**4.4.1 STI history**

220 Epidemiology Insights

As shown in Fig. 8, HIV prevalence, based on oral fluid samples, was higher in subjects recruited in sex-focused venues like saunas (14.3%), cruising venues (15.2%) sex shops and naked parties (11.5%) than in other venues such as discos and bars (4.6% and 6.7%

At city level, HIV prevalence by type of venue (sex focused versus non-sex focused) was

4.6 6.7 14.3 15.2 11.5

56% of HIV positive people were not aware of their HIV serostatus, that is, they declared they had never been tested (7.8%), were found to be HIV negative at their last HIV test (47.6%) or didn't collect their result (0.6%). As shown in Fig. 9, the rates of people unaware of their HIV positive status were almost 80% in Bucharest and Ljubljana and lower than 50%

Moreover, the average age of people unaware of their HIV positive status was 33.9 y/o lower than that of subjects that knew their seropositivity that was 37.9 y/o, based on their reported last HIV test. Another important fact is that among oral fluid HIV positive subjects, nearly one third (30.9%) reported a negative HIV test over the last 12 months. This data seems to indicate that quite a number of infections were acquired over the last 12 months. At city level this percentage was higher than 50% in Ljubljana while the lowest figure was in Bratislava (less than 20%). All other cities had intermediate values

Disco Bar Sauna Cruising Naked/Sexclub venue

significantly higher in sex focused venues in Verona, Bratislava and Ljubljana.

**4.3.2 HIV prevalence by venue type** 

0

Fig. 8. HIV Prevalence by venue type

**4.3.3 Knowledge of actual HIV status and undiagnosed infection** 

10

20

%

only in Barcelona.

(nearly 30%).

30

respectively).

Of the overall sample, 11.7% of respondents declared that they had at least one STI during the last 12 months. The highest proportion of people with a declared STI history was in Barcelona (15.3%) and the lowest in Bucharest (6.5%). For the details from all participating cities, see Fig. 10.

Fig. 10. STI during the last 12 months

The SIALON Project: Report on HIV Prevalence

**4.5.2 Alcohol and drug use** 

in the questionnaire.

people (P<0.001).

%

and Risk Behaviour Among MSM in Six European Cities 223

and lowest in Verona (58.1%). With regard to UAI with an occasional partner, this behaviour was reported in Bucharest in almost 60% of respondents, while in Prague the percentage reaches 46.5%, in Bratislava 45.7%, and similar percentages in Barcelona, Ljubljana and Verona (33.7%, 32.0%, 33.0% in this order). The percentage of MSM reporting UAI was significantly higher among young people (<25 years of age, according to the UNGASS disaggregation cut-off) with a steady (70.8%) and occasional (51.2%) partner (P<0.05 and

74.2 72.5 59.2 68.7 62.6 58.1 46.5 45.7 33.7 59.1 32.0 33.0

Prague Bratislava Barcelona Bucharest Ljubljana Verona

As the alcohol and recreational drug use seems to be connected to an increase in unprotected sexual practices, the use of alcohol and drug before or during sex was included

With regard to alcohol use is concerned (Fig. 13), a significant percentage of respondents in the overall sample stated that they had used alcohol before or during sex in the last 6 months. The percentage of subjects reach 82.9% in Bratislava, 54.2% in Verona, 85.0% in Prague, 66.0% in Barcelona, 64.3% in Bucharest, while the level is of 72.3% in Ljubljana. With regards to the alcohol use before or during their last sexual encounter, percentages are lower compared with the last 6 months. The levels of alcohol use are in this case high in Prague (56.0%), Bucharest (46.3%), Bratislava (45.2%), Barcelona (43.0%), while rates lower than 40%

With regard to drug use (see Fig. 14), drug use before or during sex in the last 6 months seems to be widely present in the sample. In Ljubljana the percentage reaches 58.8%, in Barcelona 57.1%, in Prague 52.7%. Low percentages are reported in Bucharest (33.2%), Verona (34.3%) and Bratislava (44.5%). Here again the proportion of people using drugs during sex was significantly higher among HIV positive (68.5%) than negative (44.9%)

steady partner occasional partner

P<0.001 respectively) compared to older people (64.9% and 37.8% in that order).

Fig. 12. UAI in the last 6 months with steady and occasional partner

were found only in Ljubljana and Verona (32.2% and 23.2% respectively).
