Reemergence of the HIV epidemic among men who have sex with men in North America, Western Europe, and Australia, 1996-2005.
OBJECTIVE
To describe and contextualize changes in rates of human immunodeficiency virus (HIV) notifications in men who have sex with men (MSM) in eight countries (Australia, Canada, France, Germany, Netherlands, Spain, United Kingdom, and United States) from 1996-2005.


METHODS
We analyzed trends in HIV notification rates from 1996-2000 and 2000-2005 by generalized linear regression and estimated annual percentage change (EAPC) in rates of HIV notifications. To interpret trends, we visually examined graphs of primary and secondary syphilis reports among MSM and the prevalence of recent HIV testing.


RESULTS
The rate of HIV notifications among MSM declined 5.2% per year (95% confidence interval [CI]: -5.8%, -4.7%) from 1996-2000, and increased 3.3% per year (95% CI: +2.9%,+3.7%) from 2000-2005. During the period of increasing HIV diagnoses, increases in primary and secondary syphilis diagnoses occurred among MSM, but recent HIV testing among MSM did not seem to increase.


CONCLUSIONS
After declining in the second half of the 1990s, HIV notification rates for MSM increased beginning in 2000. Increased HIV notifications in MSM are not wholly explained by changes in HIV testing. Urgent efforts are required to develop effective HIV prevention interventions for MSM, and implement them broadly in these countries.
Sullivan
Patrick S
PS
Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, GA 30322, USA. Patrick.sullivan@emory.edu
Hamouda
Osamah
O
Delpech
Valerie
V
Geduld
Jennifer E
JE
Prejean
Joseph
J
Semaille
Caroline
C
Kaldor
John
J
Folch
Cinta
C
Op de Coul
Eline
E
Marcus
Ulrich
U
Hughes
Gwenda
G
Archibald
Chris P
CP
Cazein
Francoise
F
McDonald
Ann
A
Casabona
Jordi
J
van Sighem
Ard
A
Fenton
Kevin A
KA
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001315:Australia / Q000453:epidemiology; D018563:Disease Notification / Q000379:methods / Q000706:statistics & numerical data; D004196:Disease Outbreaks; D005060:Europe / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D015528:HIV Seroprevalence / Q000639:trends; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D015229:Sexually Transmitted Diseases, Viral / Q000175:diagnosis / Q000453:epidemiology; D013587:Syphilis / Q000453:epidemiology; D055815:Young Adult