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. 2016 Mar;92(2):161-7.
doi: 10.1136/sextrans-2015-052076. Epub 2015 Aug 21.

The HIV care continuum among men who have sex with men in Moscow, Russia: a cross-sectional study of infection awareness and engagement in care

A L Wirtz  1 , C E Zelaya  2 , C Latkin  3 , A Peryshkina  4 , N Galai  5 , V Mogilniy  4 , P Dzhigun  4 , I Kostetskaya  4 , S H Mehta  6 , C Beyrer  2
Affiliations

The HIV care continuum among men who have sex with men in Moscow, Russia: a cross-sectional study of infection awareness and engagement in care

A L Wirtz et al. Sex Transm Infect. 2016 Mar.

Abstract

Objectives: Early diagnosis and treatment of HIV infection is critical to improving clinical outcomes for HIV-infected individuals. We sought to characterise the HIV care continuum and identify correlates of being unaware of one's HIV infection among men who have sex with men (MSM) in Moscow, Russia.

Methods: Participants (N=1376) were recruited via respondent-driven sampling and completed a sociobehavioural survey and HIV testing from 2010 to 2013. Sample and population estimates were calculated for key steps along the HIV care continuum for HIV-infected MSM and logistic regression methods were used to examine correlates of being unaware of one's HIV infection.

Results: 15.6% (184/1177; population estimate: 11.6%; 95% CI 8.5% to 14.7%) of participants were HIV infected. Of these, only 23.4% (43/184; population estimate: 13.2; 95% CI 11.0 to 15.4) were previously aware of their infection, 8.7% (16/184 population estimate: 4.7; 95% CI 1.0 to 8.5) were on antiretroviral therapy (ART), and 4.4% (8/164; population estimate: 3.0; 95% CI 0.3 to 5.6) reported an undetectable viral load. Bisexual identity (reference: homosexual; adjusted odds ratio (AOR): 3.69; 95% CI 1.19 to 11.43), having ≥5 sexual partners in the last 6 months (reference: ≤1; AOR: 4.23; 95% CI 1.17 to 15.28), and employer HIV testing requirements (reference: no; AOR: 15.43; 95% CI 1.62 to 147.01) were associated with being unaware of one's HIV infection. HIV testing in a specialised facility (reference: private; AOR: 0.06; 95% CI 0.01 to 0.53) and testing ≥2 times in the last 12 months (reference: none; AOR: 0.17; 95% CI 0.04 to 0.73) were inversely associated with being unaware of HIV infection.

Conclusions: There is a steep gradient along the HIV care continuum for Moscow-based MSM beginning with low awareness of HIV infection. Efforts that improve access to acceptable HIV testing strategies, such as alternative testing facilities, and linkage to care are needed for key populations.

Keywords: ANTIRETROVIRAL THERAPY; BEHAVIOURAL SCIENCE; DIAGNOSIS; HIV; HOMOSEXUALITY.

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Conflict of interest statement

COMPETING INTERESTS:

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. HIV testing and the care continuum, among HIV-infected men who have sex with men in Moscow, Russia (N=184)
Note: Error bars represent 95% confidence intervals for population estimates. Population estimates are weighted for RDS using the Volz-Heckathorn (RDS-II) estimator.
See this image and copyright information in PMC

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