HIV prevalence and risk behaviour varies between gay men in Southern and Eastern Europe

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HIV prevalence is higher amongst gay men in Southern Europe than amongst gay men in Eastern Europe, according to an international study published in the December 3rd edition of Eurosurveillance.

Almost 17% of gay men in Barcelona were HIV-positive, according to the results of the study, compared to a prevalence of 3% in Prague.

However, the investigators also found high levels of risky sexual behaviour amongst gay men in Eastern Europe and low frequency of HIV testing. “The potential for further HIV transmission in Eastern European cities is evident”, they comment.


risky behaviour

In HIV, refers to any behaviour or action that increases an individual’s probability of acquiring or transmitting HIV, such as having unprotected sex, having multiple partners or sharing drug injection equipment.


The study of the causes of a disease, its distribution within a population, and measures for control and prevention. Epidemiology focuses on groups rather than individuals.


Refers to the mouth, for example a medicine taken by mouth.

There has been a marked increase in annual HIV diagnoses amongst gay men across Europe since 2000. Although some of these diagnoses can be attributed to increased levels of HIV testing, others are due to recent onward transmission of the virus. Indeed, other research has shown that significant numbers of gay men engage in sexual behaviour that could involve a risk of contracting HIV.

To better understand the epidemiology of HIV amongst gay and other men who have sex with men, a team of investigators designed a study that involved 2241 individuals in six cities (Barcelona, Spain; Bratislava, Slovakia; Bucharest, Romania; Ljubljana, Slovenia; Prague, Czech Republic; and Verona, Italy). The study was conducted between 2008-09.

The study participants were recruited from the gay scene and all reported sex with another men in the previous twelve months. HIV prevalence was monitored using oral HIV tests. The men also completed questionnaires about their sexual risk behaviour, drug use, and HIV testing history.

HIV prevalence was much higher in Southern Europe than in Eastern Europe. The prevalence of the infection amongst gay men in Barcelona was 17% and it was 12% in Verona. Bratislava had the highest HIV prevalence in Eastern Europe (6%), followed by Ljubljana and Bucharest (both 5%) and Prague (3%).

Levels of HIV testing were highest in Barcelona (56%), followed by Verona (53%), Bucharest (43%), Prague (42%), Ljubljana (38%) and Bratislava (32%).

Reported HIV risk behaviour varied between the cities. The use of condoms with a casual partner was reported by 67% of men in Barcelona and by 36% of individuals in Prague. Condom use for anal sex was lower with regular partners, and was reported by 43% of men in Barcelona and Bucharest and by 20% of men in Bratislava.

Men in Barcelona and Verona had the highest number of reported casual partners (mean 16 and twelve respectively), with lower numbers reported by men in Eastern Europe (mean six – eight).

Alcohol was the most widely used drug in all cities, but other patterns of recreational drug use varied.


Mirandola M et al. HIV bio-behavioural survey among men who have sex with men in Barcelona, Bratislava, Bucharest, Ljubljana, Prague and Verona, 2008-09. Eurosurveillance 48: 41, 2009.