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Antiretroviral Therapy and Reasons for Not Taking It among Men Having Sex with Men (MSM)—Results from the European MSM Internet Survey (EMIS)

BACKGROUND: The preventive effects of antiretroviral treatment (ART) on onward transmission of HIV are a major reason for broadening eligibility for ART. In the WHO European Region, surveillance reveals substantial differences in access to ART across regions and sub-populations. We analysed self-rep...

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Autores principales: Marcus, Ulrich, Hickson, Ford, Weatherburn, Peter, Furegato, Martina, Breveglieri, Michele, Berg, Rigmor C., Schmidt, Axel J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4368044/
https://www.ncbi.nlm.nih.gov/pubmed/25793882
http://dx.doi.org/10.1371/journal.pone.0121047
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author Marcus, Ulrich
Hickson, Ford
Weatherburn, Peter
Furegato, Martina
Breveglieri, Michele
Berg, Rigmor C.
Schmidt, Axel J.
author_facet Marcus, Ulrich
Hickson, Ford
Weatherburn, Peter
Furegato, Martina
Breveglieri, Michele
Berg, Rigmor C.
Schmidt, Axel J.
author_sort Marcus, Ulrich
collection PubMed
description BACKGROUND: The preventive effects of antiretroviral treatment (ART) on onward transmission of HIV are a major reason for broadening eligibility for ART. In the WHO European Region, surveillance reveals substantial differences in access to ART across regions and sub-populations. We analysed self-reported data on ART and reasons for not taking ART from EMIS, a large Pan-European Internet survey among men-who-have-sex-with-men (MSM). METHODS: Respondents from 38 European countries reported their last HIV test result and, if diagnosed with HIV, their treatment status, and reasons for not taking or having stopped ART from a 7 item multiple choice list and/ or answered an open-ended question to give other reasons. Responses were classified as fear of consequences, perceived lack of need, and ART inaccessibility based on factor analysis. Associations between not taking ART because of fear of consequences, and demographic, behavioural and contextual indicators were identified in a multivariable regression model. RESULTS: 13,353 (7.7%) of 174,209 respondents had been diagnosed with HIV. Among them 3,391 (25.4%) had never received ART, and 278 (2.1%) had stopped taking ART. Perceived lack of need was by far the most common reason for not taking or stopping ART (mentioned by 3259 (88.8%) respondents), followed by fear of consequences (428 (11.7%)), and ART inaccessibility (86 (2.3%)). For all reasons, an East-West gradient could be seen, with larger proportions of men living in Central and Eastern Europe reporting reasons other than medical advice for not taking ART. A minority of men were reluctant to start ART independent of medical advice and this was associated with experiences of discrimination in health care systems. CONCLUSIONS: ART is widely available for MSM diagnosed with HIV across Europe. Not being on treatment is predominantly due to treatment not being recommended by their physician and/or not perceived to be needed by the respondent.
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spelling pubmed-43680442015-03-27 Antiretroviral Therapy and Reasons for Not Taking It among Men Having Sex with Men (MSM)—Results from the European MSM Internet Survey (EMIS) Marcus, Ulrich Hickson, Ford Weatherburn, Peter Furegato, Martina Breveglieri, Michele Berg, Rigmor C. Schmidt, Axel J. PLoS One Research Article BACKGROUND: The preventive effects of antiretroviral treatment (ART) on onward transmission of HIV are a major reason for broadening eligibility for ART. In the WHO European Region, surveillance reveals substantial differences in access to ART across regions and sub-populations. We analysed self-reported data on ART and reasons for not taking ART from EMIS, a large Pan-European Internet survey among men-who-have-sex-with-men (MSM). METHODS: Respondents from 38 European countries reported their last HIV test result and, if diagnosed with HIV, their treatment status, and reasons for not taking or having stopped ART from a 7 item multiple choice list and/ or answered an open-ended question to give other reasons. Responses were classified as fear of consequences, perceived lack of need, and ART inaccessibility based on factor analysis. Associations between not taking ART because of fear of consequences, and demographic, behavioural and contextual indicators were identified in a multivariable regression model. RESULTS: 13,353 (7.7%) of 174,209 respondents had been diagnosed with HIV. Among them 3,391 (25.4%) had never received ART, and 278 (2.1%) had stopped taking ART. Perceived lack of need was by far the most common reason for not taking or stopping ART (mentioned by 3259 (88.8%) respondents), followed by fear of consequences (428 (11.7%)), and ART inaccessibility (86 (2.3%)). For all reasons, an East-West gradient could be seen, with larger proportions of men living in Central and Eastern Europe reporting reasons other than medical advice for not taking ART. A minority of men were reluctant to start ART independent of medical advice and this was associated with experiences of discrimination in health care systems. CONCLUSIONS: ART is widely available for MSM diagnosed with HIV across Europe. Not being on treatment is predominantly due to treatment not being recommended by their physician and/or not perceived to be needed by the respondent. Public Library of Science 2015-03-20 /pmc/articles/PMC4368044/ /pubmed/25793882 http://dx.doi.org/10.1371/journal.pone.0121047 Text en © 2015 Marcus et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Marcus, Ulrich
Hickson, Ford
Weatherburn, Peter
Furegato, Martina
Breveglieri, Michele
Berg, Rigmor C.
Schmidt, Axel J.
Antiretroviral Therapy and Reasons for Not Taking It among Men Having Sex with Men (MSM)—Results from the European MSM Internet Survey (EMIS)
title Antiretroviral Therapy and Reasons for Not Taking It among Men Having Sex with Men (MSM)—Results from the European MSM Internet Survey (EMIS)
title_full Antiretroviral Therapy and Reasons for Not Taking It among Men Having Sex with Men (MSM)—Results from the European MSM Internet Survey (EMIS)
title_fullStr Antiretroviral Therapy and Reasons for Not Taking It among Men Having Sex with Men (MSM)—Results from the European MSM Internet Survey (EMIS)
title_full_unstemmed Antiretroviral Therapy and Reasons for Not Taking It among Men Having Sex with Men (MSM)—Results from the European MSM Internet Survey (EMIS)
title_short Antiretroviral Therapy and Reasons for Not Taking It among Men Having Sex with Men (MSM)—Results from the European MSM Internet Survey (EMIS)
title_sort antiretroviral therapy and reasons for not taking it among men having sex with men (msm)—results from the european msm internet survey (emis)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4368044/
https://www.ncbi.nlm.nih.gov/pubmed/25793882
http://dx.doi.org/10.1371/journal.pone.0121047
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