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Comparative European data using Second Generation Surveillance System (SGSS) are scarce among gay, bisexual and other men who have sex with men. This study evaluated the implementation of Sialon II, a bio-behavioural HIV research combined with targeted HIV prevention in 13 European cities conducted in collaboration with community partners. A mixed-methods process evaluation assessed the project's coverage, outputs, quality, challenges and opportunities for improvement. Data collected through structured questionnaire from 71 data collectors from community-based organisations and semi-structured interviews with 17 managers of participating gay venues were analysed. Overall implementation was successful, achieving 4901 valid behavioural questionnaires and obtaining 4716 biological samples. Challenges in conducting bio-behavioural research in gay venues related to strict research protocols and unfavourable characteristics of venues. Formative research, collaboration with community gay venues, and offering HIV prevention emerged as facilitators. Community researchers' training was crucial for fidelity to research protocols, increased trust amongst communities and enabled data collectors to effectively address practical problems in the field. Scientifically sound SGSS with community participation is feasible and allows for including 'hard-to-reach' populations. Prevention benefits include awareness raising, capacity building and sexual health promotion in gay venues. The findings are beneficial for epidemiological research among other HIV key populations. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the prevalence and correlates of disclosure to network members of being hepatitis C virus (HCV)- or human immunodeficiency virus (HIV)-infected among injecting dyads of infected injection drug users (IDUs) in Budapest, Hungary and Vilnius, Lithuania,. Multivariate generalized estimating equations (GEE) were used to assess associations. Very strong infection disclosure norms exist in Hungary, and HCV disclosure was associated with using drugs and having sex within the dyad. Non-ethnic Russian IDUs in Lithuania were more likely to disclose HCV infection to non-Roma, emotionally close and HCV-infected network members, and to those with whom they shared cookers, filters, drug solutions or rinse water or got used syringes from, and if they had fewer non-IDU or IDU network members. Ethnic Russian Lithuanian IDUs were more likely to disclose HCV if they had higher disclosure attitude and knowledge scores, 'trusted' network members, and had lower non-injecting network density and higher injecting network density. HIV-infected Lithuanian IDUs were more likely to disclose to 'trusted' network members. Disclosure norms matched disclosure behaviour in Hungary, while disclosure in Lithuania to 'trusted' network members suggests possible stigmatization. Ongoing free and confidential HCV/HIV testing services for IDUs are needed to emphasize and strengthen disclosure norms, and to decrease stigma. [ABSTRACT FROM AUTHOR]

IntroductionThe HIV epidemic represents an important public health issue in Europe particularly among men who have sex with men (MSM). Global AIDS Monitoring indicators (GAM) have been widely and jointly promoted as a set of crucial standardised items to be adopted for monitoring and responding to the epidemic.MethodsThe Sialon II study, implemented in 13 European cities (2013-14), was a complex multi-centre integrated bio-behavioural cross-sectional survey targeted at MSM, with a concomitant collection of behavioural and biological (oral fluid or blood specimens) data. Rigorous sampling approaches for hard-to-reach populations were used (time-location sampling and respondent-driven sampling) and GAM indicators were calculated; sampling frames were adapted to allow weighted estimates of GAM indicators.Results4,901 MSM were enrolled. HIV prevalence estimates ranged from 2.4% in Stockholm to 18.0% in Bucharest. When exploring city-level correlations between GAM indicators, prevention campaigns significantly correlated with levels of condom use and level of HIV testing among MSM.ConclusionThe Sialon II project has made an important contribution to the monitoring and evaluation of the HIV epidemic across Europe, integrating the use of GAM indicators within a second generation HIV surveillance systems approach and in participatory collaboration with MSM communities. It influenced the harmonisation of European data collection procedures and indicators via GAM country reporting and contributed essential knowledge informing the development and implementation of strategic, evidence-based HIV prevention campaigns for MSM.

Uptake of hepatitis C (HCV) treatment in HIV-coinfected patients is not well described. Of 2356 HCV-seropositive patients, 180 (7.6%) started HCV treatment with interferon-based therapies. In multivariate Poisson-regression models, there was a 38% increase per year in the incidence of starting HCV treatment (95% CI 26 - 51%, p<0.0001); this increased from 3.9 per 1000 person-years follow-up (PYFU) before 1998 (95% CI 1.6 - 6.1) to 32.6 per 1000 PYFU at/after 2004 (95% CI 22.5 - 42.7). Although prescription of HCV therapy is increasing in HIV-coinfected patients, it remains infrequent and variable across regions of Europe.

The aim of this study was to review epidemiological situation of HIV infection and AIDS in Lithuania during 1988-2001 and to try to forecast possible trends of further HIV transmission. The data were obtained from the database of Lithuanian AIDS Center, which is the only organization in Lithuania in charge of HIV epidemiological data sampling and analysis. First, the general overview of both development of the HIV/AIDS epidemics, reporting and surveillance system is presented that proves systematic and scientific approach to the problem, while taking into consideration recommendations and guidelines of key international organizations acting in the HIV/AIDS field. Secondly, HIV transmission trends are analyzed in the so-called target groups including intravenous drug users, sex workers and homosexuals. Lastly, cases of a full-blown HIV infection--AIDS are discussed allowing to track epidemics from the very beginning.

Number of drug using people in Lithuanian prisons has been growing every year: in the beginning of 2001, 1010 people in total were on a record of dispensary care, which made 8.8% of all imprisoned persons at that time. The same percent has increased in the beginning of 2002 reaching 12.25%, and growing up to 13.3% in the beginning of 2003. Drug availability and unsafe use of illegal drugs, especially sharing of needles and syringes in one of the fourteen country's penal establishments - Alytus strict regime correctional facility - resulted in a rapid HIV outbreak in spring 2002. Three hundred prisoners infected with HIV were identified during the voluntary testing. Though majority of prisoners are quite well informed about HIV, their knowledge does not alter the risky behavior. The well-informed on HIV prisoners, nevertheless, use drugs despite the risk of HIV infection. Furthermore, shortage in treatment of drug use, in rehabilitation and occupation of prisoners provide benevolent conditions for rapid spread of HIV and other blood-born infections in the Lithuanian penitentiaries. Many prisoners are not able to reintegrate into society after their release because of broken social relationships, lack of social services in the country, therefore they do often relapse into a drug use, and endanger not only their close people but also society in whole. HIV and virus hepatitis might be transmitted from them to a general population by a variety of transmission modes.