Increase in the prevalence of HIV and in associated risk behaviors in men who have sex with men: 12 years of behavioral surveillance surveys in Catalonia (Spain)

Objectives: To describe trends in HIV prevalence, in risk behaviors associated with HIV transmission, and in knowledge and attitudes related to antiretroviral therapy (ART) among men who have sex with men (MSM) recruited in Catalonia between 1995 and 2006. Methods: Biannual cross-sectional surveys were performed. An opportunistic sample of MSM was recruited in saunas, sex shops, bars and a cruising site in a public park. in addition, an anonymous self-administered questionnaire was sent by mail to all members of a gay and lesbian association (Coordinadora Gai-Lesbiana). Oral fluid samples were collected to determine HIV prevalence. Linear trends in proportions were assessed by the chi(2) test, stratified by age. Results: The overall prevalence of HIV infection increased from 8.5% (1995) to 14.1% (2006) among men aged less than 30 years old (p = 0.162) and from 18.2% (1995) to 21.2% (2006) among those aged 30 years old or more (p = 0.07). Consistent condom use in anal intercourse with occasional partners decreased from 72.9% to 58.7% in men aged less than 30 years old (p < 0.05) and from 77.2% to 65.6% in those aged 30 years old or more (p < 0.001). The proportion of men who reported they chose riskier behaviors because of ART increased from 9.2% to 19.4% in men aged less than 30 years old and from 8.3% to 16.7% in those aged 30 years old or more (p<0.05). Conclusions: An increasing trend in the prevalence of HIV and associated risk behaviors was found in Catalonia among MSM. Therefore, preventive programs targeting this population should be intensified and should include new risk reduction strategies, as well as other educational messages about ART. (C) 2009 SESPAS. Published by Elsevier Espana, S.L. All rights reserved.