Objectives: To describe trends in the prevalence of HIV infection, in risk behaviors and in knowledge and attitudes related to antiretroviral therapy (ART) among men who have sex with men (MSM) recruited in Barcelona (Spain) between 1995 and 2002.
Methods: Cross-sectional surveys were conducted twice yearly from 1993. MSM were recruited in saunas, sex-shops, a cruising site in a public park and by a mailing sent to all members of a gay organization, using an anonymous self-administered questionnaire. From 1995 saliva samples were requested to determine the prevalence of HIV infection.
Results: The prevalence of HIV infection remained stable from 14.2% in 1995 to 18.3% in 2002 (p > 0.05). The proportion of men who had more than 10 sexual partners in the previous 12 months showed an increasing trend (from 45.2% in 1995 to 55.7% in 2002, p < 0.0001). Unprotected anal intercourse (UAI) with casual partners did not change significantly between 1995 and 2002 (25.8% en 2002). In 2002, 55.8% of steady couples in which one or both members did not know their serological status and 27.5% of serodiscordant couples reported UAI. The proportion of men who believed that "HIV-positive persons taking ART (7.7% in 2002) or with undetectable viral load (6.4% in 2002) cannot transmit the virus" remained steady since 1998 (p > 0.05).
Conclusions: The prevalence of HIV and risk behaviors continues to be high among MSM in Barcelona. A strategic objective in the control of the HIV epidemic must be to continue the decrease in the number of occasions on which UAI takes place between men with discordant serological status.