Continuous increase in HIV-1 incidence after the year 2000 among men who have sex with men in Rome: insights from a 25-year retrospective cohort study

• Published in: Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 19; no. 47; p. 20969
• Main Authors: Giuliani, M, Vescio, M F, Latini, A, Palamara, G, Pimpinelli, F, Dona, M G, Stivali, F, Carduccelli, F, Ensoli, F, Di Carlo, A, Rezza, G
• Format: Journal Article
• Language: English
• Published: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 27.11.2014
• Subjects: Adolescent; Adult; Age Distribution; Epidemics; Follow-Up Studies; HIV; HIV Infections - epidemiology; HIV Seroprevalence - trends; HIV-1; Homosexuality, Male - statistics & numerical data; Human immunodeficiency virus; Humans; Incidence; Italy - epidemiology; Male; Middle Aged; Multivariate Analysis; Poisson Distribution; Proportional Hazards Models; Regression analysis; Retrospective Studies; Risk Factors; Risk-Taking; Rome - epidemiology; Sexually transmitted diseases; Sexually Transmitted Diseases, Viral - prevention & control; Socioeconomic Factors; STD; Young Adult; Italy; Rome; Rome Italy
• ISSN: 1560-7917; 1025-496X; 1560-7917
• DOI: 10.2807/1560-7917.ES2014.19.47.20969

To assess trends in HIV-1 incidence and risk factors for seroconversion among men who have sex with men (MSM) resident in Rome, Italy, a retrospective longitudinal cohort study was conducted over 25 years. Incidence rates and trends were modelled using Poisson regression and risk factors were assessed by multivariate Cox models. Of 1,862 HIV-1-negative individuals, 347 seroconverted during follow-up. HIV-1 incidence rates increased from 5.2/100 persons/year (p/y) in 1986 (95% confidence interval (CI): 2.3–11.5) to 9.2/00 p/y in 1992 (95% CI: 6.4–13.0), decreased to 1.3/100 p/y in 2001 and increased until 2009 (11.7/100 p/y; 95% CI: 7.4–18.6). The risk of HIV-1 seroconversion increased during the study period in younger MSM (incidence rate ratio (IRR) = 17.18; 95% CI: 9.74–30.32 in 16–32 year-olds and IRR = 5.09; 95% CI: 2.92–8.87 in 33–41 year-olds) and in those who acquired syphilis (IRR = 7.71; 95% CI: 5.00–11.88). In contrast, the risk of seroconversion decreased among highly educated MSM (IRR = 0.54; 95% CI: 0.35–0.82) and those without Italian citizenship (IRR = 0.45; 95% CI: 0.28–0.71). The HIV epidemic in MSM living in Rome continues to expand. Targeted prevention programmes against sexually transmitted infections to enhance knowledge transfer and behavioural skills are urgently required.