The attendees of the COBATEST Network member meeting

The VII Annual Meeting of the COBATEST NETWORK took place on January 25th and 26th at Ca l’Alier in Barcelona, bringing together more than 50 professionals from 23 countries across Europe and Central Asia. Representatives of the network’s member centres shared their experiences and discussed HIV/STI/HV testing and monitoring at community centres.

Representatives of the network’s coordinating organizations, Dr. Jordi Casabona from IGPT, CEEISCAT (Spain) and Christos Krasidis from Aids Action Europe (Germany) opened the meeting by welcoming all the participants. The members of the COBATEST Steering Committee were then introduced, along with the new members elected in the 2023 elections: Nino Tsereteli from the Center for Information and Counseling on Reproductive Health TANADGOMA (Georgia); and Mihai Lixandru from the Romanian Anti-AIDS Association (ARAS). An inspiring video by Laurel Sprague, Head of Community and Young Engagement at UNAIDS, was played, highlighting the importance of community testing in the fight against HIV/STI.

The network members presented research studies and reports on testing and prevention projects implemented in their respective countries. Arman Sahakyan and Sergey Grabielyan from the NGO New Generation Humanitarian (a new member from Armenia) presented on the HIV and STI prevention and treatment program for men who have sex with men, sex workers, and transgender individuals in Armenia. Maka Gogia from the Georgian Harm Reduction Network presented the “Lite-BBS” pilot program, which aims to increase the acceptance of STI/HIV tests and their linkage to the country’s prevention program. Meanwhile, Stefania Florentina Mihale from the Baylor Black Sea Foundation (Romania) shared the findings of a pilot study on HIV self-tests in Romania, which has been highly successful among young generation.

Dr. Megi Gogishvili from CEEISCAT summarized the activities implemented by COBATEST during 2023 and highlighted important findings from the 2022 data collected by COBATEST members. In 2022, 136,626 people were tested by 70 member centers, with over half of them (64.9%) being CIS men and 0.9% being transgender individuals. Forty percent of the tested individuals were men who have sex with men, and 25% of the total were under 25 years old. It is also notable that 1% of tested persons had reactive test results.

Open discussion group

A flexible format was adapted for the last day of the meeting, with discussion tables organized by the participants themselves. Specifically each discussing topic was proposed during a brainstorming session among all participants on the first day of the meeting, and then led by the person who proposed it. Some of the issues addressed included Pre-Exposure Prophylaxis (PrEP) aand access to healthcare barriers faced by migrants, injectable antiretroviral therapies (ARTs), self-tests, testing minors, the difficulties with establishing Checkpoints, the integration of new services, and the effective use of online resources. At the end of the meeting, each discussion group shared their conclusions with all other participants in a common session, followed by a brief closing led by Dr. Laura Fernàndez-López from CEEISCAT (Spain) and Lella Cosmaro from the LILA Milano association (Italy), marking the end of the meeting.

Participants sharing the conclusions of their discussion groups

The COBATEST Network not only drives standardized data collection and analysis to inform future interventions but also promotes information exchange and sharing best-practices among its members. Additionally, it facilities formation of international collaborations among CBVCTs. Currently, the network comprises 118 centres from 29 European countries and 2 from Central Asia. These centres offer their services outside conventional health facilities, often through field interventions, which facilitates access to testing and counselling for hard-to-reach vulnerable population groups.

Minutes and presentations are listed below:

Minutes:

Presentations:

COBATEST Netork is pleased to anounce some important updates regarding the official documents that will be in use from January 1 onwards.

1. New Data Collection Form and Instructions:

   We are pleased to share with you the updated data collection form along with comprehensive instructions for its completion. 

2. Data Collection Forms for PrEP/Chemsex Modules and Other STIs:

   In addition to the general data collection form, we have included the specific updated forms for PrEP/Chemsex modules and other sexually transmitted infections, for those who collect this data.

3. Instructions and Aggregated Data Excel:

   For those submitting aggregated data, detailed instructions and an Excel sheet for aggregated data reporting have been updated.

4. Instructions and Disaggregated Data Excel:

   Likewise, for those submitting disaggregated data, please find updated instructions and the corresponding Excel sheet for your reporting.

All updated documents can be foun in here.

The HepHIV 2023 conference took place from November 13th to 15th, 2023 in Madrid, Spain. Results from three research studies were presented by COBATEST network at the conference.

Dr. Megi Gogishvili presented findings of a study on HIV positive diagnosis among migrants compared to native-born in Europe and Central Asia. 

Presentation demonstrated analysis of HIV-testing trends and prevalence of HIV positive diagnosis among migrants in Europe and Central Asia (ECA) compared with native-born individuals in 2021 and 2022. All 62 CBVCTs from COBATEST network who submitted standardized aggregated or disaggregated data in both years were included in the study. As conclusions, we found that migrants in ECA had a higher risk of HIV-positive diagnoses compared to native-born individuals in both years, with increased prevalence ratio in 2022 compared to 2021. We also identified transgender migrants, MSM migrants, and MSM native-born, at higher risk of HIV-positive diagnoses compared with non-MSM, and other sex in case of transgender migrants. Further research performing analysis by migrants’ country of origin and including data from 2023 is needed to assess whether the influx of migrants from Ukraine is straining available HIV-related resources and impacting the health of newly arrived PLHIV. This analysis is of crucial importance and is need to inform future interventions to further guarantee access to HIV care and treatment to all migrants. Please find the full results in the presentation online.

Dr. Miguel Alarcón Gutiérrez presented findings of a study on Chemsex, HIV testing and associated factors in gay, bisexual and other men who have sex with men (GBMSM) and transgender individuals, among European community-based centres.

A presentation consisted of analysis of associated factors with chemsex practice among GBMSM and transgender population who attended community-based voluntary counselling and HIV/STI testing (CBVCT) centres in Europe. We included 31 COBATEST Network CBVCT centres from Belgium, Italy and Spain who submitted chemsex-related questions, between 2019 and 2022. After analysis, we concluded that chemsex is a prevalent practice among GBMSM and transgender people who attend CBVCT centres and it is significantly related to HIV positive testing. Vulnerable subpopulations and specific opportunities were identified to generate interventions oriented to the prevention of chemsex related harms in the CBVCT setting. Please find the full results in the presentation online

Dr. Laura Fernández López presented a poster with the findings of a study on the assessment of HIV self-testing and self-sampling use and intention to use among COBATEST Network members. 

The poster consisted of the analysis of the use of HIV self-testing (HST) and self-sampling (HSS) among COBATEST Network members as part of the project ‘Community Led and Based HIV Services-Key to Ending the HIV Epidemic in Europe and Central Asia “Zeroing In-Ending the HIV Epidemic”‘. An online survey was conducted among COBATEST network members from February to March 2023, covering different aspects related to the use or intention to use of HST/HSS in their services. HSS was less utilized than HST among COBATEST Network members. Legal considerations posed barriers to both methods, and primary reasons for not offering them were concerns about price, follow-up, linkage to care, and concerns about self-administration without counselling. Despite high client interest, ensuring effective follow-up of test results remained a significant challenge. Please find the full results in the poster online.

The XLI Spanish Epidemiology Society (SEE) meeting took place from September 5th to 8th, 2023 in Porto, Portugal. Two abstracts were presented by COBATEST network at the meeting.

Dr. Megi Gogishvili presented an abstract on the impact of COVID-19 on HIV-testing among community centers in Catalonia. 

Presentation consisted of time series analysis of the testing trends from 2018 to 2020. Four periods were analysed: pre-lockdown (PRE), lockdown (LD), de-escalation (DE), and new normality (NN). In total, 18,265 tests were reported. Males comprised 56.1% of testers in PRE, 71.4% in LD and 49.5% in NN, while largest proportion of females were found in DE (54.1%). During PRE 10,034 tests were performed, during LD 82 (84.4% less than expected), 211 during DE (62.5% less), and 2305 in NN, which is 12.5% less than predicted by the model according to the previous trends. Males had the highest difference in expected to observed tests (LD = 86.3%, DE = 73.9% and NN = 24.3% less than expected). Females tested 81.1% (LD) and 37.5% (DE) less than expected and 2.9% more than expected during NN. Transgenders tested 86.7% less than expected in LD, 92.9% in DE, and 25.2% in NN. Meno who have sex with men (MSM) tested 87.9% less than expected during LD, 84.8% during DE, and 34.5% during NN. Sex workers (SWs) tested 86.5%, 83.1%, and 33.8% less than expected. People who inject drugs (PWIDs) tested 62.5%, 46.2%, and 33.3% less than expected. Migrants tested 84.9%, 51.1% less than expected and 10.4% more during NN. Please find full presentation online.

Dr. Miguel Alarcón Gutiérrez presented an abstract based on analysis of quantitative data collected by COBATEST network members from 2013 to 2022 concentrating on transgender individuals and men who have sex with men (MSM).

A presentation consisted of analysis of HIV and other STI associated factors among MSM and transgender individuals in 60 European community-led testing centers from COBATEST network. Out of 81,776 testers were GBMSM and 1,603 were transgender individuals. Total reactive testing prevalence among GBMSM population was 5.89% (CI: 5.64-6.14), and 12.48% (CI: 10.90-14.19) among transgender individuals. Multivariate analysis in GBMSM showed that factors associated with reactive testing were: age (aOR=1.01; CI: 1.00-1.01), being a migrant from outside of European Union (EU) (aOR=1.77; CI: 1.56-2.00), have been previously tested for HIV (aOR=1.37; CI: 1.19-1.59), having any risk exposure as motivation for testing (aOR=1.64; CI: 1.46-1.85), condomless penetration during last sexual intercourse (aOR =1.34; CI: 1.21-1.49), previous STIs (aOR=2.04; CI: 1.78-2.33), and receiving money or drugs for sex during last 12 months (aOR=1.61; CI: 1.35-1.93). In transgender population, factors associated with reactive testing were being a migrant from outside of the EU (aOR=2.90; CI: 1.55-5.42), having any risk exposure as motivation for testing (aOR=1.95; CI: 1.39-2.74), previous STIs (aOR=1.60; CI: 1.07-2.39), and receiving money or drugs for sex during last 12 months (aOR=2.04; CI: 1.10-3.77). Please find full presentation online

There are currently 2 vacancies in the COBATEST Steering Committee for the 3-year term 2024 – 2026, starting on 1st Jan 2024. One of the seats is reserved for a representative of Eastern Europe and Central Asia.

In accordance with the COBATEST Election Procedure and COBATEST Steering Committee Terms of Reference, the Steering Committee members are directly elected by the COBATEST members. This procedure ensures transparency and fair participation of the network’s members in the decision-making.

All members of the network are highly encouraged to send in their candidacy (from November 20th to December 11th) to become new members of the Steering Committee and of course to vote during the elections (from November 11th to November 25th). You can find eligibility criteria and other details about the elections in the Elections Announcement document. Active participation from the members is very important part of forming successful network! 

The AidsImpact conference took place from June 12th to 15th, 2023 in Stockholm, Sweden. Two abstracts were presented by COBATEST network at the conference.

Dr.Megi Gogishvili presented an abstract based on the quantitative and qualitative data collected through an online questionnaire from EECA members of COBATEST network, ECOM, AFEW, and Aids Action Europe in 2022. 

A presentation was conducted on the results of an assessment of operational and structural realities and obstacles encountered by CBVCTs in EECA during HIV/STI testing and data collection. The data was based on the assessment of 20 CBVCTS, 8 from Eastern European countries and 3 from Central Asian countries. Majority of CBVCTs (14/20) depended primary on international grants and only few (2/20) operated mainly on a local governmental funds. Target testing population of majority of the CBVCTs were MSM (15/20), PWIDs (13/20), and SW (12/20). While 13 of CBVCTs provided assistance on how to navigate national health systems, only 1 provided legal counselling. All CBVCTs tested for HIV, 17 of them on HCV, 13 on HBV, and only 3 on Syphilis. Only 5 CBVCTs could perform confirmatory tests in their centers. Fifteen CBVCTs provided self-testing kits, however only 2 always received results of the testing. All participating CBVCTs collected data, 14/20 utilized both online and offline tool. Data is mostly collected for donor reporting purposes. However, interest was shown in being able to utilize collected data for improving services provided, informing future projects, and publishing articles. Primary themes identified in challenges named while testing and collecting data were: lack of funding (for personnel, tests), confidentiality and stigma, and political environment of the countries (restrictive laws, war). Please find full presentation online.

Dr.Laura Fernandez Lopez presented an abstract based on quantitative data collected by COBATEST network members from 2013 to 2022.

A presentation was conducted on a key population belonging and HIV associated factors among 60 European community-led testing centers from COBATEST network. 73,799 HIV tested people were included in the cross-sectional study, of whom 65.3% (n=48,168) belonged to some key population. HIV reactive testing general prevalence was 1.68% (CI:1.59-1.78), while in key population was 2.41% (CI:2.27-2.55) and 0.31% (CI:0.25-0.38) in non-key population. In the multivariate analysis in key population group, being younger (aOR=0.99; CI:0.986-0.999), a man (aOR=6.05; CI:4.44-8.24) or a transgender (aOR=10.02; CI:7.07-14.20), being migrant from abroad the UE (aOR=1.76; CI:1.52-2.04), less condomless penetration during last sexual intercourse (aOR=1.36; CI:1.19-1.55), previous STI during last 12 months (aOR=1.41; CI:1.17-1.71) and doing sexual work (aOR=1.56; CI:1.27-1.91) were significantly associated with HIV reactive testing. In contrast, in non-key population, associated factors to HIV reactive testing were being older (aOR=1.03; CI:1.02-1.05) and a man (aOR=1.93; CI:1.17-3.19). Please find full presentation online

The biannual meeting of Steering Committee of the COBATEST Network was held on June 8th and 9th, 2023 in Berlin, Germany, on the campus of AIDS Action Europe. Great and productive discussions took place on updating data collection form, future planning for the network, and brainstorming for next COBATEST members annual meeting.

COBATEST network takes part in Boost project 2023-2025, funded by the European Commission’s Action grant, together with 45 participants from more than 20 organizations. The kick-off meeting of the project was held in Rome, Italy, on February 13 and 14, 2023. As part of the project, COBATEST will assist with improvement of HIV/HCV/STIs testing data collection among harm reduction services across Europe.

COBATEST Network takes part in CORE project (Community Response to End Inequalities) 2023-2025, funded by the European Commission’s Action grant, alongside with participants from 20 other organizations. The kick-off meeting of the project was held in Berlin, Germany, on January 30th, 2023. COBATEST will assist community organisations to improve monitoring of testing and linkage to care for HIV/STI/ TB/VH.

COBATEST Network was present in the 2022 version of EECA Interact, a scientific workshop on HIV, Hepatitis C and Tuberculosis in Eastern Europe and Central Asia.

Dr. Megi Gogishvili presented the progress of data from COBATEST EECA members. Data shows that there is big gap between HIV testing among MSM and other vulnerable groups in EECA, specifically among transgender people, PWID, and SW. Low percentage of persons tested during past 12 months and high proportion of reactive test results indicates need of increase in testing outreach programs in EECA. Overall, increase in participation from EECA members has been found in COBATEST network, but data submission is not consistent throughout 5 years. Please find full presentation online.