AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #152 - Empowering HIV testing as a prevention tool: targeting interventions for high risk men who have sex with men
Authors: Presenting Author: Mr Nicolas Lorente - INSERM U912
Additional Authors: Cr. Chantal Vernay-Vaisse, Ms. Marion Mora, Ms. Jérôme Blanche, Ms. Lionel Fugon, Dr. Marie Suzan-Monti, Dr. Philippe Dhotte, Ms. Jean-Marie Legall, Mr. Patrick Rovera, Dr. Patrizia Carrieri, Dr. Bruno Spire,
Aim: In France, HIV testing can be performed in free and anonymous Voluntary Counseling Testing (VCT) centers. Previous reports showed that more than four in five men who had sex with men (MSM) had already been HIV tested and among those tested, approximately three in four did so in the previous two years. However, little is known about the risk behaviors of MSM attending VCT centers in France. The objective of this study was to characterize the population of MSM HIV-tested in VCT centers and to identify factors associated with inconsistent condom use (ICU).
Method / Issue: A cross-sectional study was conducted from March to December 2009 in four VCT centers based in three French cities: two in Paris, one in Marseilles and one in Nice. A self-administered questionnaire was proposed to all MSM who were going to perform a HIV test in these VCT centers. Inconsistent condom use (ICU) was defined as reporting to not use condoms systematically during anal intercourse with casual partners. To improve representativeness, weights proportional to the inverse of the number of HIV tests performed in VCT centers during the previous two years were used in the statistical analyses. A weighted logistic regression was also used to identify the best set of correlates of ICU in this population.
Results / Comments: Among the 357 MSM who participated in the study, 74% were enrolled in Paris, 12% in Marseilles and 14% in Nice. Median age [IQR] was 32[26-41], 68% were living alone, 67% had completed secondary school and 76% were in active employment. The median number [IQR] of sexual male partners in the previous year was 5[1-14] and overall, 35% reported ICU in the previous six months. One third had never been HIV tested before the study or had been last tested more than two years previously. The following factors were independently associated with ICU: replying “never” to the question “Do you avoid one night stands?” (AOR=3.09[1.57-6.07]), never having been HIV tested or having last been HIV tested more than 2 years previously (2.69 [1.42-5.08]), experiencing difficulty in using condoms with a HIV negative partner (3.67[1.73-7.78]) or when under the influence of drugs or alcohol (2.57[1.30-5.07]) and finally, reporting to have had a large number of casual male partners in the previous six months (1.02[1.00;1.04]).
Discussion: Most MSM attending VCT centers had already been HIV tested at least once in their life. Paradoxically, those who had never been tested and those who had been tested more than two years previously, were significantly more likely to report high risk behaviors. As knowledge of HIV status is associated with less risky practices, frequent HIV testing can screen MSM during the early phase of HIV infection. Interventions to engage these highest risk groups of MSM in regular testing can potentially have a major impact on prevention.
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