Community-based HIV-1 early diagnosis and risk behavior analysis of men having sex with men in Hong Kong

Abstract

BACKGROUND: In 2013, the number HIV-1 infection has reached a historically high level in Hong Kong. In the past few years, MSM became the dominant risk group of the increasing HIV-1 prevalence in Hong Kong. The alarming trend of MSM infections indicates the need of tracking sexually active and acutely infected individuals for targeted prevention. To this end, no studies have investigated the incident rate of MSM infections in Hong Kong over 30 years of the HIV-1 infection epidemic. For community settings, it is necessary to establish a rapid diagnostic method to capture the acutely infected individuals for early prevention intervention and treatment so as to avoid the transmission in a timely fashion, and to conduct risk behavior survey to assist early preventive interventions. METHODS: The participants were recruited randomly from five community-based sites of MSM within a one-year period. Fast antibody test (FAT) and real-time dried blood spots (DBS)-based quantitative polymerase chain reaction (DBS-qPCR) were used for early diagnosis. Risk behavior analysis was performed by studying information obtained from the participants during the study period. RESULTS: Of 474 MSM participants, the HIV-1 prevalence rate was 4.01% (19/474) and the incident rate was 1.47% (7/474). Three out of the seven newly infected participants were found positive for DBS-qPCR but negative for FAT and were therefore considered to be in the acute phase of infection. Statistic analysis identified anal sex and syphilis infection as a significant risk for HIV-1 infection. According to our findings, 46.4% (220/474) MSM were using condom for anal sex regularly but none for oral sex. An increased number of foreign MSM infections were also found in Hong Kong. CONCLUSIONS: This is the first study provided both prevalence and incident rates of HIV-1 infection among MSMs in Hong Kong. Critically, we demonstrated that it was feasible to use DBS-qPCR and FAT assays together for capturing the acutely infected individuals based on our communities'' settings. Moreover, the risk analysis also provided evidence that behaviour intervention strengthening is necessary to fight against the increasing epidemic of MSM HIV-1 in Hong Kong and surrounding regions in Asia.