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EMIS 2017 Journal Articles 2017

Recreational and sexualised drug use among gay, bisexual, and other men who have sex with men (gbMSM) in Ireland–Findings from the European MSM internet survey (EMIS) 2017

PLoS One 2023;18(7):e0288171 (doi: 10.1371/journal.pone.0288171)

Authors: Fionn P. Daly , Kate O’Donnell, Martin P. Davoren, Chris Noone, Peter Weatherburn, Mick Quinlan, Bill Foley, Fiona Lyons, Derval Igoe, Peter Barrett

Abstract

Background

Gay, bisexual, and other men who have sex with men (gbMSM) report a higher prevalence of drug use in comparison to the general male population. However, in Ireland, there is a paucity of literature regarding the prevalence of drug use and its determinants among gbMSM.

Aims/Objectives

To quantify the prevalence of (i) recreational drug use (RDU) and (ii) sexualised drug use (SDU) among gbMSM in Ireland, and to identify the factors associated with these drug use practices.

Methods

The European MSM Internet Survey (EMIS) 2017 was an online, anonymous, internationally-promoted questionnaire. Two binary outcomes were included in our analyses: (1) RDU and (2) SDU in the previous year. Multivariable-adjusted logistic regression explored factors associated with these outcomes, and all independent covariates were adjusted for one another.

Results

Among gbMSM without HIV (n = 1,898), 40.9% and 13.1% engaged in RDU and SDU in the previous year, respectively. Among diagnosed-positive gbMSM (n = 141), the past-year respective prevalence estimates were 51.8% and 26.2%. Increased odds of RDU were observed among gbMSM who were younger (vs. 40+ years) (18–24 years; AOR 2.96, 95% CI 2.05–4.28, 25–39 years; AOR 1.66, 95% CI 1.27–2.16), lived in Dublin (vs. elsewhere) (AOR 1.47, 95% CI 1.17–1.83), and engaged in condomless anal intercourse (CAI) in the previous year (vs. none) (1–2 partners; AOR 1.79, 95% CI 1.34–2.38, 6+ partners; AOR 1.79, 95% CI 1.18–2.71). Greater odds of SDU were identified among those who lived in Dublin (vs. elsewhere) (AOR 1.50, 95% CI 1.07–2.10), and engaged in CAI (vs. none) (1–2 partners; AOR 3.16, 95% CI 2.05–4.88, 3–5 partners; AOR 2.50, 95% CI 1.47–4.26, and 6+ partners; AOR 3.79, 95% CI 2.23–6.43).

Conclusion

GbMSM report a high prevalence of drug use in Ireland. Targeted interventions, including harm reduction campaigns, may be needed to support healthier drug use choices among this community.

Available online

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EMIS 2017 International reports 2017

EMIS-2017: European Report

The EMIS Network. EMIS-2017 – The European Men-Who-Have-Sex-With-Men Internet Survey. Key findings from 50 countries.

Report details:
Stockholm, European Centre for Disease Prevention and Control, 2019 (ISBN 978-92-9498-341-1).

Suggested citation:
The EMIS Network. EMIS-2017 – The European Men-Who-Have-Sex-With-Men Internet Survey. Key findings from 50 countries. Stockholm: European Centre for Disease Prevention and Control; 2019.

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EMIS 2017 International reports 2017

LAMIS: Latin America Report

Latin American MSM Internet Survey.

[ES] Encuesta latinoamericana por internet en hombres que tienen sexo con hombres.
[PT] Pesquisa da América Latina online em homens que fazem sexo com homens.

Suggested citation:
Reyes-Diaz M, Folch C, Celly A, Stuardo V, Veras V, Schmidt AJ, Cáceres CF, Casabona J. LAMIS-2018: Informe Regional. Right PLUS/Coalition PLUS. 2022.

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EMIS 2017 National reports 2017

EMIS-2017 National Reports

Since data collection has closed in February 2018, we have distributed 39 country of residence datasets to our EMIS-2017 partners who are working on a wide range of national reports, in a variety of formats. As these reports are published they will be added here. No datasets were requested from Luxemburg, Bosnia iH, Iceland, or Turkey. As of July 2023, 22 countries have provided at least one national report. Many countries were interrupted in their report writing by the COVID-19 pandemic. We might still receive a report from the Netherlands, Poland, Portugal, and Slovakia. No reports are expected from Bulgaria, Croatia, Finland, Hungary, Lebanon, Lithuania, Latvia, North Macedonia, Romania, Serbia, Slovenia, the Philippines, or the United Kingdom.

EMIS-2017: Austria EMIS-2017 National Reports

EMIS-2017: Belarus EMIS-2017 National Reports

EMIS-2017: Belgium (België) EMIS-2017 National Reports

EMIS-2017: Belgium (Belgique) EMIS-2017 National Reports

EMIS-2017: Canada (main report) EMIS-2017 National Reports

EMIS-2017: Canada (Infographic summary) EMIS-2017 National Reports

EMIS-2017: Czechia EMIS-2017 National Reports

EMIS-2017: Cyprus EMIS-2017 National Reports

EMIS-2017: Denmark EMIS-2017 National Reports

EMIS-2017: Estonia EMIS-2017 National Reports

EMIS-2017: France EMIS-2017 National Reports

EMIS-2017: Germany EMIS-2017 National Reports

EMIS-2017: Greece (1) EMIS-2017 National Reports

EMIS-2017: Greece (2) EMIS-2017 National Reports

EMIS-2017: Ireland (Main Report) EMIS-2017 National Reports

EMIS-2017: Ireland (Community Report 1) EMIS-2017 National Reports

EMIS-2017: Ireland (Community Report 2) EMIS-2017 National Reports

EMIS-2017: Ireland (Community Report 3) EMIS-2017 National Reports

EMIS-2017: Ireland (Community Report 4) EMIS-2017 National Reports

EMIS-2017: Ireland (Infographic Demographics) EMIS-2017 National Reports

EMIS-2017: Ireland (Infographic Health) EMIS-2017 National Reports

EMIS-2017: Ireland (Infographic Behaviours) EMIS-2017 National Reports

EMIS-2017: Ireland (Infographic Needs) EMIS-2017 National Reports

EMIS-2017: Ireland (Infographic Interventions) EMIS-2017 National Reports

EMIS-2017: Ireland (Health technology assessment for PrEP) EMIS-2017 National Reports

EMIS-2017: Israel EMIS-2017 National Reports

EMIS-2017: Italy EMIS-2017 National Reports

EMIS-2017: Malta EMIS-2017 National Reports

EMIS-2017: Moldova EMIS-2017 National Reports

EMIS-2017: Norway EMIS-2017 National Reports

EMIS-2017: Russia EMIS-2017 National Reports

EMIS-2017: Spain EMIS-2017 National Reports

EMIS-2017: Sweden EMIS-2017 National Reports

EMIS-2017: Switzerland (Suisse) EMIS-2017 National Reports

EMIS-2017: Switzerland (Schweiz) EMIS-2017 National Reports

EMIS-2017: Ukraine EMIS-2017 National Reports

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EMIS 2017 Journal Articles 2017

Comparison of the burden of self-reported bacterial sexually transmitted infections among men having sex with men across 68 countries on four continents

BMC Public Health 2023; 23:1008 (doi: 10.1186/s12889-023-15946-8)

Authors: Ulrich Marcus, Maria Veras, Jordi Casabona, Carlos F. Caceres, Nathan Lachowsky, Susanne B. Schink, Axel J. Schmidt

Abstract

Background 

Men who have sex with men (MSM) are in general more vulnerable to sexually transmitted infections (STIs) than the heterosexual men population. However, surveillance data on STI diagnoses lack comparability across countries due to differential identification of MSM, diagnostic standards and methods, and screening guidelines for asymptomatic infections.

Methods 

We compared self-reported overall diagnostic rates for syphilis, gonorrhea, and chlamydia infections, and diagnostic rates for infections that were classified to be symptomatic in the previous 12 months from two online surveys. They had a shared methodology, were conducted in 68 countries across four continents between October 2017 and May 2018 and had 202,013 participants.

Results 

Using multivariable multilevel regression analysis, we identified age, settlement size, number of sexual partners, condom use for anal intercourse, testing frequency, sampling rectal mucosa for extragenital testing, HIV diagnosis, and pre-exposure prophylaxis use as individual-level explanatory variables. The national proportions of respondents screened and diagnosed who notified some or all of their sexual partners were used as country-level explanatory variables. Combined, these factors helped to explain differences in self-reported diagnosis rates between countries. The following differences were not explained by the above factors: self-reported syphilis diagnoses were higher in Latin America compared with Europe, Canada, Israel, Lebanon, and the Philippines (aOR 2.30–3.71 for symptomatic syphilis compared to Central-West Europe); self-reported gonorrhea diagnoses were lower in Eastern Europe and in Latin America compared with all other regions (aOR 0.17–0.55 and 0.34–0.62 for symptomatic gonorrhea compared to Central-West Europe); and self-reported chlamydia diagnoses were lower in Central East and Southeast Europe, South and Central America, and the Philippines (aOR 0.25–0.39 for symptomatic chlamydia for Latin American subregions compared to Central West Europe).

Conclusions 

Possible reasons for differences in self-reported STI diagnosis prevalence likely include different background prevalence for syphilis and syndromic management without proper diagnosis, and different diagnostic approaches for gonorrhea and chlamydia.

Available online

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EMIS 2017 Journal Articles 2017

Spatio-temporal changes in pre-exposure prophylaxis uptake among MSM in mainland France between 2016 and 2021: a Bayesian small area approach with MSM population estimation

J. Int. AIDS Soc. 2023, 26:e26089 (doi: 10.1002/jia2.26089)

Authors: Haoyi Wang, Jean-Michel Molina, Rosemary Dray-Spira, Axel J. Schmidt, Ford Hickson, David van de Vijver, Kai J. Jonas

Abstract:

Introduction

In France, oral pre-exposure prophylaxis (PrEP) for HIV prevention has been publicly available since 2016, mainly targeting at men who have sex with men (MSM). Reliable and robust estimations of the actual PrEP uptake among MSM on a localized level can provide additional insights to identify and better reach marginalized MSM within current HIV prevention service provision. This study used national pharmaco-epidemiology surveillance data and regional MSM population estimations to model the spatio-temporal distribution of PrEP uptake among MSM in France 2016–2021 to identify marginalized MSM at risk for HIV and increase their PrEP uptake.


Methods

We first applied Bayesian spatial analyses with survey-surveillance-based HIV incidence data as a spatial proxy to estimate the size of (1) regional HIV-negative MSM populations and (2) MSM who could be eligible for PrEP use according to French PrEP guidelines. We then applied Bayesian spatio-temporal ecological regression modelling to estimate the regional prevalence and relative probability of the overall- and new-PrEP uptake from 2016 to 2021 across France.


Results

HIV-negative and PrEP-eligible MSM populations vary regionally across France. Île-de-France was estimated to have the highest MSM density compared to other French regions. According to the final spatio-temporal model, the relative proba- bility of overall PrEP uptake was heterogeneous across France but remained stable over time. Urban areas have higher-than- average probabilities of PrEP uptake. The prevalence of PrEP use increased steadily (ranging from 8.8% [95% credible interval 8.5%;9.0%] in Nouvelle-Aquitaine to 38.2% [36.5%;39.9%] in Centre-Val-de-Loire in 2021).


Conclusions

Our results show that using Bayesian spatial analysis as a novel methodology to estimate the localized HIV- negative MSM population is feasible and applicable. Spatio-temporal models showed that despite the increasing prevalence of PrEP use in all regions, geographical disparities and inequalities of PrEP uptake continued to exist over time. We identified regions that would benefit from greater tailoring and delivery efforts. Based on our findings, public health policies and HIV prevention strategies could be adjusted to better combat HIV infections and to accelerate ending the HIV epidemic.

Available online

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EMIS 2017 International reports 2017

EMIS-2017: Community Reports Europe

We thank our network partners for their translations of the following Community Reports.

The 3rd EMIS-2017 Community Report, published 14 August 2021, covers the stress factors affecting mental and sexual health and well-being and was coordinated by Mick Quinlan (Gay Health Network, Dublin, Ireland). It has been translated into the six most commonly spoken (apart from English) languages in Europe: German, Russian, French, Turkish, Italian, and Spanish, as well as into Arabic, Czech, and Portuguese. The 3rd community report was funded by Ireland’s Health Services (HSE)

The 2nd EMIS-2017 Community Report, published 27 November 2020, focuses on gay men living with HIV in Europe and was coordinated by Mick Quinlan (Gay Health Network, Dublin, Ireland). It has been translated into the seven most commonly spoken (apart from English) languages in Europe: German, Russian, French, Turkish, Italian, Polish, and Spanish, as well as into Arabic, Czech, and Portuguese. The 2nd community report was funded by Ireland’s Health Services (HSE)

The 1st EMIS-2017 Community Report targeted at EMIS respondents and MSM in general was published in 31 languages by the end of 2018. We thank our network partners for their contributions and translations, and particularly the German NGO Deutsche AIDS-Hilfe for leading the process, and the Swiss AIDS Federation for financial support.

The first Community Report describes safer sex knowledge (including knowledge on Pre-Exposure Prophylaxis (PrEP) and Undetectable=Untransmittable (U=U). The English version was first presented at AIDS2018 in Amsterdam. The Philippines opted out from the 1st Community Report, so it covers 49, not 50, countries.

3rd EMIS-2017 Community Report

3rd EMIS-2017 Community Report (Arabic)

3rd EMIS-2017 Community Report (Czech)

3rd EMIS-2017 Community Report (English)

3rd EMIS-2017 Community Report (French)

3rd EMIS-2017 Community Report (German)

3rd EMIS-2017 Community Report (Italian)

3rd EMIS-2017 Community Report (Portuguese)

3rd EMIS-2017 Community Report (Russian)

3rd EMIS-2017 Community Report (Spanish)

3rd EMIS-2017 Community Report (Turkish)

2nd EMIS-2017 Community Report

2nd EMIS-2017 Community Report (Arabic)

2nd EMIS-2017 Community Report (Czech)

2nd EMIS-2017 Community Report (English)

2nd EMIS-2017 Community Report (French)

2nd EMIS-2017 Community Report (German)

2nd EMIS-2017 Community Report (Italian)

2nd EMIS-2017 Community Report (Polish)

2nd EMIS-2017 Community Report (Portuguese)

2nd EMIS-2017 Community Report (Russian)

2nd EMIS-2017 Community Report (Spanish)

2nd EMIS-2017 Community Report (Turkish)

1st EMIS-2017 Community Report

1st EMIS-2017 Community Report (Arabic)

1st EMIS-2017 Community Report (Bulgarian)

1st EMIS-2017 Community Report (Croatian)

1st EMIS-2017 Community Report (Czech)

1st EMIS-2017 Community Report (Danish)

1st EMIS-2017 Community Report (Dutch)

1st EMIS-2017 Community Report (English)

1st EMIS-2017 Community Report (Estonian)

1st EMIS-2017 Community Report (Finnish)

1st EMIS-2017 Community Report (French)

1st EMIS-2017 Community Report (Switzerland-French)

1st EMIS-2017 Community Report (German)

1st EMIS-2017 Community Report (Switzerland-German)

1st EMIS-2017 Community Report (Greek)

1st EMIS-2017 Community Report (Hebrew)

1st EMIS-2017 Community Report (Hungarian)

1st EMIS-2017 Community Report (Icelandic)

1st EMIS-2017 Community Report (Italian)

1st EMIS-2017 Community Report (Switzerland-Italian)

1st EMIS-2017 Community Report (Latvian)

1st EMIS-2017 Community Report (Lithuanian)

1st EMIS-2017 Community Report (Macedonian)

1st EMIS-2017 Community Report (Norwegian)

1st EMIS-2017 Community Report (Polish)

1st EMIS-2017 Community Report (Portuguese)

1st EMIS-2017 Community Report (Romanian)

1st EMIS-2017 Community Report (Russian)

1st EMIS-2017 Community Report (Serbian)

1st EMIS-2017 Community Report (Slovak)

1st EMIS-2017 Community Report (Slovenian)

1st EMIS-2017 Community Report (Spanish)

1st EMIS-2017 Community Report (Swedish)

1st EMIS-2017 Community Report (Turkish)

1st EMIS-2017 Community Report (Ukrainian)

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EMIS 2017 International reports 2017

LAMIS: Community Reports Latin America

In February 2022, Right PLUS published four infographics as Community Reports in Spanish: about knowledge of and access to ART; about migration to love more openly as a gay or bisexual or trans person, anxiety and depression; on substance use; and on HIV, STS, and hepatitis B & C .

In April 2020, the Brazilian NGO Associação Brasileira de Lésbicas, Gays, Bissexuais, Travestis, Transexuais e Intersexos (ABGLT), published a comparable Community Report for Brazil, based on data from the Latin American Internet Survey (LAMIS), with support from Maria Amelia de Sousa Mascena Veras (Faculdade de Ciências Médicas da Santa Casa de São Paulo) and Sigma Research

Community Report (Brasil)

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EMIS 2017 Journal Articles 2017

Prevalence and risk factors for transactional sex among Swedish-born and foreign-born MSM in Sweden

BMC Public Health 2022; 22:2412. (doi: 10.1186/s12889-022-14764-8)

Authors: Sara Causevic, Mariano Salazar, Anna Mia Ekström, Torsten Berglund, Kristina Ingemarsdotter Persson, Mikael Jonsson, Jonas Jonsson, Susanne Strömdahl

Abstract:

Background

Little is known about transactional sex (TS) (selling and buying sex) among men who have sex with men (MSM) in Sweden, especially among foreign-born MSM. This study aims to assess the prevalence and risk fac- tors of TS (ever and in the previous five years) among MSM living in Sweden and to determine if there is a difference between Swedish-born MSM and foreign-born MSM.

Methods

Swedish data from a multicountry online banner survey (EMIS-2017) was used (= 4443). Multivariable regression analysis was applied to analyse the data.

Results

The prevalence of ever-selling sex among all MSM participants was 13.2% and 5.9% in the previous five years. Selling sex ever and in the previous five years was higher among foreign-born MSM (16% and 8.4%, respec- tively) than Swedish-born MSM (12.7% and 5.4%, respectively). Among all participants, younger age (aOR:3.19, 95% CI:1.57–6.45) and really struggling to live on current income (aOR:3.37, 95% CI:2.29–4.96) increased the odds of selling sex. Being foreign-born MSM (aOR:1.33, 95% CI:1.02–1.73) and having had sex with a woman in the previous 12 months increased the odds of selling sex (aOR:1.44, 95% CI:1.00–2.07).

The prevalence of ever buying sex among MSM participants in Sweden was 10.8% and 6.7% in the previous five years, with the same trend among foreign-born MSM (11.6% and 6.9%, respectively) and Swedish-born MSM (10.7% and 6.6%, respectively). Higher education and not having a current partner increased the odds of buying sex. Younger age was protective for buying sex (aOR:0.05, 95% CI:0.02–0.14). Among the foreign-born MSM, the length of stay in Sweden decreased the odds of buying sex (aOR: 0.98, 95% CI: 0.96–0.99).

Conclusions

The comparatively high prevalence of TS among MSM participants in Sweden, where buying sex is illegal, with a higher prevalence among foreign-born MSM participants, calls for sexual and reproductive health and rights interventions in this population. Increased attention, including HIV prevention programming and education, should be aimed at younger MSM, MSM struggling with their current income, and foreign-born MSM, as they are more likely to report selling sex.

Available online

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EMIS 2017 Journal Articles 2017

Association of internalised homonegativity with partner notification after diagnosis of syphilis or gonorrhoea among men having sex with men in 49 countries across four continents

BMC Public Health. 2023; 23(8). doi: 10.1186/s12889-022-14891-2

Authors: Ulrich Marcus, Kai Jonas, Rigmor Berg, Maria Amelia Veras, Carlos F. Caceres, Jordi Casabona, Susanne B. Schink & Axel J. Schmidt

Abstract

Background

Partner notification (PN) after a sexually transmitted infection (STI) diagnosis is being promoted as a means to interrupt transmission chains. We investigated whether Internalised Homonegativity (IH) is associated with PN among men having sex with men (MSM).

Methods

PN, defined as notifying at least one partner after diagnosis of syphilis and gonorrhoea, was queried in two internet-based self-completion surveys conducted between Oct 2017 and May 2018 in 68 countries in Europe, Latin America, Canada, and the Philippines. IH is defined by a man’s level of agreement or disagreement with negative social beliefs about male homosexuality. Covariates included in a multivariate regression model with a random intercept at country level were age, HIV diagnosis, partnership status, sexual self-efficacy, HIV serostatus communication during last sex with a non-steady partner, place where this partner was met, and PN-related socio-historical background of the country of residence. We grouped countries in three areas: North- and Central-Western European countries plus Canada, former socialist countries, and Latin-American/Mediterranean countries plus the Philippines. In each of the three areas individuals were assigned to 4 subgroups based on IH quartiles and PN rates were determined for each subgroup.

Results

PN rates were calculated for 49 countries (excluding countries with less than 10 diagnoses). Mean proportions of MSM notifying their partners were 68.1% and 72.9% after syphilis and gonorrhoea diagnoses, respectively. PN rates were lower in Latin American countries and the Philippines compared to European countries. Within Europe, a North–South divide with lower PN rates in Mediterranean countries was observed. In each of the three regions we mostly observed a stepwise increase of PN rates with decreasing IH.

Regression analysis showed lower IH scores associated with higher PN rates. Higher perceived self-efficacy, living in a partnership, and HIV status communication were positively associated with PN. Men who had met their last partner in a gay social venue were more likely to have notified their partners of a syphilis diagnosis compared to men who had met this partner online. Men with diagnosed HIV were less likely to report PN.

Conclusions

We could demonstrate that IH was associated with PN among MSM across all countries included in our analysis. Reducing cultural homophobia and ensuring inclusive policies may contribute to STI prevention and control.

Available online