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. 2021 Sep 6;21(1):917.
doi: 10.1186/s12879-021-06582-x.

Regional disparity of HIV incidence and prevalence among men who have sex with men

D N Vergara-Ortega #  1 , H López-Gatell #  1 , S Bautista-Arredondo  2 , A Colchero  2 , S G Sosa-Rubí  2 , M Morales-Vazquez  2 , A Herrera-Ortiz  1 , M Olamendi-Portugal  1 , S García-Cisneros  1 , E E Sevilla-Reyes  3 , M Hernández-Avila  4 , M A Sánchez-Alemán  5
Affiliations

Regional disparity of HIV incidence and prevalence among men who have sex with men

D N Vergara-Ortega et al. BMC Infect Dis. .

Abstract

Background: HIV incidence can be estimated with cross-sectional studies using clinical, serological, and molecular data. Worldwide, HIV incidence data in only men who have sex with men (MSM) are scarce and principally focus on those with healthcare or under treatment. However, better estimates can be obtained through studies with national representativeness. The objective was to estimate the prevalence, incidence, and factors associated with acquiring HIV in a national sample of MSM who attend meeting places, considering geographical regions.

Methods: A nationally representative survey of MSM attending meeting places was performed in Mexico. Participants answered a questionnaire, and a dried blood spot (DBS) was collected. Samples were classified as recent infections using an algorithm with HIV status, antiretroviral therapy, and the result of BED-EIA assay. Parameters were analysed considering regions and demographic and sexual behaviour characteristics.

Results: The national HIV prevalence was 17.4% with regional differences; the highest prevalence (20.7%) was found in Mexico City, and the lowest prevalence was found in the West region (11.5%). The incidence was 9.4 per 100 p/y, with regional values from 6.2 to 13.2 for the Northeast and the Centre regions, respectively. Age, age at sexual debut, low wealth index, and rewarded sex were associated with HIV prevalence. Centre region, use of private clinics as health services, and having sex exclusively with men were associated with recent HIV infections.

Conclusions: The incidence and prevalence showed regional differences, suggesting a difference in the dynamics of HIV transmission; some regions have a greater case accumulation, and others have a greater rate of new infections. Understanding this dynamic will allow developing health programs focused on HIV prevention or treating people already living with HIV.

Keywords: HIV; HIV MSM; HIV transmission; Incidence; Prevalence; Risk factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Recent infection test algorithm (RITA). It shows the designed algorithm that combines the results of serological tests and information on the initiation of ART (antiretroviral therapy), each step with its corresponding number of samples. The 242 recent HIV infections were used to calculate the incidence
Fig. 2
Fig. 2
Scenarios of HIV transmission by geographic region. Based on the regional variables, we constructed the graph concerning national data (blue lines); located each geographical region in terms of its prevalence and incidence. With this organization, we observed three regions (West, Northeast and Northwest), lean towards the lower left quadrant, which can be considered the one with the best situation because of its lowest prevalence and incidence. On the contrary, South, Mexico City and Centre, are located towards the part of the graph where the highest prevalence and incidence data are displayed. Likewise, mortality corresponds with the diameter of the bubbles and the coverage of antiretroviral treatment with the color
See this image and copyright information in PMC

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