Piloting second generation HIV surveillance in Berlin, Germany, 2005 - 2007: Risk profile of recently acquired HIV infections in MSM
Keywords:
KABP-survey, HIV, BED-CEIA, second-generation HIV surveillance, recency of infection.Abstract
Men having sex with men (MSM) are by far the transmission-risk-category most affected by HIV in Berlin and
were investigated in this pilot-study with the aim to identify detailed risk- and prevention-behaviours in
recently infected persons. From November, 2005 - February, 2007, venous blood samples were taken from
patients in Berlin aged 18 years within 3 months after diagnosis of HIV-infection and tested with BED IgG
capture-ELISA (BED-CEIA) to differentiate between longstanding and recent HIV-infections dating back no
longer than 140 days from blood sampling. Data on knowledge, attitudes, behaviour and practices (“KABP
survey”) relating to HIV/AIDS, were collected anonymously by structured patients’ questionnaires,
accomplished by demographic data via additional questionnaires filled by the physicians. SPSS 15.0 was
used for data analysis. This sub-analysis includes 37 MSM with confirmed recently acquired HIV infection.
Mean age was 34 years (20 - 53). Good knowledge on HIV/AIDS in Germany and transmission risks was
present in most cases; nevertheless unprotected sexual contacts were indicated by 90% of recently HIV
infected MSM (independent from type of intercourse and partners’ sero -status) with 64% reporting
unprotected anal intercourse. Unprotected anal intercourse with a person they knew to be infected with HIV
was stated by 19% of cases. In 5% drugs/alcohol and in 48% (n = 18/37) uncertain HIV-related knowledge,
hope and beliefs about transmission risks were stated as reasons for unprotected sex. Almost half of
recently infected MSM in this pilot -study were infected because hope and beliefs on HIV- transmission-risks
had guided their personal decisions on HIV-prevention efforts. Limitations due to a small study population,
lack of HIV-negative-tested controls and selection bias should be optimised in future studies; however, the
findings have strong implications for amending prevention messages in Germany addressing MSM.
