Headlines - PREVAGAY 2015 Study: Estimate of HIV Prevalence

Santé publique France has published the HIV prevalence estimate from the 2015 PREVAGAY study. This multicenter survey of HIV and hepatitis B and C seroprevalence, conducted among men who have sex with men (MSM) frequenting gay social venues (bars, saunas, backrooms) in Lille, Lyon, Montpellier, Nice, and Paris from September to December 2015, comprised two concurrent and linked components: self-collection of capillary blood drops from the fingertip on filter paper, and an anonymous self-administered behavioral questionnaire.

In total, 2,658 MSM (50% of those approached) agreed to participate, of whom 2,646 provided samples and completed questionnaires that were both usable. Overall, HIV prevalence was 14%, higher in Montpellier, Nice, and Paris, while it was significantly lower in Lille (figure). Prevalence was 4.4% among men under 25 and increased with age. Among all MSM who tested HIV-positive (n=433), 92% had been diagnosed, and 95% of those were on antiretroviral therapy. The proportion of HIV-positive MSM who had not been previously diagnosed was 9%, regardless of city.

These results pertain to a well-defined population of MSM and cannot be generalized to the entire MSM population (MSM who refused to participate accounted for 50% of those approached; they were significantly older [median age of 42] and reported being HIV-positive significantly less often). Nevertheless, these data show that HIV prevalence is high in this population, despite the fact that a significant proportion (one-third) does not consistently use condoms. This finding is fortunately tempered by the fact that the vast majority of HIV-positive MSM are diagnosed and on antiretroviral therapy, indicating good access to treatment. These results not only encourage the continuation of preventive measures in gay social venues but also, due to the significant prevalence of HIV among MSM under the age of 30 (6%), call for the consideration of additional interventions that closely align with the evolving social dynamics of this community.