Underreporting of HIV Transmission among Men who have Sex with Men in the Ukraine. Knowledge of the modes of HIV transmission is essential for targeting prevention interventions, and yet, the accuracy and completeness of reporting of modes of transmission are often poor, particularly in places where reporting of certain risk behaviors can lead to stigmatization or even legal consequences . Data suggest that sexual contact between men is frequently underreported, even in countries where stigma is minimal and there are no associated adverse legal consequences. For instance, in the United States, ~ ¾ of the 7,612 men reported with HIV infection in 2011 who had no reported risk factor for transmission were later reassigned to male-male sexual contact . HIV case surveillance data may be particularly sensitive to underreporting transmission category because they require that physicians ascertain this information from their patients and then report it. Reluctance by clinicans to enquire about their patients' sexual behavior and hesitation by patients to self-report risk may lead to misclassification or non-reporting of transmission risk. Anonymous surveys are likely to provide more accurate information on risk behavior among men who have sex with men (MSM) than HIV case surveillance data. We compared findings from HIV seroprevalence surveys to HIV case surveillance data to estimate the magnitude of underreporting of HIV among MSM in Ukraine over a seven year period (2005-2011).
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