Quantifying unmet prevention needs among MSM in Europe through a multi-site bio-behavioural survey

Massimo Mirandola, Lorenzo Gios, Nigel Sherriff, Ulrich Marcus, Toskin, Igor A., Magdalena Rosińska, Susanne Barbara Schink, Sharon Kühlmann-Berenzon, Barbara Suligoi, Cinta Folch, Nöstlinger, Christiana Maria, S Dias, Danica Staneková, Irena Klavs, Saulius Caplinskas, Alexandru Rafila, Marin, Carolina, Ivailo Alexiev, Zohrabyan, Lev S., Teymur NooriMenel-Lemos, Cinthia, Sialon II Network

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Introduction: The HIV epidemic represents an important public health issue in Europe particularly among men who have sex with men (MSM). Global AIDS
Monitoring indicators (GAM) have been widely and jointly promoted as a set of crucial standardised items to be adopted for monitoring and responding to the
epidemic. Methods: The Sialon II study, implemented in 13 European cities (2013-14), was a complex multicentre integrated bio-behavioural cross sectional survey targeted at MSM, with a concomitant collection of behavioural and biological (oral fluid or blood specimens) data. Rigorous sampling approaches for hard-to-reach populations were used (time-location sampling and respondent-driven sampling) and GAM indicators were calculated; sampling frames were adapted to allow weighted estimates of GAM indicators. Results: 4,901 MSM were enrolled. HIV prevalence estimates ranged from 2.4% in Stockholm to 18.0% in Bucharest. When exploring city-level correlations between GAM indicators, prevention campaigns significantly correlated with levels of condom use and level of HIV testing among MSM. Conclusion: The Sialon II project has made an important contribution to the monitoring and evaluation of the HIV epidemic across Europe, integrating the use of GAM indicators within a second generation HIV surveillance systems approach and in participatory collaboration with MSM communities. It influenced the harmonisation of
European data collection procedures and indicators via GAM country reporting and contributed essential knowledge informing the development and implementation of strategic, evidence-based HIV prevention campaigns for MSM.
Original languageEnglish
Article number1800097
Pages (from-to)1800097-1800109
Number of pages12
Issue number49
Publication statusPublished - 6 Dec 2018


  • GAM indicators
  • HIV
  • HIV testing
  • HIV weighted prevalence
  • MSM
  • Bio-behavioural survey


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