during last 12 months | no negative test resultb
| 27.4% | ref. | |||
negative antibody test | 40.6% |
1.81
| 1.58 | 2.06 | <0.001 | |
negative viral load test | 55.3% |
3.28
| 2.36 | 4.56 | <0.001 | |
Total
|
35.3%
| <0.001 | ||||
Most recent viral load measurementa
| detectable viral load | 60.6% | ref. | |||
undetectable viral load | 55.7% | 0.82 | 0.38 | 1.75 | 0.60 | |
respondent did not know | 28.3% |
0.26
| 0.12 | 0.54 | <0.001 | |
Total
|
39.8%
| <0.001 | ||||
Sexual role during most recent AI | insertive | 35.3% | ref. | |||
receptive | 32.8% | 0.89 | 0.76 | 1.05 | 0.17 | |
both | 39.1% | 1.17 | 1.00 | 1.38 | 0.05 | |
Total
|
35.5%
| 0.005 | ||||
Number of substances used during most recent AI | no substances | 39.7% | ref. | |||
1–2 substances | 31.8% |
0.71
| 0.62 | 0.81 | <0.001 | |
> 2 substances | 32.1% |
0.72
| 0.56 | 0.91 | 0.01 | |
Total
|
35.3%
| <0.001 | ||||
HIV status awareness | newly diagnosed | 22.5% | ref. | |||
negative | 35.0% |
1.86
| 1.24 | 2.79 | <0.001 | |
already known | 56.4% |
4.47
| 2.76 | 7.23 | <0.001 | |
Total
|
35.8%
| <0.001 |
Factors associated with HIV serostatus disclosure
Odds Ratio | 95% Confidence Interval | p-Value | |||
---|---|---|---|---|---|
Type of partner during most recent AI | <0.001 | ||||
steady partner | ref. | ||||
non-steady partner |
0.16
| 0.14 | 0.20 | <0.001 | |
more than one partner |
0.18
| 0.12 | 0.26 | <0.001 | |
Negative HIV test result during last 12 months | <0.001 | ||||
no HIV test result | ref. | ||||
negative antibody test |
2.69
| 2.23 | 3.23 | <0.001 | |
negative viral load test | 0.63 | 0.30 | 1.33 | 0.23 | |
Outness towards family members, friends, and co-workers | <0.001 | ||||
none or few | ref. | ||||
less than half | 1.22 | 0.91 | 1.63 | 0.18 | |
more than half | 1.32 | 1.00 | 1.73 | 0.05 | |
all/almost all |
1.69
| 1.32 | 2.16 | <0.001 | |
HIV status awareness | <0.001 | ||||
not infected with HIV (tested or untested) | ref. | ||||
newly diagnosed |
0.51
| 0.31 | 0.86 | 0.01 | |
already known |
6.47
| 3.37 | 12.45 | <0.001 | |
Age group | 0.0747 | ||||
18–24 | 0.80 | 0.64 | 1.00 | 0.051 | |
25–34 | ref. | ||||
35–44 | 1.10 | 0.89 | 1.37 | 0.37 | |
45–54 | 0.84 | 0.63 | 1.14 | 0.26 | |
55+ | 0.79 | 0.51 | 1.24 | 0.31 | |
Perceived gay stigma | 0.04 | ||||
experienced positive attitudes (score points 11–15) | ref. | ||||
experienced neutral attitudes (score points 8–10.5) | 0.82 | 0.68 | 1.00 | 0.04 | |
experienced negative attitudes (score points 1–7.5) | 0.72 | 0.54 | 0.97 | 0.03 | |
Condom use during most recent AI | <0.001 | ||||
condom use | ref. | ||||
no condom use |
1.80
| 1.51 | 2.14 | <0.001 | |
_cons | 0.46 | 0.34 | 0.62 | <0.001 | |
city | 0.003 | 0,00 | 23.22 |
HIV risk management tactics in the study sample
Hierarchy of risk management | Risk management | HIV-negative | Proportion excluding missing | HIV-positive | Proportion excluding missing | Total | Proportion excluding (including) missing | Partner exposure |
---|---|---|---|---|---|---|---|---|
1 | condom use |
1878
|
146
|
2024
| 50.9% | |||
1 + 2 | condom use +treatment | n.a. |
75
|
75
| ||||
2 | treatment | n.a. |
92
|
92
| ||||
Subtotal | disclosure-independent risk management |
1878
|
50.9%
|
313
|
72.5%
|
2191
| 53.1% (44.7%) | |
3 + 4 | serostatus disclosure |
789
|
21.4%
|
18
|
8.8%
|
807
| 19.6% (16.5%) | |
3 | serostatus concordance disclosure (correct) | HIV-negative serostatus concordance: 743
| HIV-positive serostatus concordance: 8
|
751
| ||||
>1p | 14 | 0 | ||||||
nsp | 110 | 2 | ||||||
sp | 619 | 6 | ||||||
4 | serostatus discordance disclosure (correct) | partner disclosed having HIV: 46
| respondent disclosed having HIV: 10
|
56
|
10
| |||
>1 p | 2 | 2 | ||||||
nsp | 8 | 5 | ||||||
sp | 36 | 3 | ||||||
5 + 6 | no (or incorrect) serostatus disclosure |
1026
|
27.8%
|
101
|
23.4%
|
1127
| 27.3% (23.0%) | |
5 | serostatus disclosure (incorrect) |
failed serosorting: 20
|
4.6%
|
20
| ||||
>1p | 2 | |||||||
nsp | 5 | |||||||
sp | 13 | |||||||
6 | no condom, no treatment, no disclosure |
1026
|
27.8%
|
81
|
18.8%
|
1107
| 26.8% (22.6%) |
81
|
HIV negative concordance assumption | 504 | 13.6% | 30 | 6.9% | ||||
>1p | 22 | 3 | ||||||
nsp | 212 | 14 | ||||||
sp | 270 | 13 | ||||||
no reported assumptions | 522 | 14.1% | 51 | 11.8% | ||||
>1p | 43 | 8 | ||||||
nsp | 245 | 24 | ||||||
sp | 234 | 19 | ||||||
Subtotal, missing excluded |
3693
|
100%
|
432
|
100%
|
4125
| 100% (84.2%) |
111
| |
Missing | missing data on disclosure and/or type of partner | 612 | – | 65 | – | 677 | (13.8%) | 65 |
>1p | 14 | 4 | ||||||
nsp | 49 | 9 | ||||||
sp | 72 | 13 | ||||||
mpd | 477 | 39 | ||||||
missing or conflicting information on HIV serostatus | 99 | (2.0%) | ||||||
Total |
4305
|
497
|
4901
|
(100%)
|
176
|
HIV risk management of participants identified as being HIV antibody positive
HIV serostatus disclosure and HIV exposures
Discussion
Limitations
Conclusions
Acknowledgements
Funding
Availability of data and materials
Ethics approval and consent to participate
Country
|
City
|
Date of approval
|
Number of the doc
|
Name of the EC
|
Belgium | Brussels | 18/3/2013 | ITG 860/13 | Ethics Committee – University of Antwerp |
Bulgaria | Sofia | 26/3/2013 | – | Ethics Committee – National Centre of Infectious and Parasitic Diseases Sofia |
Germany | Hamburg | 28/2/2013 | EA1/024/13 | Ethics Committee – Charité University |
Italy | Verona | 22/05/2013 | Prot.N.25334; N.Prog. 2341 | Ethics Committee - Verona University Hospital |
Lithuania | Vilnius | 14/05/2013 | N. 158,200–13–608-188 | Regional Ethics Committee Biomedical Research – Vilnius |
Poland | Warsaw | 18/4/2013 | 1/2013 | Ethics Committee – Warsaw |
Portugal | Lisbon | 14/6/2013 | 12–2013-PI | Ethics Committee - Instituto de Higiene e Medicina Tropical |
Romania | Bucharest | 18/04/2013 | C. 1937 | Ethics Committee Institute M. Bals – Bucharest |
Slovakia | Bratislava | 16/05/2013 | – | Ethics Committee of the Slovak Medical University |
Slovenia | Ljubljana | 16/4/2013 | 87/04/13 | Ethics Committee Republic of Slovenia |
Spain | Barcelona | 17/4/2013 | PI 13014 | Ethics Committee – Germans Trias i Pujol Hospital |
Sweden
|
Stockholm
|
14/5/2013
|
2013/3:5–2013–05-02
|
Ethics Committee – Folkhalsomyndigheten
|
UK
|
Brighton
|
26/01/2013
|
FREGC-13-001.R1
|
Faculty of Health and Social Science Research Ethics and Governance Committee
|