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

Andrea Wirtz, C. E. Zelaya, Carl A Latkin, A. Peryshkina, Noya Galai, V. Mogilniy, P. Dzhigun, I. Kostetskaya, Shruti Hemendra Mehta, Christopher Beyrer

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)161-167
Number of pages7
JournalSexually Transmitted Infections
Volume92
Issue number2
DOIs
StatePublished - Mar 1 2016

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Moscow
Continuity of Patient Care
Russia
Cross-Sectional Studies
HIV
HIV Infections
Infection
Odds Ratio
Population
Sexual Partners
Viral Load
Early Diagnosis
Logistic Models

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

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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. / Wirtz, Andrea; Zelaya, C. E.; Latkin, Carl A; Peryshkina, A.; Galai, Noya; Mogilniy, V.; Dzhigun, P.; Kostetskaya, I.; Mehta, Shruti Hemendra; Beyrer, Christopher.

In: Sexually Transmitted Infections, Vol. 92, No. 2, 01.03.2016, p. 161-167.

Research output: Contribution to journalArticle

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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 {\^a}‰¥ 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 {\^a}‰¥ 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.",
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T2 - A cross-sectional study of infection awareness and engagement in care

AU - Wirtz, Andrea

AU - Zelaya, C. E.

AU - Latkin, Carl A

AU - Peryshkina, A.

AU - Galai, Noya

AU - Mogilniy, V.

AU - Dzhigun, P.

AU - Kostetskaya, I.

AU - Mehta, Shruti Hemendra

AU - Beyrer, Christopher

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N2 - 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.

AB - 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.

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