Findings from 38 countries. UM instigated the project, led the study design and drafted the manuscript. MSM individuals or subgroups which do not contribute to the HIV epidemic because they are not effectively connected would not be included in this estimate. From these questions we determined the number of survey participants not already diagnosed with HIV at the beginning of who reported to have been tested and diagnosed with HIV in According to information provided by the respective national contact points the data reported to ECDC or published elsewhere were adjusted for reporting delays. The strong correlation between EMIS derived self-reported HIV diagnosis incidence and surveillance system derived data critically depends on an estimated parameter, the size of the respective MSM populations.
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For the Netherlands, there is indeed some indication for an increased selection bias, and thus an increased SSD value [ 6 ], possibly attributable to the yearly internet surveys in this country, which may result in survey fatigue affecting HIV-uninfected and untested men disproportionally more than men diagnosed with HIV.
Association between proportion of households with broadband internet access and calculated survey-surveillance discrepancy based on countries with repeated internet-based behavioural surveys among MSM between and HIV surveillance in Europe in It will also be counterproductive in the longer run, because it will undermine the capacities of MSM communities to mount an effective response towards the HIV epidemic.
We hypothesized that the main bias in survey participation is due to variance in household internet access. Endorsement of the study by the websites provided community support.
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|Table S1 [column I], under these assumptions the minimum number of MSM diagnosed in in Belarus, Russia, and Ukraine would be estimated to be at least 4—5 times larger than officially reported, in Turkey even 40 times larger.
It will also be counterproductive in the longer run, because it will undermine the capacities of MSM communities to mount an effective response towards the HIV epidemic. It must be assumed that the SSD is modified by country-specific factors.
For these countries the ratio of EMIS participants reporting to have been diagnosed in to the number of MSM diagnosed in and reported within the national surveillance system was larger than 0. Increasing prevalence of male homosexual partnerships and practices in Britain — Estimating the regional distribution of men who have sex with men MSM based on Internet surveys.
Conclusion To conclude, HIV diagnosis incidence measured with self-reports in a large pan-European internet survey recruiting primarily through gay dating websites correlate very well with data from the respective national surveillance systems after making the data formats comparable.
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Obvious outlier values are likely explained by targeted offline promotion of internet surveys SSD values increased or mis-interpretable wording of respective questions values too low and were disregarded.
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Briefly, six Associated Partners APs recruited another 77 Collaborating Partners CPs from academia, public health and civil society across 35 countries.
Relevant to both measurement strategies is the unknown size of the MSM population which critically depends on the definition of MSM [ 1 ]while the relative size of this population the proportion of the adult male population who have sex with men may be different between countries and may change over time in response to social, economic, political and cultural developments.
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It will also be counterproductive in the longer run, because it will undermine the capacities of MSM communities to mount an effective response towards the HIV epidemic. Particularly, among Danish and Finnish EMIS respondents only four and two respondents respectively reported having been diagnosed inwhile the mean number for men diagnosed in the previous four years were 9.
Table S1, column I.
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|Estimating the regional distribution of men who have sex with men MSM based on Internet surveys. This suggests that variability in participation rates to community-based internet surveys by country is likely also related to external factors such as access to the internet, and popularity of internet dating and contact sites for MSM in different countries.
A heterosexual mode of transmission was reported for cases, sex between males for 2 cases. To summarize, under the assumption that the SSD is mainly but not exclusively dependent on the household internet access, we estimated SSD values as a function of household internet access based on earlier repeated internet surveys among MSM from several Western and Central European countries.
FH participated in the study design, constructed the online survey and contributed to the manuscript; PW participated in the study design, co-ordinated the survey promotion and contributed to the manuscript; AJS participated in the study design, coordinated the study and the EMIS Network, and contributed to the manuscript.
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International comparisons of the incidence of newly diagnosed HIV infections among men who have sex with men MSM are challenging for a variety of reasons. Findings from 38 countries. Men who have sex with men in great Britain: The lowest SSD was calculated for the Netherlands with 1. According to information provided by the respective national contact points the data reported to ECDC or published elsewhere were adjusted for reporting delays.
Acknowledgements We thank the following persons for providing national data and study results, and for validating national surveillance data reported to ECDC: In addition, the total size of the national samples was used as a second survey-derived parameter in the analysis.
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|Italics, SSD value likely too low or too high: Comparison of community-based survey data with surveillance data suggests only minor sampling biases in the former that — except for a few countries - do not seriously distort inter-country comparability, despite large variations in participation rates across countries.
Click here for file 61K, pdf. In Luxemburg, the problematic parameter may be the number of EMIS participants living in the country who reported having been diagnosed with HIV in Thus, a linear relationship between household internet access and SSD could not be expected.