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Aca newsfile vol 14, no. 7 - july 2007 (issue no. 163)

Editorial Board
Vol 14, no 7–July 2007 (issue no Executive Editor: Mr WONG Man-kong ACA Secretariat ____ _______________________________________________________________________________________________ 59th ACA Meeting
The 59th ACA meeting will be held on 6 July 2007 (Friday) at 2:30 pm at the DH Conference Room, 21/F Wu Chung House, Wan Chai. There will be three main items on the agenda: • ACA & MSM
Implementing Rapid HIV Testing in the Labour Ward
to Supplement the Universal Antenatal HIV Testing
HIV Prevalence and Risk Behavioural Survey of MSM
in Hong Kong (PRISM)
The Community-based Risk Behavioural and
Seroprevalence Survey of Female Sex Workers in Hong
Kong (CRISP)
Interested readers may watch for the next issue of the ACA Newsfile for more details. Schedule
Report on the Assessment of Recently Acquired HIV
Infection in Men Having Sex with Men (MSM) in
Hong Kong
The Department of Health commissioned the Stanley Ho Centre for Emerging Infectious Diseases in last August to conduct a study to assess the situation, explore the underlying risk factors and suggest evidence-based recommendations in relation to MSM and HIV infection in response to the rising trend of HIV prevalence
and infections among MSM as reported by the Centre for Health
The Executive Summary overleaf (pages 26 & 27) is extracted from
the report released in April 2007. Readers wish to access the full report can click on . ___________________________________________________________________________________________________________________________ Hong Kong Advisory Council on AIDS Secretariat 5/F, Yaumatei Jockey Club Clinic, 145 Battery Street, Kowloon, Hong Kong Tel:(852) 2304 6100; Fax:(852) 2337 0897; ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ Report on the Assessment of Recently Acquired
HIV Infection in Men Having Sex with Men
perception associated with improved treatment (MSM) in Hong Kong
of HIV, international travel and commercial sex. Executive Summary
The situation in Hong Kong is similar to that in other countries. Data from different 1. In response to the rising trend of HIV sources suggested that new infections in MSM prevalence and reports among men having sex have doubled within the past 3 years. The sharp with men (MSM) reported by Centre for Health rise among MSM has dominated the overall Protection, Department of Health, Hong Kong, a increase of HIV infection contracted through risk study was conducted to assess the situation, behaviours in Hong Kong. Most of the HIV explore the underlying risk factors and suggest positive MSM patients are Chinese young or evidence-based recommendations. The study middle aged adults who acquired the infection in comprises a desktop review of the global and local HIV situation in MSM, a qualitative investigation of two clusters of 46 patients stakeholders, and a questionnaire survey detected in 2006 suggested that there were very administered on HIV positive MSM attending active sexual activities among subgroups of two specialist clinics in the territory. usage rate among MSM was in the range of 60%. Global and local HIV infection among MSM
Cross border sex, getting acquaintance with sex partners through internet and having sex in sauna Worldwide, there’s an emerging epidemic were common practice. A mathematical model of HIV in MSM populations. About 5 to 10% of predicted a 3-fold increase in the cumulative people living with HIV were transmitted number of HIV infected MSM within 5 years. between men in 2005. In Western Europe and North America, MSM accounted for about half MSM risk network
of all HIV cases diagnosed. In Southeast Asia, it is estimated that there are about 10 million MSM. Prevalence of HIV varies from less than 1% in together individuals as well as through access Malaysia to 28% in Bangkok of Thailand. In the points called “nodes”. Some, like the internet past five years, HIV among MSM rose sharply in and gay-oriented magazines, are information the United States, Canada, many European and nodes that link people to physical venues Southeast Asia countries. In Rome, Spain and (physical nodes) where sexual activities may Australia, for example, the HIV incidence occur. The profile and popularity of these nodes among MSM has doubled or tripled within the have changed over the years. Public toilets are no longer popular and are replaced by saunas, massage houses, bars and parties in the past 3. Various factors have been suggested to decade. Internet provides a virtual platform explain the global epidemic. An increasing where MSM can meet at any time and place. number of sex partners and the practice of unprotected anal intercourse have been reported. Apart from a change of the popularity of MSM who are online tend to have multiple the nodes, there has been an intensification of casual partners and unprotected sex. Party and connections between different nodes with party drugs (including Viagra) are popular in the unprotected anal sex and HIV infection. Other     to be continued… ___________________________________________________________________________________________________ ACA Newsfile Vol 14 Page 26 ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾
Executive Summary
sex at about 23 years old, and subsequently got infected at an average age of 30s. The popularity of internet means that young MSM can easily come into contact of MSM network during or shortly after the period of identity formation In a simulation exercise, given the same level of risk behaviours, the increased connection of 10. It is encouraging to discover from our nodes would predispose to HIV transmission study that after diagnosis of HIV, MSM have through enhancing the exposure opportunities of generally reduced their practice of identifying partners and having sex in various gay venues Vulnerability of MSM to HIV infections
generally increased. The contexts of such improvement and whether this can be sustained changed in the recent 5 years, as reflected in the results of a questionnaire survey that explored Conclusions and recommendations
the behavioural practice before their infections. Public toilets and beaches became less popular 11. We conclude that the changing partnership while internet was the main avenue for sourcing patterns and therefore the evolving configuration of MSM network constituted the major driving common venue for sex although sauna remains force behind the observed increase of HIV popular in the MSM community. About half of the HIV infected MSM had history of visiting other countries for sex before their contracting the virus. An important observation is that HIV (a) strategically promote safer sex targeting was not perceived as a significant risk by some Generally speaking, the practice of sexual (b) design specific interventions to reach behaviours (condom usage, oral/anal sex, active or passive role) has remained largely the same in MSM who contracted the virus recently (on or (c) develop HIV prevention that incorporates after 2001) in comparison to those infected sexual health instead of HIV per se, so as before 2001. The pattern of safer sex practice with regular and casual partners have also remained the same, while commercial sex was (d) systematize clinic-based HIV prevention; relatively uncommon over the years. However, (e) develop pilot projects and/or studies that an increasing use of soft drugs while having sex was observed. This was often associated with homosexual at around 17 years of age. They normally entered the MSM network and had first ___________________________________________________________________________________________________________________________ Reported HIV/AIDS Quarterly Statistics - 1st Quarter, 2007 hospitals/clinics/laboratories Hong Kong Red Cross ___________________________________________________________________________________________________ ACA Newsfile Vol 14 Page 28


Swots corner: what is an odds ratio? Swots Corner: What is an odds ratio? Bandolier readers wil know that we favour the number-needed-to-treat (NNT) as a way of describing the benefits (or harms) of treatments, both in individual trials and in systematic reviews. Few papers report results using this easily interpretable measure, so Bandolier has had to get its head around how to do the calculations. NNT cal

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