Characteristics of men having sex with men (MSM) being HIV diagnosed at gay men’s health clinic (Venhalsan), Soder Hospital, Stockholm, Sweden
Background: Venhalsan is an outpatient clinic for MSM. In addition to providing HIV-positive MSM medical and psychosocial care, the clinic offers STI screening and pre- and post- HIV counseling and testing. Method: Medical and contact tracing files of all patients being HIV diagnosed at Venhalsan since 1992 were examined. The group was divided into those being infected before (‘early’ seroconverters) and after (‘late’) January 1997 to examine group differences on demographics, other STI, sexual behavior, and CD4 and HIV-RNA levels. Contact tracing, which is mandatory and regulated by the Swedish Communicable Disease Act, is performed by social workers. Results: Up to 2004, 314 MSM were HIV diagnosed and 9% were simultaneously diagnosed with AIDS. The average number of new HIV cases per year (n = 26) was stable. 14% were identified through contract tracing. The mean age was 37+/- 10 and 74% were of Swedish origin. The most common transmission route was unprotected anal sex. Only 5-10% patients denied having had anal sex and claimed to have been infected through oral sex. In the ‘Late’ group more had been infected during the last year (46% vs 36%), more reported earlier HIV tests (75% vs 63%), more had another STI (20% vs 8%) and the ‘Late’ seroconverters had higher CD4 count (460+/- 297 vs 399+/- 260). The groups did not differ on age, ethnicity, sexual behavior (oral and anal sex), AIDS diagnosis, and HIV-RNA level. Conclusion STIs are a risk factor for HIV. The current increase in STI among MSM might have implications for the increase in recently HIV infected men. Therefore STI testing and prevention has high priority. Oral sex is the most probable route of infection in only a small proportion. There is no increase in the number of AIDS at HIV-diagnosis, indicating low number of MSM unaware of their HIV-infection. There is no indication for increased HIV spread among young men. Contact tracing is an effective way of finding undiagnosed HIV-infected MSM.