Trends in HIV incidence in homosexual men in developed countries
Andrew E. Grulich A B and John M. Kaldor AA National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW 2010, Australia.
B Corresponding author. Email: agrulich@nchecr.unsw.edu.au
Sexual Health 5(2) 113-118 https://doi.org/10.1071/SH07075
Submitted: 27 September 2007 Accepted: 21 February 2008 Published: 2 June 2008
Abstract
Objectives: To describe trends in HIV notifications and in other measures of HIV incidence in homosexual men in developed countries. Methods: A literature search was conducted using PubMed. In addition to the peer-reviewed literature, data on HIV surveillance trends were sought by searching websites of surveillance authorities in developed countries. Results: The availability of long-term HIV surveillance data varied considerably. However, in almost all jurisdictions in which such data were available, notifications of new HIV diagnoses among homosexual men have increased, mostly since the late 1990s. The magnitude of this increase varied, but was more than 50% in many countries. There were much fewer data available on trends in direct measures of HIV incidence in homosexual men, and increases in HIV testing rates may have contributed to the increases in HIV diagnoses in many countries. However, since the late 1990s, several clinic- and community-based cohort studies in Europe and North America reported increasing incidence. Conclusion: There were increases in HIV notifications in homosexual men in almost all developed countries, starting in the late 1990s and continuing to 2006. Although increases in HIV testing probably contributed to the increases in some settings, limited cohort data do support the existence of a true increase in HIV incidence in European and North American countries. Improved monitoring of HIV incidence in homosexual men at the population level is required to allow more timely assessment of the drivers underlying such trends.
Additional keywords: cohort studies, HIV surveillance, HIV testing.
Acknowledgements
The National Centre in HIV Epidemiology and Clinical Research (NCHECR) is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, University of New South Wales.
[1]
[2] Guy RJ, McDonald AM, Bartlett MJ, Murray JC, Giele CM, Davey TM, et al. HIV diagnoses in Australia: diverging epidemics within a low-prevalence country. Med J Aust 2007; 187 1–4.
[3] Janssen RS, Satten GA, Stramer SL, Rawal BD, O’Brien TR, Weiblen BJ, et al. New testing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes. JAMA 1998; 280 42–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[4]
[5] Hamers FF, Downs AM. The changing face of the HIV epidemic in Western Europe: what are the implications for public health policies? Lancet 2004; 364 83–94.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[6] Hamers FF, Infuso A, Alix J, Downs AM. Current situation and regional perspective on HIV/AIDS surveillance in Europe. J Acquir Immune Defic Syndr 2003; 32 S39–48.
| PubMed |
[7] del Romero J, Castilla J, Garcia S, Clavo P, Ballesteros J, Rodriguez C. Time trend in incidence of HIV seroconversion among homosexual men repeatedly tested in Madrid, 1988–2000. AIDS 2001; 15 1319–21.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[8] Barrasa A, Castilla J, del Romero J, Pueyo I, de Armas C, Varela JA, et al. Sentinel surveillance of HIV infection in HIV test clinics, Spain 1992–2002. Euro Surveill 2004; 9 27–9.
| PubMed |
[9] Giuliani M, Di Carlo A, Palamara G, Dorrucci M, Latini A, Prignano G, et al. Increased HIV incidence among men who have sex with men in Rome. AIDS 2005; 19 1429–31.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[10] Hurtado I, Alastrue I, Ferreros I, del Amo J, Santos C, Tasa T, et al. Trends in HIV testing, serial HIV prevalence and HIV incidence among people attending a Center for AIDS Prevention from 1988 to 2003. Sex Transm Infect 2007; 83 23–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[11] Dukers NH, Fennema HS, van der Snoek EM, Krol A, Geskus RB, Pospiech M, et al. HIV incidence and HIV testing behavior in men who have sex with men: using three incidence sources, The Netherlands, 1984–2005. AIDS 2007; 21 491–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[12] Dukers NH, Spaargaren J, Geskus RB, Beijnen J, Coutinho RA, Fennema HS. HIV incidence on the increase among homosexual men attending an Amsterdam sexually transmitted disease clinic: using a novel approach for detecting recent infections. AIDS 2002; 16 F19–24.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[13] Murphy G, Charlett A, Brown AE, Gill ON, Parry JV. Is HIV incidence increasing in homo/bisexual men attending GUM clinics in England, Wales and Northern Ireland? Commun Dis Public Health 2004; 7 11–4.
| PubMed |
[14] Murphy G, Charlett A, Jordan LF, Osner N, Gill ON, Parry JV. HIV incidence appears constant in men who have sex with men despite widespread use of effective antiretroviral therapy. AIDS 2004; 18 265–72.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[15] Dougan S, Elford J, Chadborn TR, Brown AE, Roy K, Murphy G, et al. Does the recent increase in HIV diagnoses among men who have sex with men in the UK reflect a rise in HIV incidence or increased uptake of HIV testing? Sex Transm Infect 2007; 83 120–5.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[16]
[17] Marcus U, Voss L, Kollan C, Hamouda O. HIV incidence increasing in MSM in Germany: factors influencing infection dynamics. Euro Surveill 2006; 11 157–60.
| PubMed |
[18] Stolte IG, de Wit JB, Kolader ME, Fennema HS, Coutinho RA, Dukers NH. Low HIV-testing rates among younger high-risk homosexual men in Amsterdam. Sex Transm Infect 2007; 83 387–91.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[19]
[20]
[21]
[22] Remis RS, Alary M, Otis J, Masse B, Demers E, Vincelette J, et al. No increase in HIV incidence observed in a cohort of men who have sex with other men in Montreal. AIDS 2002; 16 1183–5.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[23] Hogg RS, Weber AE, Chan K, Martindale S, Cook D, Miller ML, et al. Increasing incidence of HIV infections among young gay and bisexual men in Vancouver. AIDS 2001; 15 1321–2.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[24] Calzavara L, Burchell AN, Major C, Remis RS, Corey P, Myers T, et al. Increases in HIV incidence among men who have sex with men undergoing repeat diagnostic HIV testing in Ontario, Canada. AIDS 2002; 16 1655–61.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[25]
[26]
[27] Hall HI, Song R, McKenna MT. Increases in HIV diagnoses–29 States, 1999–2002. Morb Mortal Wkly Rep 2003; 52 1145–8.
[28]
[29] Espinoza L, Hall H, Campsmith ML, Lee LM. Trends in HIV/AIDS Diagnoses–33 States, 2001–2004. Morb Mortal Wkly Rep 2005; 54 1149–53.
[30] Glynn MK, Lee LM, McKenna MT. The status of national HIV case surveillance, United States 2006. Public Health Rep 2007; 122 63–71.
| PubMed |
[31] Vu MQ, Steketee RW, Valleroy L, Weinstock H, Karon J, Janssen R. HIV incidence in the United States, 1978–1999. J Acquir Immune Defic Syndr 2002; 31 188–201.
| PubMed |
[32] Koblin B, Chesney M, Coates T. Effects of a behavioural intervention to reduce acquisition of HIV infection among men who have sex with men: the EXPLORE randomised controlled study. Lancet 2004; 364 41–50.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[33] Truong HM, Kellogg T, Klausner JD, Katz MH, Dilley J, Knapper K, et al. Increases in sexually transmitted infections and sexual risk behaviour without a concurrent increase in HIV incidence among men who have sex with men in San Francisco: a suggestion of HIV serosorting? Sex Transm Infect 2006; 82 461–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[34] Valleroy LA, MacKellar DA, Karon JM, Rosen DH, McFarland W, Shehan DA, et al. HIV prevalence and associated risks in young men who have sex with men. Young Men’s Survey Study Group. JAMA 2000; 284 198–204.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[35] Sifakis F, Flynn CP, Metsch L, LaLota M, Murrill C, Koblin BA, et al. HIV prevalence, unrecognized infection, and HIV testing among men who have sex with men–five U.S. cities, June 2004–April 2005. Morb Mort Wkly Rep 2005; 54 597–601.
[36] Osmond DH, Pollack LM, Paul JP, Catania JA. Changes in prevalence of HIV infection and sexual risk behavior in men who have sex with men in San Francisco: 1997–2002. Am J Public Health 2007; 97 1677–83.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[37] Xia Q, Osmond DH, Tholandi M, Pollack LM, Zhou W, Ruiz JD, et al. HIV prevalence and sexual risk behaviors among men who have sex with men: results from a statewide population-based survey in California. J Acquir Immune Defic Syndr 2006; 41 238–45.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[38] MacKellar DA, Valleroy LA, Secura GM, Behel S, Bingham T, Celentano DD, et al. Unrecognized HIV infection, risk behaviors, and perceptions of risk among young men who have sex with men: opportunities for advancing HIV prevention in the third decade of HIV/AIDS. J Acquir Immune Defic Syndr 2005; 38 603–14.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[39] MacKellar DA, Valleroy LA, Anderson JE, Behel S, Secura GM, Bingham T, et al. Recent HIV testing among young men who have sex with men: correlates, contexts, and HIV seroconversion. Sex Transm Dis 2006; 33 183–92.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[40]
[41] Dickson N, Davidson OJ. HIV prevention in New Zealand–still room for improvement. N Z Med J 2006; 119 U2250.
| PubMed |
[42] Jin F, Prestage G, McDonald A, Ramacciotti T, Imrie JC, Kippax SC, et al. Trends in HIV incidence in a cohort of homosexual men in Sydney: data from the HIM Study. Sex Health 2008; 5 109–12.
| Crossref | GoogleScholarGoogle Scholar |
[43] Kaldor J, Williamson P, Guinan JJ, Imrie A, Gold J. Falling incidence of HIV infection in a cohort of clinic attenders. Aust J Public Health 1993; 17 334–8.
| PubMed |
[44] Burcham JL, Tindall B, Marmor M, Cooper DA, Berry G, Penny R. Incidence and risk factors for human immunodeficiency virus seroconversion in a cohort of Sydney homosexual men. Med J Aust 1989; 150 634–9.
| PubMed |
[45] Becker NG, Watson LF, Marschner IC, Motika M, Newstead SV, Carlin JB. Assessing the extent of the Australian HIV epidemic from AIDS surveillance data. Aust J Public Health 1993; 17 226–31.
| PubMed |
[46] Prestage G, Jin F, Zablotska I, Imrie J, Kaldor JM, Grulich AE. Trends in HIV prevalence among homosexual and bisexual men in eastern Australian states. Sex Health 2008; 5 103–7.
| Crossref | GoogleScholarGoogle Scholar |
[47] Jin FY, Prestage G, Law MG, Kippax S, Van de Ven P, Rawsthorne P, et al. Predictors of recent HIV testing in homosexual men in Australia. HIV Med 2002; 3 271–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[48] Prestage G, Zablotska I, Imrie J, Grulich AE, Pitts M. Trends in HIV testing among homosexual and bisexual men in eastern Australian states. Sex Health 2008; 5 119–23.
| Crossref | GoogleScholarGoogle Scholar |
[49] Nemoto T. HIV/AIDS surveillance and prevention studies in Japan: summary and recommendations. AIDS Educ Prev 2004; 16 27–42.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[50]
[51] van Griensven F, Thanprasertsuk S, Jommaroeng R, Mansergh G, Naorat S, Jenkins RA, et al. Evidence of a previously undocumented epidemic of HIV infection among men who have sex with men in Bangkok, Thailand. AIDS 2005; 19 521–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[52] Grulich A. HIV risk behaviour in gay men: on the rise? BMJ 2000; 320 1487–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[53] Fenton KA, Imrie J. Increasing rates of sexually transmitted diseases in homosexual men in Western Europe and the United States: why? Infect Dis Clin North Am 2005; 19 311–31.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[54] McDonald AM, Gertig DM, Crofts N, Kaldor JM. A national surveillance system for newly acquired HIV infection in Australia. National HIV Surveillance Committee. Am J Public Health 1994; 84 1923–8.
| PubMed |
[55] Kaldor J, McDonald A. HIV/AIDS surveillance systems in Australia. J Acquir Immune Defic Syndr 2003; 32 S18–23.
| PubMed |
[56] Van de Ven P, Prestage G, Crawford J, Grulich A, Kippax S. Sexual risk behaviour increases and is associated with HIV optimism among HIV-negative and HIV-positive gay men in Sydney over the 4 year period to February 2000. AIDS 2000; 14 2951–3.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[57] Zablotska I, Prestage G, Grulich AE, Imrie J. Divergent trends in sexual risk behaviours in three Australian states: New South Wales, Victoria and Queensland, 1998–2006. Sex Health 2008; 5 125–30.
| Crossref | GoogleScholarGoogle Scholar |
[58]