Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Sex Transm Infect. 2021 Nov;97(7):534-540. doi: 10.1136/sextrans-2020-054786. Epub 2021 Jan 13.
This paper aims to estimate the percentage of European men who have sex with men (MSM) who may benefit from pre-exposure prophylaxis (PrEP), applying the three most widely used HIV risk indices for MSM (MSM Risk Index, Menza score, San Diego Early Test (SDET) score) and drawing on a large-scale multisite bio-behavioural survey (Sialon II).
The Sialon II study was a bio-behavioural survey among MSM implemented in 13 European cities using either time-location sampling or respondent-driven sampling. Biological and behavioural data from 4901 MSM were collected. Only behavioural data of HIV-negative individuals were considered. Three widely used risk indices to assess HIV acquisition risk among MSM were used to estimate individual HIV risk scores and PrEP eligibility criteria.
4219 HIV-negative MSM were considered. Regardless the HIV risk score used and the city, percentages of MSM eligible for PrEP were found to range between 5.19% and 73.84%. Overall, the MSM Risk Index and the Menza score yielded broadly similar percentages, whereas the SDET Index provided estimates constantly lower across all cities. Although all the three scores correlated positively (r>0.6), their concordance was highly variable (0.01<CCC<0.62).
Our findings showed the impact of different scoring systems on the estimation of the percentage of MSM who may benefit from PrEP in European cities. Although our primary aim was not to compare the performance of different HIV risk scores, data show that a considerable percentage of MSM in each city should be offered PrEP in order to reduce HIV infections. As PrEP is highly effective at preventing HIV among MSM, our findings provide useful, practical guidance for stakeholders in implementing PrEP at city level to tackle HIV infections in Europe.
本文旨在应用最常用于男男性行为者（MSM）的三种 HIV 风险指数（MSM 风险指数、Menza 评分、圣地亚哥早期测试（SDET）评分），评估可能从暴露前预防（PrEP）中受益的欧洲男性 MSM 的比例，并利用大规模多地点生物行为调查（Sialon II）的数据。
Sialon II 研究是一项在 13 个欧洲城市进行的 MSM 生物行为调查，采用时间地点抽样或受访者驱动抽样。共收集了 4901 名 MSM 的生物学和行为数据，仅考虑 HIV 阴性个体的行为数据。使用三种广泛用于评估 MSM 获得 HIV 风险的风险指数来估计个体 HIV 风险评分和 PrEP 资格标准。
共纳入 4219 名 HIV 阴性 MSM。无论使用哪种 HIV 风险评分和城市，都发现 PrEP 合格的 MSM 比例在 5.19%至 73.84%之间。总体而言，MSM 风险指数和 Menza 评分得出的百分比大致相似，而 SDET 指数在所有城市的估计值都较低。尽管所有三个评分都呈正相关（r>0.6），但它们的一致性变化很大（0.01<CCC<0.62）。
我们的研究结果表明，不同评分系统对估计欧洲城市可能从 PrEP 中受益的 MSM 比例有影响。虽然我们的主要目的不是比较不同的 HIV 风险评分的性能，但数据表明，每个城市都有相当比例的 MSM 应该提供 PrEP，以减少 HIV 感染。由于 PrEP 在预防 MSM 中的 HIV 方面非常有效，我们的研究结果为利益相关者在城市层面实施 PrEP 以应对欧洲的 HIV 感染提供了有用的实用指导。
