Increases in newly acquired HIV infections in Victoria, Australia: epidemiological evidence of successful prevention?
Anita Feigin A , Carol El-Hayek A , Margaret Hellard A B , Alisa Pedrana A B , Ellen Donnan C , Christopher Fairley D , B. K. Tee E and Mark Stoové A B FA Centre for Population Health, Burnet Institute, Melbourne, Vic. 3004, Australia.
B Department of Epidemiology and Preventive Medicine, Melbourne, Vic. 3004, Australia.
C Communicable Disease Prevention and Control Unit, Victorian Government Department of Health, Melbourne, Vic. 3000, Australia.
D Melbourne Sexual Health Centre and the School of Population Health University of Melbourne, Vic. 3053, Australia.
E Centre Clinic, Victorian AIDS Council, Melbourne, Vic. 3182, Australia.
F Corresponding author. Email: stoove@burnet.edu.au
Sexual Health 10(2) 166-170 https://doi.org/10.1071/SH12064
Submitted: 3 May 2012 Accepted: 30 November 2012 Published: 5 April 2013
Abstract
Background: Rates of newly acquired HIV notifications provide useful data for monitoring transmission trends. Methods: We describe 10-year (2001–10) trends in newly acquired HIV notifications in Victoria, Australia. We also examine recent trends in HIV testing and incidence and risk behaviours among gay and other men who have sex with men (MSM) attending four high MSM caseload clinics. Results: Between 2001 and 2010 there was a significant increasing linear trend in newly acquired HIV that was driven primarily by increases between 2009–2010. MSM accounted for 85% of newly acquired HIV notifications. Between 2007–10, the total number of HIV tests per year at the high caseload clinics increased 41% among MSM and HIV incidence declined by 52%; reported risk behaviours remained relatively stable among these MSM. Conclusion: More newly acquired HIV notifications may reflect recent increased testing among MSM; continued scrutiny of surveillance data will assess the sustained effectiveness of testing as prevention, health promotion and the contribution of risk and testing behaviours to HIV surveillance outcomes.
Additional keywords: AIDS, epidemiology, HIV testing, men who have sex with men, surveillance.
References
[1] Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia annual surveillance report 2011. Sydney: The University of New South Wales; 2011.[2] National Centre in HIV Epidemiology and Clinical Research. HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia annual surveillance report 2002. Sydney: The University of New South Wales; 2002.
[3] Burnet Institute. HIV surveillance summary annual report for 2009. Melbourne: Communicable Disease Prevention and Control Unit, Health Protection Branch; 2009.
[4] Burnet Institute. HIV/AIDS monthly surveillance report – October 2011. Victoria: Communicable Disease Prevention and Control Unit, Health Protection Branch; 2011.
[5] Holt M, Mao L, Prestage G, Zablotska I, de Wit J. Gay community periodic surveys – national report 2010. Sydney: University of New South Wales; 2011.
[6] Lee E, Holt M, Zablotska I, Prestage G, McKenzie T, Batrouney C, et al. Gay community periodic survey: Melbourne 2010. Sydney: National Centre in HIV Social Research, The University of New South Wales; 2010.
[7] Zablotska IB, Prestage G, Middleton M, Wilson D, Grulich AE. Contemporary HIV diagnoses trends in Australia can be predicted by trends in unprotected anal intercourse among gay men. AIDS 2010; 24 1955–8.
| Contemporary HIV diagnoses trends in Australia can be predicted by trends in unprotected anal intercourse among gay men.Crossref | GoogleScholarGoogle Scholar | 20543653PubMed |
[8] Middleton MG, Grulich AE, McDonald AM, Donovan B, Hocking JS, Kaldor JM. Could sexually transmissible infections be contributing to the increase in HIV infections among men who have sex with men in Australia? Sex Health 2008; 5 131–40.
| Could sexually transmissible infections be contributing to the increase in HIV infections among men who have sex with men in Australia?Crossref | GoogleScholarGoogle Scholar | 18588778PubMed |
[9] Hoare A, Wilson DP, Regan DG, Kaldor J, Law MG. Using mathematical modelling to help explain the differential increase in HIV incidence in New South Wales, Victoria and Queensland: importance of other sexually transmissible infections. Sex Health 2008; 5 169–87.
| Using mathematical modelling to help explain the differential increase in HIV incidence in New South Wales, Victoria and Queensland: importance of other sexually transmissible infections.Crossref | GoogleScholarGoogle Scholar | 18686336PubMed |
[10] World Health Organisation (WHO). Diagnostics and Laboratory Technology. Geneva: WHO; 2011. Available online at: http://www.who.int/diagnostics_laboratory/links/hiv_incidence_assay/en/index.html [verified January 2013]
[11] Horyniak D, Stoové M, Yohannes K, Breschkin A, Carter T, Hatch B, et al The impact of migration on the burden of HIV infection in Victoria, Australia. Sex Health 2009; 6 123–8.
| The impact of migration on the burden of HIV infection in Victoria, Australia.Crossref | GoogleScholarGoogle Scholar | 19457291PubMed |
[12] Goller J, Guy R, Gold J, Lim M, El-Hayek C, Stoové M, et al Methods and attributes of a linked sentinel surveillance system for BBVs and STIs in Victoria, Australia. Sex Health 2010; 7 425–33.
| Methods and attributes of a linked sentinel surveillance system for BBVs and STIs in Victoria, Australia.Crossref | GoogleScholarGoogle Scholar | 21062582PubMed |
[13] STIs in Gay Men Action Group (STIGMA). Sexually transmitted infection testing guidelines for men who have sex with men 2010. Sydney: STIGMA; 2010. Available online at: http://www.stigma.net.au/resources/STIGMA_MSM_Testing_Guidelines_2010.pdf [verified January 2013]
[14] Australian Government Department of Health and Ageing (DoHA). National HIV strategy 2010–2013. Canberra: DoHA; 2010.
[15] Australian Government Department of Health and Ageing (DoHA). National HIV/AIDS strategy 2005–2008: revitalising Australia’s response. Canberra: DoHA; 2005.
[16] Australian Government Department of Health and Ageing (DoHA). Sixth national HIV strategy 2010–2013. Canberra: DoHA; 2010.
[17] HIV treatment as prevention – it works. Lancet 2011; 377 1719
| HIV treatment as prevention – it works.Crossref | GoogleScholarGoogle Scholar | 21601691PubMed |
[18] Pedrana A, Hellard M, Guy R, El-Hayek C, Gouillou M, Asselin J, et al Stop the Drama Downunder: a social marketing campaign increases HIV/STI knowledge and testing in Australian gay men. Sex Transm Dis 2012; 39 651–8.
| Stop the Drama Downunder: a social marketing campaign increases HIV/STI knowledge and testing in Australian gay men.Crossref | GoogleScholarGoogle Scholar | 22801349PubMed |
[19] Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr 2005; 39 446–53.
| Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs.Crossref | GoogleScholarGoogle Scholar | 16010168PubMed |
[20] Montaner JS, Lima VD, Barrios R, Yip B, Wood E, Kerr T, et al Association of highly active antiretroviral therapy coverage, population viral load, and yearly new HIV diagnoses in British Columbia, Canada: a population-based study. Lancet 2010; 376 532–9.
| Association of highly active antiretroviral therapy coverage, population viral load, and yearly new HIV diagnoses in British Columbia, Canada: a population-based study.Crossref | GoogleScholarGoogle Scholar | 20638713PubMed |
[21] Wilson DP, Hoare A, Regan DG, Law MG. Importance of promoting HIV testing for preventing secondary transmissions: modelling the Australian HIV epidemic among men who have sex with men. Sex Health 2009; 6 19–33.
| Importance of promoting HIV testing for preventing secondary transmissions: modelling the Australian HIV epidemic among men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 19254488PubMed |
[22] Pedrana A, Hellard ME, Wilson K, Guy R, Stoové M. High rates of undiagnosed HIV infections in a community sample of gay men in Melbourne, Australia. J Acquir Immune Defic Syndr 2012; 59 94–9.
| High rates of undiagnosed HIV infections in a community sample of gay men in Melbourne, Australia.Crossref | GoogleScholarGoogle Scholar | 21992925PubMed |
