Since data collection has closed, 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 June 2021, 20 countries have provided at least one national report. Many countries were interrupted in their report writing by the COVID-19 pandemic. We still expect a report from the Netherlands, Poland, Portugal, and Slovakia. No feedback has been received from BG, HR, LV/LT, SI, PH, RS. No reports are expected from Finland, Hungary, Lebanon, North Macedonia, Romania, or the United Kingdom.
For World AIDS Days 2018–2021 we partnered with UNAIDS to present some key findings from the European and Latin American MSM Internet Surveys on the UNAIDSwebsite for key populations. Findings are shown as interactive maps that include various sexual health indicatiors for gay men, bisexual men and other MSM.
Recruitment and Outness
Crude Recruitment Rate: Number of men reached by EMIS-2017/LAMIS, per 10,000 men aged 15–65
Not open about sexual orientation (non-outness): “Out” to few or none of friends, family, work (%)
HIV
HIV diagnosis: ever diagnosed with HIV (%)
Recent HIV diagnosis: HIV diagnosis in the past 12 months (%), excluding men diagnosed with HIV more than 12 months ago
HIV testing: Tested for HIV in the last 12 months (%), excluding those diagnosed longer ago
Community-based HIV testing: Using community HIV- testing at last HIV test (%, denominator includes untested men)
Sexually Transmitted Infections: Testing, Diagnosis, and Partner Notifiaction
Comprehensive STI screen: HIV test, STI blood test, rectal swab, urethral (trans men if applicable: vaginal) swab or urine in the last 12 months (%), excluding men diagnosed with HIV more than 12 months ago
STI testing: any test for a sexually transmitted infection, in the previous 12 months (%)
Disclosure in health care: Disclosure of same-sex contacts towards health care provider during STI-testing in the last 12 months (%)
Syphilis: diagnosed in the previous 12 months (%)
Symptomatic syphilis: in the previous 12 months (%)
Gonorrhoea: diagnosed in the previous 12 months (%)
Symptomatic gonorrhoea: in the previous 12 months (%)
Chlamydia: diagnosed in the previous 12 months (%)
Symptomatic chlamydia: in the previous 12 months (%)
Partner notification among men with syphilis (%)
Partner notification among men with gonorrhoea (%)
Interventions
Targeted information: Saw or heard information about HIV/STIs for MSM, last 12 months (%)
Received free condoms: Received free condom from NGOs, clinics, bars, or saunas, last 12 months (%)
Risk and precaution behaviour
Condomless anal sex: Condomless anal sex with non-steady male partners of unknown HIV status, last 12 months (%)
PrEP use: Currently taking HIV pre-exposure prophylaxis daily or on demand (%), excluding HIV-diagnosed men
Knowledge
Lack of PrEP knowledge: Not knowing that PrEP is a pill taken before as well as after sex to prevent HIV infection (%)
Lack of PEP knowledge: Not knowing that PEP stops HIV infection after exposure (%)
Lack of U=U knowledge: Not knowing U=U (that a person with undetectable viral load cannot pass on HIV, %)
Vaccinations
HAV vaccination: history of at least one dose of hepatitis A vaccine (%), exluding those with a history of hepatitis A
HBV vaccination: history of at least one dose of hepatitis B vaccine (%), exluding those with a history of hepatitis B
Suggested citation for EMIS/LAMIS indicators on the UNAIDS website for key populations:
UNAIDS Key Population Atlas: EMIS & LAMIS Indicators for men-who-have-sex-with-men. Geneva, 2018–21. Available at: https://kpatlas.unaids.org/dashboard
Disclaimer: Indicators published on the UNAIDS website for key populations based on data collected by the Latin America MSM Internet Survey (LAMIS) are not official/governmental data of the participating countries.
Available in 33 languages, the European MSM Internet Survey (EMIS-2017) recruited 137,358 qualifying participants from 46 countries across Europe and Lebanon, Israel, Canada and the Philippines. The Latin American MSM Internet Survey (LAMIS) recruited 64,655 participants from 18 countries.
EMIS-2017 was undertaken by researchers from Sigma Research at the London School for Hygiene and Tropical Medicine and the Robert Koch Institute. Data was collected between 18 October 2017 and 31 January 2018.
LAMIS, using the same questionnaire and finishing data collection on 12 May 2018, was the first multi-country survey for gay, bisexual, and other men who have sex with men (MSM) in Latin America. It was implemented by researchers from the RIGHT-PLUS*, a coalition of researchers from Latin America, Portugal, Spain and the Netherlands, with support from the EMIS team. EMIS and LAMIS required a great deal of international cooperation and relied on the support of national stakeholders to aid local recruitment. Through this cooperation comparable data are now available for the first time for more than 60 countries across 4 continents.
LAMIS contributions: CEEISCAT, Spain (Jordi Casabona Barbara, Percy Fernández Dávila): LAMIS network and local recruitment coordination, economic and legal aspects of hosting the database. CIISSS, Peru (Carlos F. Cáceres, E. Michael Reyes): LAMIS Report for Latin America. NUDHES, Brazil (Maria Amelia de Sousa Mascena Veras, Daniel Barros): study website and its graphic design. LSHTM, United Kingdom (Sigma Research: Axel J. Schmidt, Ford Hickson, David Reid, Peter Weatherburn): questionnaire design, support with survey software and monitoring of recruitment, graphic arts of banners for promotion, data cleaning and labelling, error handling, variable manual, templates for national and community reports, collaboration with UNAIDS. Robert Koch Institute, Germany (Ulrich Marcus): negotiations with web pages/apps for free promotion of LAMIS and coordination of central recruitment.
LAMIS acknowledgements: We thank all men who took part in LAMIS, as well as our app partners Grindr and PlanetRomeo who helped to recruit participants through free-of-charge instant messages, and our local partners who recruited participants via Facebook and other social media, and placed promotional banners on their websites. Thank you for being part of something huge!
The following list acknowledges all LAMIS partners by country.
AR: Federación Argentina de Lesbianas, Gays, Bisexuales y Trans (FALGBT). BO: Fundación Diversencia; MANODIVERSA. BR: Núcleo de Pesquisa em Direitos Humanos e Saúde LGBT+ (NUDHES) da Faculdade de Ciências Médicas da Santa Casa de São Paulo; ABGLT. CL: Escuela de Salud Pública – Universidad de Chile; Fundación Savia; APROFA. CO: Asociación Ágora; UNIMINUTO Seccional Bello. CR: Centro de Investigación y Promoción para América Central de Derechos Humanos (CIPAC). EC: Fundación Ecuatoriana Equidad. GT: Fundación Sida y Sociedad; Centro de Investigaciones de las Ciencias de la Salud, Facultad de Ciencias Médicas, Universidad de San Carlos de Guatemala. HN: Asociación Kukulcan. MX: Red GayLatino. NI: Centro para la Educación y Prevención del SIDA (CEPRESI). PA: Grupo Génesis Panamá+. PY: SOMOSGAY. PE: Center for Research on Sexuality, AIDS and Society at Universidad Peruana Cayetano Heredia. SR: Parea Surinam. SV: Asociación Entre Amigos. UY: Colectivo Ovejas Negras; +VIHdas. VE: Venezuela Igualitaria.
LAMISfunding: Questionnaire design, core survey execution and variable manual were provided by EMIS-2017 (funded by the EU Health Programme 2014–2020 for Europe), and adapted for LAMIS use. Additional financial support was provided by CEEISCAT, CIISSS, Instituto de Saúde Pública da Universidade do Porto, Maastricht University, NUDHES, and Robert Koch Institute.
*The Red Iberoamericana de Estudios en Hombres Gay, otros Hombres que tienen Sexo con Hombres y Personas Trans is composed of the following institutions: Núcleo de Pesquisa em Direitos Humanos e Saúde LGBT+ (NUDHES) da Faculdade de Ciências Médicas da Santa Casa de São Paulo (Brazil); Escuela de Salud Pública, Universidad de Chile (Chile); CIISSS at Universidad Peruana Cayetano Heredia (Peru); CICS – Facultad de Ciencias Médicas, Universidad de San Carlos de Guatemala (Guatemala); Instituto de Saúde Pública da Universidade do Porto (Portugal); the Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i VIH/Sida de Catalunya (CEEISCAT, Spain).
Authors: J P Costa, P Meireles, A Aguiar, A J Schmidt, H Barros
Abstract
Recently, it became clear that undetectable equals untransmittable (U=U), stressing the importance of engaging in medical care and adhering to antiretroviral therapy. HIV testing and counselling (HTC) are offered in different settings and can be an opportunity to inform people. We aimed to understand if HIV testing history, including recency, place and, result, was associated with U=U knowledge.
We used data from 2242 MSM living in Portugal participating in EMIS 2017 that answered if they already knew that “A person with HIV who is on effective treatment (called ‘undetectable viral load’) cannot pass their virus to someone else during sex”, opting of 5 possible answers, dichotomized in “I already knew” vs. any other option. Regarding HIV testing history, participants were categorized as follows:1. HIV positive; 2. HIV negative and last test ≤12 months in a community setting; 3. HIV negative and last test ≤12 months in a medical setting, and 4. never tested for HIV or last test >12 months or tested in other settings (reference). Logistic regression models were fitted to estimate crude and city size and education-adjusted associations.
The median (P25; P75) age of participants was 34 (25; 43) years. No significant statistical association was found with age or current occupation. Those with more years of education and living in a big or very big city were more likely to know that U=U (aOR:1.55; 95%CI:1.20-1.99 and aOR:1.26; 95%CI:1.04-1.53, respectively). Considering HIV testing history and diagnosis, men with diagnosed HIV (aOR:6.33; 95%CI:4.50-8.90), those who had the last test in community setting (aOR:2.44; 95%CI:1.87-3.17) and those who had the last test in a medical setting (aOR: 1.57; 95%CI:1.26-1.95) were more aware of U=U than those not tested in the last 12 months.
Our results suggest that there is a gradient of U=U knowledge associated with HIV testing history among MSM. Efforts should focus on improving counselling about U=U at all HIV testing settings.
Key messages
The knowledge of U=U seems to be associated with the place, recency and result of the last HIV test.
Counselling should focus on the best evidence available at all HIV testing settings, to inform and empower the individuals.
