Abstract
Objective: To describe characteristics of men having sex with men (MSM) participating in the Omega Cohort, to describe HIV-positive participants at baseline interview, and to estimate HIV incidence.
Methods: The Omega Cohort is a study on the incidence and psychosocial determinants of HIV infection among MSM living in Montreal. MSM complete a questionnaire and are tested for HIV every six months.
Results: During the previous six months, 31% and 12% of 810 participants (mean age=33 years) reported unprotected anal sex with regular and casual partners, respectively. Eight participants (0.98%) were HIV-infected at baseline. HIV incidence was 0.89 per 100 person-years (7/787 person-years) [95% confidence interval: 0.36–1.83].
Conclusion: A significant proportion of participants reported current risk behaviours. Despite this, HIV incidence is relatively low. It is important to target MSM who do not practice safe sex and to encourage those practicing safe sex to sustain these behaviours.
Résumé
Objectif: Décrire les caractéristiques des hommes ayant des relations sexuelles avec d’autres hommes (HRSH) participant à la Cohorte Omega, caractériser les participants séropositifs à l’entrée dans l’étude, et estimer l’incidence du VIH sur des données préliminaires.
Méthode: La Cohorte Omega porte sur l’incidence et les déterminants psychosociaux de l’infection par le VIH chez les HRSH habitant Montréal. Les participants complètent un questionnaire et sont testés pour le VIH à tous les six mois.
Résultats: Lors des six derniers mois, 31 % et 12 % des 810 participants (âge moyen=33 ans) ont eu des relations anales non protégées avec des partenaires réguliers et occasionnels, respectivement. Huit participants (0,98 %) étaient infectés par le VIH à l’entrée dans l’étude. L’incidence du VIH était de 0,89 par 100 personne-années (7/787 personne-années) [intervalle de confiance à 95 %: 0,36–1,83].
Conclusion: Certains participants de la Cohorte Omega ont couramment des comportements à risque d’infection par le VIH. Malgré cette observation, l’incidence du VIH est relativement peu élevée. Il est primordial de cibler les HRSH qui pratiquent des comportements à risque et d’encourager ceux qui pratiquent déjà des comportements sexuels sécuritaires à continuer ainsi.
Footnotes
The Omega Study Group is composed of Michel Bouchard, Michel Châteauvert, André Desmarais, Frédéric Doutrelepont, Micheline Dupuis, Yves Jalbert, Pierre Junod, Ralf Jürgens, Roger Leblanc, Eric Lefebvre, René Légaré, Catherine Lowndes, Eva Nonn, Sylvie Savard, Robert Steinman, Réjean Thomas and Anne Vassal.
This research was supported by the National Research and Development Program (NHRDP), Health Canada (Grant number R6605-4639-AIDS). Additional funding was also provided by the Centre québécois de coordination sur le sida and through the AIDS Research Network of the Fonds de la recherche en santé du Québec (Grant number 960071.06). Ms. Annie Dufour was recipient of a training award from NHRDP (Grant number 6605-4857-47A). Dr. Alary is a research scholar of the Fonds de la recherche en santé du Québec (Grant number 970097).
References
- 1.Kaslow RA, Ostrow DG, Detels R, et al. The Multicenter AIDS Cohort Study: Rationale, organization, and selected characteristics of the participants. Am J Epidemiol. 1987;126:310–18. doi: 10.1093/aje/126.2.310. [DOI] [PubMed] [Google Scholar]
- 2.Winkelstein W, Lyman DM, Padian N, et al. Sexual practices and risk infection by the Human Immunodeficiency Virus: The San Francisco Men’s Health Study. JAMA. 1987;257:321–25. doi: 10.1001/jama.1987.03390030051019. [DOI] [PubMed] [Google Scholar]
- 3.Stevens CE, Taylor PE, Zang EA, et al. Human T-Cell Lymphotropic Virus type III infection in a cohort of homosexual men in New York City. JAMA. 1986;255:2167–72. doi: 10.1001/jama.1986.03370160065028. [DOI] [PubMed] [Google Scholar]
- 4.Goedert JJ, Sarngadharan MG, Biggar RJ, et al. Determinants of retrovirus (HTLV-III) antibody and immunodeficiency conditions in homosexual men. Lancet. 1984;ii:711–15. doi: 10.1016/S0140-6736(84)92624-2. [DOI] [PubMed] [Google Scholar]
- 5.Schechter MT, Boyko WJ, Jeffries E, et al. The Vancouver Lymphadenopathy–AIDS Study: 1. Persistent generalized lymphadenopathy. Can Med Assoc J. 1985;132:1273–79. [PMC free article] [PubMed] [Google Scholar]
- 6.Strathdee SA, Hogg RS, Martindale SL, et al. Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;19:61–66. doi: 10.1097/00042560-199809010-00010. [DOI] [PubMed] [Google Scholar]
- 7.Van Griensven GJP, Tielman RAP, Goudsmk J, et al. Risk factors and prevalence of HIV antibodies in homosexual men in the Netherlands. Am J Epidemiol. 1987;125:1048–57. doi: 10.1093/oxfordjournals.aje.a114620. [DOI] [PubMed] [Google Scholar]
- 8.Jaffe HW, Darrow WW, Echenberg DF, et al. The Acquired Immunodeficiency Syndrome in a cohort of homosexual men: A six-year follow-up study. Ann Intern Med. 1985;103:210–14. doi: 10.7326/0003-4819-103-2-210. [DOI] [PubMed] [Google Scholar]
- 9.Hunt AJ, Christofonis G, Coxon APM, et al. Seroprevalence of HIV-1 infection in a cohort of homosexually active men. Genitourin Med. 1990;66:423–27. doi: 10.1136/sti.66.6.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Osmond DH, Page K, Wiley J, et al. HIV infection in homosexual and bisexual men 18 to 29 years of age: The San Francisco Young Men’s Health Study. Am J Public Health. 1994;84:1933–37. doi: 10.2105/AJPH.84.12.1933. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Lemp GF, Hirozawa AM, Givertz D, et al. Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men: The San Francisco/Berkeley Young Men’s Survey. JAMA. 1994;272:449–54. doi: 10.1001/jama.1994.03520060049031. [DOI] [PubMed] [Google Scholar]
- 12.McCusker J, Stoddard AM, Mayer KH, et al. Behavioral risk factors for HIV infection among homosexual men at a Boston community health center. Am J Public Health. 1988;78:68–71. doi: 10.2105/AJPH.78.1.68. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Valdiserri RO, Lyter DW, Kingsley LA, et al. The effect of group education on Improving attitudes about AIDS risk reduction. NY State J Med. 1987;87:272–78. [PubMed] [Google Scholar]
- 14.Coutinho RA, Krone WJA, Smit L, et al. Introduction of Lymphadenopathy Associated Virus or Human T Lymphotropic Virus (LAV/HTLV-III) into the male homosexual community in Amsterdam. Genitourin Med. 1986;62:38–43. doi: 10.1136/sti.62.1.38. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Dean L, Meyer I. HIV prevalence and sexual behaviours in a cohort of New York City gay men (aged 18–24) J Acquir Immune Defic Syndr Human Retrovirol. 1995;8:208–11. doi: 10.1097/00042560-199502000-00014. [DOI] [PubMed] [Google Scholar]
- 16.Caceres CF, Rosasco AM. The correlates of safer behavior among homosexually active men in Lima. AIDS. 1997;11(suppl1):S53–S59. [PubMed] [Google Scholar]
- 17.Remis RS, Najjar M, Pass C, Paradis G. Seroepidemiologic study of HIV infection and sexual behaviour among men attending a medical clinic in Montreal. 1989. [Google Scholar]
- 18.Myers T, Godin G, Calzavara L, Lambert J, Locker D, the Canadian AIDS Society . The Canadian survey of gay and bisexual men and HIV infection: Men’s survey. Ottawa: Canadian AIDS Society; 1993. [Google Scholar]
- 19.Alary M, Parent R. Incidence of HIV infection among patients consulting a network of sentinel physicians in the province of Quebec. Can J Infect Dis. 1994;5(suppD):40D. [Google Scholar]
- 20.Morris M, Zavisca J, Dean L. Social and sexual networks: Their role in the spread of HIV/AIDS among young gay men. AIDS Educ Prev. 1995;7(suppl):24–35. [PubMed] [Google Scholar]
- 21.Page-Shafer K, Veugelers PJ, Moss AR, et al. Sexual risk behavior and risk factors for HIV-1 seroconversion in homosexual men participating in the Tricontinental Seroconverter Study, 1982–1994. Am J Epidemiol. 1997;146:531–42. doi: 10.1093/oxfordjournals.aje.a009311. [DOI] [PubMed] [Google Scholar]
- 22.Remis RS, Leclerc P, Vandal AC. La situation du sida et de l’infection au VIH au Québec, 1996. Montréal, Québec: Centre québécois de coordination sur le sida; 1996. [Google Scholar]
- 23.Holmberg SD. The estimated prevalence and incidence of HIV in 96 large US metropolitan areas. Am J Public Health. 1996;86:642–54. doi: 10.2105/AJPH.86.5.642. [DOI] [PMC free article] [PubMed] [Google Scholar]