Formative Research results · Proportion of MSM tested for HIV during the last 12m and who know...
Transcript of Formative Research results · Proportion of MSM tested for HIV during the last 12m and who know...
FRR Annex 5: Presentation of the FR results in the project meeting, Berlin, 11.‐13.02.2013
Formative Research results
Sandra Dudareva‐Vizule, Ulrich MarcusRobert Koch Institute11 February 2013
Content
• Background
• Methodology
• Results– Previous experience with studies among MSM
– Prevention
– MSM Population
– Venues• Venues in countries
• Recency of visiting venues
• Who is reached in venues and who is not?
Background
• 13 SIALON II countries
• Preselected:
– Study area
• Mainly large cities together with surrounding areas
– Recruitment methodology
• Time Location Sampling (TLS) – 9 countries
• Respondent Driven Sampling (RDS) – 4 countries
– Sample size 400
Information source
• FR questionnaires
– Filled out by each study country
– Information on:
• study site, previous experience with different study methodologies and target groups, gay‐friendly commercial and non‐commercial sites, prevention activities, HIV, STIs, HBV, and HCV testing and therapy, legislation and stigmatization
• EMIS data
– demographic characteristics, behaviour, gay‐venue attendance, and HIV and STI history by study area
SIALON II study areas
Country Study area AbbreviationN of EMIS records for respective area
Belgium Brussels city centre BE 1,044Bulgaria Sofia BG 485Italy Verona IT 314Germany Hamburg DE 2,569Spain Barcelona ES 1,732Lithuania Vilnius LT 274Poland Warsaw PL 928Portugal Lisbon and Setubal regions PT 2,448Romania Bucharest RO 651Sweden Stockholm SE 1,362Slovenia Ljubljana SI 402Slovakia Bratislava SK 252United Kingdom Brighton and Hove UK 290
Previous experience with studies among MSM
Experience with
Planning Country TLS RDS Other
TLS
BE MSM FSW MSMBG MSMDE IDU MSMPL IDU MSMPT IDU, DU MSMSI MSM MSMES MSM Youth MSMSE IDU MSMUK MSM MSM MSM
RDS
IT MSM MSMLT IDU MSMRO MSM MSMSK MSM MSM
Prevention activities and outreach work in the study area in the last 12 months
Country Outreach workPrevention
activities
Evaluation of
prevention
activities
BE Y Y Y
BG Y Y N
DE Y Y Y
IT Y Y N
LT . . Y
PL Y Y N
PT Y Y N
RO Y Y N
SK N Y .
SL Y Y N
ES Y Y Y
SE Y Y Y
UK Y Y Y
Major types of prevention activities
• Information campaigns
• Distribution of condoms and lubricants in gay venues
• Websites
• Consultation (and testing) services for MSM
• Outreach work and mobile medical units
• Telephone, online and Skype consultations
• Peer education
• Advocacy
• Activities for communities of PLWHIV
Characterisation of the target population
Age distribution
Q2
IQR
Q1 Q3
p‐value (Kurskal Wallis)<0.001
Outness
1967 P M (2015) A
1792 P M A
1944 P M A
1979 P M A
1969 P
1991 P
1932 H
1974 P
1982 P M
1887 H
1990 H
1993 H
2002 H
H ‐ Homosexuality legal
but same sex unions not
recognised
P ‐ Other type of official
partnership possible
M ‐Marriage performed
A ‐ Adoption possible
Homosexuality legal since
Recognised partnership
Gay friends
Positivity rate of HIV and recent STI
Proportion of MSM tested for HIV during the last 12m and who know their results*
*excluding those tested HIV+ more than 12m ago
Percentage of MSM who both correctly identify ways of preventing the sexual transmission of HIV and who reject major misconceptions about HIV transmission
Average 41%
Gay friendly venues
Commercial venues by study siteStudy site
Total, NSexual contact facilitated, N
Condoms, %Prevention leaflets , %
Outreach worker, %
ES 39 18 38% 77% 15%
DE 36 15 47% 97% 100%
BE 28 10 50% 88% 73%
PT 28 15 71% 100% 96%
SE 25 7 36% 36% 28%
UK 24 4 96% 100% 92%
PL 16 10 63% 69% 56%
IT 8 5 50% 0% 25%
BG 7 6 100% 100% 100%
LT 7 3 57% 14% 14%
SI 6 4 83% 83% 100%
RO 4 0 100% 100% 0%
SK 4 2 25% 0% 25%
Non‐commercial venues by study site
Study site
Total, N
Community centre, N
Cruising site, N
Other, N
Sexual contact facilitated, N
Condoms, %
Prevention leaflets, %
Outreach worker, %
SE 12 4 5 3 7 50% 83% 42%BG 10 1 9 9 90% 100% 100%ES 10 7 3 1 0% 70% 90%PL 7 2 5 0 0% 29% 0%UK 7 5 2 2 29% 71% 86%DE 6 2 4 4 33% 33% 100%RO 5 1 4 0 0% 20% 20%PT 4 1 3 0 0% 25% 100%IT 3 1 2 0 0% 33% 33%LT 3 1 2 0 0% 33% 33%BE 2 1 1 0 0% 50% 100%SI 1 0 1 1 0% 0% 0%SK 0 0 0 0
Recency of visiting any gay social venue in the country of residence
Who is reached in the venues and whois not?
EMIS data for TLS Countries
MSM who are out about being attracted to men
Outness
VenueAll or
almost allSome
Few ornone
p‐value
Bars, pubs, or cafes 82.0% 74.6% 41.0% 0.000
Community centre, organisation or social group
29.0% 21.4% 10.1% 0.000
Saunas 26.9% 26.4% 26.1% 0.725
Gay disco or night‐club 68.9% 65.0% 35.1% 0.000
Backroom, sex‐club, sex‐party 30.0% 23.3% 15.7% 0.000
Cruising sites 30.0% 26.4% 26.1% 0.725
HIV+ MSM
HIV status
Venue HIV‐ HIV+ p‐value*
Bars, pubs, or cafes 68.0% 80.8% 0.000
Community centre, organisation or social group
21.3% 27.2% 0.000
Saunas 24.7% 43.6% 0.000
Gay disco or night‐club 58.3% 65.7% 0.000
Backroom, sex‐club, sex‐party 21.9% 46.2% 0.000
Cruising sites 24.7% 43.6% 0.000
In venues we will potentially reach proportionally more HIV+ MSM (than we would reach in a population‐representative sample)
Recently tested positive for STI
STI (in last 12 months)
Venue STI‐ STI+ p‐value*
Bars, pubs, or cafes 67.7% 82.0% 0.000
Community centre, organisation or social group
21.2% 26.9% 0.000
Saunas 25.1% 38.6% 0.000
Gay disco or night‐club 57.3% 73.7% 0.000
Backroom, sex‐club, sex‐party 22.2% 41.7% 0.000
Cruising sites 25.1% 38.6% 0.000
In venues we will reach proportionally more recently tested positive for STI MSM (than we would reach in a population‐representative sample)
Younger or older?
Age ‐ visitedAge ‐ did not
visit
Venue Median (IQR) Median (IQR) p‐value
Bars, pubs, or cafes 33 (26‐41) 32 (25‐42) 0.016
Community centre, organisationor social group
33 26‐42 33 26‐41 0.625
Saunas 36 29‐43 32 25‐40 0.000
Gay disco or night‐club 32 26‐39 35 27‐44 0.000
Backroom, sex‐club, sex‐party 36 30‐44 32 25‐40 0.000
Cruising sites 36 29‐43 32 25‐40 0.000
Number of different types of venues for MSM that have been visited in the last 12 months
Study area Median IQRES 4 2‐5BE 3 2‐5DE 3 2‐5UK 3 2‐5SE 3 2‐4PL 3 2‐4PT 3 1‐4IT 3 1‐4BG 2 1‐3LT 2 1‐3SK 2 1‐3RO 2 0‐3SI 2 0‐3
Type of venues:• Bars, pubs and cafés• Community centres,
organisations or social groups• Gay saunas• Gay disco or night‐club• Sex‐club, sex‐party• Cruising sites
Formative Research Report
• Study‐site specific results• Information on:
– Characterisation of the target population– Legislative background in SIALON II countries
• Gay/gay friendly commercial and non‐commercial sites• Characterisation of the MSM population in venues• The prevention activities• HIV, Syphilis and Viral hepatitis B (HBV) and C (HCV), testing and therapy
• Information about the experience with study methodology and studies among MSM
Formative Research Results
• Better planning of the sampling
• To timely avoid potential risks
• Information on venues (Annex 4 and 5)
– TLS sampling
• Information on HIV testing and counseling and fact sheets
– Prevention activities
• Interpretation of study results
Acknowledgement:Ulrich MarcusSIALON II partners
Thank you!