P3.142 Epidemiology of STI in Men Having Sex with Men in Italy, 1991–2010

Background In recent years, sexually transmitted infections (STI) have been increasing among men who have sex with men (MSM) in several industrialised countries. The objective of this study was to assess socio-demographic, behavioural and clinical characteristics of MSM with STI, in Italy. Methods Data were obtained from the Italian Sentinel STI Surveillance System based on a network of 12 specialised clinical centres located in large cities (1991–2010). All MSM are offered HIV testing and serostatus is recorded. Results Between 1991 and 2010, 85,073 STI cases were reported; 13,081 (15.6%) were diagnosed among MSM. The annual number of STI cases remained stable over time, whereas the proportion of MSM with STI increased from 11.2% in 1991 to 17.5% in 2010. The most frequent diagnoses among MSM were: genital warts (33.3%), primary and secondary syphilis (19.5%), and gonoccocal urethritis (15.4%). The annual number of cases of primary and secondary syphilis remained stable until 2000 (about 24 cases/year) and then increased ten-fold in 2005 (No. 325) compared to 2000, with a slight decrease after 2005. Overall, among the 10,850 (82.9%) MSM with STI who underwent HIV testing, the HIV prevalence was 21.1%, showing a decrease during the study period from 28.1% in 1991 to 21.3% in 2010. Among the 2,288 HIV-positive MSM, 35.7% were new HIV diagnoses. Conclusion The proportion of MSM with STI increased between 1991 and 2010. In 2010, compared to heterosexuals, HIV prevalence among MSM was eight times higher and the proportion of primary and secondary syphilis was six times higher. These results stress the need for prevention campaigns targeted at reducing the spread of STI among MSM, and the need for an active proposal of HIV testing (including the opt-out approach) among STI patients.