title: High HIV incidence among men who have sex with men attending a community-based voluntary counselling and testing service in Barcelona, Spain: results from the ITACA cohort.
abstract: OBJECTIVE
  To identify the HIV incidence and its associated factors (AFs) of the ITACA, a community-based cohort of HIV-negative men who have sex with men (MSM) established in Barcelona, Spain from 2008 to 2011.
  
  
  METHODS
  Participants were men aged 18 years or older, having a negative HIV test result at baseline and agreeing to participate. Bio-behavioural data were collected by peers in each visit. HIV incidence rates using person-time measures and 95% CIs were calculated. Cox logistic regression models were used to identify AFs to seroconversion.
  
  
  RESULTS
  Over the period, 3544 participants with at least one follow-up visit or those who had a first visit no longer than a year prior to the date of data censoring were included in the analysis contributing 3567.09 person-year (p-y) and 85 MSM seroconverted for an overall HIV incidence of 2.4 per 100 p-y (95% CI 1.9 to 2.9) ranging from 1.21/100 (2009) to 3.1/100 p-y (2011). Independent AF included: foreign origin, having more than five HIV tests at baseline, reporting in the preceding 6 months the following: condomless anal sex with the last steady partner of unknown serostatus, more than 10 casual partners, condomless anal sex with casual partner, self-reported gonorrhoea and entered in the cohort in 2010 or 2011.
  
  
  CONCLUSIONS
  The ITACA cohort revealed a high and increasing HIV incidence among MSM, especially important among foreign-born men. The findings underscore the need to implement multilevel interventions for MSM taking into account different types of partners, cultural origins and the exposure to other sexually transmitted infections.
authors.affiliation: Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain Institut d'Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.
authors.forename: Laia
authors.initials: L
authors.lastname: Ferrer
authors.affiliation: Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain Institut d'Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Loureiro
authors.affiliation: Projecte dels Noms-Hispanosida, BCN Checkpoint, Barcelona, Spain.
authors.forename: Michael
authors.initials: M
authors.lastname: Meulbroek
authors.affiliation: Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain Institut d'Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Bellaterra (Cerdanyola), Spain.
authors.forename: Cinta
authors.initials: C
authors.lastname: Folch
authors.affiliation: Projecte dels Noms-Hispanosida, BCN Checkpoint, Barcelona, Spain.
authors.forename: Felix
authors.initials: F
authors.lastname: Perez
authors.affiliation: Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain Institut d'Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Bellaterra (Cerdanyola), Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Esteve
authors.affiliation: Projecte dels Noms-Hispanosida, BCN Checkpoint, Barcelona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Saz
authors.affiliation: Projecte dels Noms-Hispanosida, BCN Checkpoint, Barcelona, Spain.
authors.forename: Hector
authors.initials: H
authors.lastname: Taboada
authors.affiliation: Projecte dels Noms-Hispanosida, BCN Checkpoint, Barcelona, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Pujol
authors.affiliation: Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain Institut d'Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Bellaterra (Cerdanyola), Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Casabona
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D037001:Directive Counseling; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012309:Risk-Taking; D012747:Sexual Partners / Q000523:psychology*; D013030:Spain / Q000453:epidemiology
keywords: COMMUNITY SERVICES; HIV; HOMOSEXUALITY; SEXUAL BEHAVIOUR