Disproportionate and increasing burden of HIV infection among men who have sex with men in Slovenia: surveillance data for 1999-2008.

The report presents data on HIV infection among men who have sex with men (MSM) in Slovenia during 1999-2008. HIV surveillance was based on universal mandatory reporting of HIV/AIDS cases, monitoring HIV infection prevalence among sentinel populations of MSM and STI patients and selected behaviour indicators in a sentinel population of MSM. Among 48 newly diagnosed HIV cases reported for 2008, 34 were MSM. Since 1999, the annual reported rate of HIV diagnoses in MSM rose from 7.1 to 46.8 per million men aged 15-64 years (an increase of more than six times). During 1999-2008, the proportion of MSM diagnosed with AIDS within three months of HIV diagnosis declined from 60% to 21%, however, the corresponding rate per million men aged 15-64 increased from 4.3 to 9.6. During 1999-2008, HIV prevalence among male clients of STI outpatient services tested for syphilis (including a substantial proportion of MSM) increased from 0% to 3.4%, and it remained below 5% in a sentinel population of MSM in Ljubljana. In the same sentinel population of MSM, the proportion reporting HIV test last year increased from 29% in 2003 to 38% in 2008 while the proportion reporting condom use at last anal intercourse decreased from 81% in 2004 to 66% in 2008. The burden of HIV among MSM in Slovenia is disproportionately high and increasing fast. Promotion of safer sexual behaviour and HIV testing among MSM as well as positive prevention among MSM with diagnosed HIV infection are urgently needed.