Lessons learnt from SIALON

According to SIALON I findings, the HIV prevalence among MSM attending the gay venues ranges from 17.0% in Barcelona to 2.6% in Prague. Alarming findings include undiagnosed HIV infections. Over half the respondents were unaware of their HIV positive status. This proportion was slightly lower only in Barcelona, but very high (nearly 80%) in Ljubljana and Bucharest.

Nearly one third of MSM found to be HIV-positive through oral fluid samples reported a negative HIV test result over the last 12 months, so the undiagnosed infections were recent.

These data suggested that a high percentage of MSM are not aware of their real serumstatus, and that testing and access to Voluntary Counselling and Testing (VCT) is a crucial factor in combating the spread of HIV-STIs.

Moreover, young MSM exhibited the riskiest behaviour, as the highest rates of unprotected anal intercourse with occasional partners, both last time (last sexual intercourse) and in the last 6 months, were found amongst young people under 25 years old.

Finally, the association between HIV risk and alcohol and drug use was confirmed. At least one third of respondents had used drugs before or during sex over the last six months and half the respondents had used alcohol. This proportion was above half in Ljubljana, Barcelona and Prague for drugs, and higher than 80% in Prague and Bratislava.

In addition, the impact of perceived homonegativity on MSM access to sexual health services seems to play a relevant part. This SIALON I result is in line with an increasing number of research and debate related to the factors that influence sexual health and sexual well-being. According to the WHO definition, sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality, which plays a relevant part in influencing sexual behaviours.

This data suggested (i) the need for health promotion and prevention messages particularly focused on sexual behaviour and alcohol and drug use (ii) the need for prevention and information programmes for STI given that the presence of an STI increases the risk of HIV infection (iii) the need for policies and strategies promoting VCT among hard to reach populations such as MSM, especially young MSM (iv) the need to take into consideration sexual health as a state of physical, emotional, mental and social well-being in relation to sexuality.


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