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HIV testing has become the cornerstone of the fight against HIV and AIDS: antiretroviral treatments now allow preserving life expectancy, preventing HIV transmission and, although available only in a few countries, to prevent HIV acquisition in uninfected individuals.

Community-based voluntary counselling and testing (CBVCT) services are structures led by community NGOs that provide HIV testing (mainly rapid tests using finger prick blood samples), but often more: other sexually transmitted infections testing, counselling, prevention materials, linkage to care, and social or psychological support.

When targeting especially men who have sex with men (MSM) – a group where HIV is still fast-spreading – these CBVCT services manage to reach most-at-risk individuals and provide an environment that is likely to be non-stigmatising. These venues help MSM to talk, with less fear of being judged, about their sexual practices and their concerns regarding HIV prevention.
 
CBVCT services: a suitable place for community-based research in HIV-negative MSM

Working with CBVCT services is a great opportunity to recruit and follow-up HIV-negative MSM. Such data are still scarce in Europe, but two CBVCT services previously showed the feasibility of this kind of MSM cohort: the BCN Checkpoint (Barcelona) and the CheckpointLX (Lisbon).

The objective of the COBA-Cohort study (COmmunity-BAsed Cohort) was to implement, in the framework of the Euro HIV EDAT project, a multicentre cohort of HIV-negative MSM in 6 European countries (Denmark, France, Greece, Italy, Portugal and Slovenia). All MSM older than 18 attending one of the 17 participating CBVCT services and who had a negative HIV test result are offered to participate in COBA-Cohort. Those who accept have to fill-in a baseline questionnaire and another one every time they come back for a test.

The Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT), a Public Health research unit linked to the Agència de Salut Pública de Catalunya (ASPCAT) and to the Universitat Autònoma de Barcelona (UAB), based in Campus Can Ruti acts as the Principle Investigator and coordinator of the project.
 
Working 'with' the community and not only 'for' the improvement of knowledge and prevention

Since the beginning of the study, community health workers and researchers have been working together. The biggest challenge was to reach a consensus regarding a common behavioural questionnaire addressing epidemiological and social science issues, but also including each CBVCT services’ existing questions (basically to monitor the testing activity) in order to avoid double data collection work.
On 29th February 2016, 2.313 participants were enrolled in the cohort, taking into account that many sites were just starting (one did not started yet). Today, several sites already finished their recruitment and, overall, at least 4.000 MSM would be enrolled by the end of 2017.

This cohort will allow describing the testing habits of the recruited MSM, monitoring the spread of HIV and identifying factors influencing at-risk practices. These data will be particularly useful to improve testing coverage (at least once a year following national and international recommendations) as well as HIV prevention in MSM.