HIV is rare among low-risk heterosexual men and significant potential savings could occur through phone results
Matiu R. Bush A B C , Henrietta Williams A B and Christopher K. Fairley A BA Melbourne Sexual Health Centre, Alfred Hospital, 580 Swanston Street, Vic. 3053, Australia.
B School of Population Health, University of Melbourne, 580 Swanston Street, Vic. 3053, Australia.
C Corresponding author. Email: mbush@mshc.org.au
Sexual Health 7(4) 495-497 https://doi.org/10.1071/SH09088
Submitted: 19 August 2009 Accepted: 23 February 2010 Published: 10 November 2010
Abstract
Background: The legislation in Victoria requires HIV-positive results to be given in person by an accredited health professional. Many sexual health clinics require all men to receive HIV results in person. Our aim was to determine the proportion of low-risk heterosexual men at a sexual health centre who tested HIV-positive. Methods: The electronic data on all HIV tests performed between 2002 and 2008 on heterosexual men at the Melbourne Sexual Health Centre (MSHC) was reviewed. The individual client files of all heterosexual men who tested HIV-positive were reviewed to determine their risks for HIV at the time that the HIV test was ordered. Results: Over the 6 years there were 33 681 HIV tests performed on men, of which 17 958 tests were for heterosexual men. From these heterosexual men, nine tested positive for the first time at MSHC (0.05%, 95% confidence interval (CI): 0.01%, 0.09%). These nine cases included six men who had had sex with a female partner from the following countries: Thailand, Cambodia, China, East Timor, Botswana and South Africa. Two men had injected drugs and one had a HIV-positive female partner. Of the 17 958 test results for heterosexual males, 14 902 (83% 95% CI: 84%, 86%) test results were for men who did not have a history of intravenous drug use or had sexual contact overseas. Of these 14 902 low-risk men, none tested positive (0%, 95% CI: 0, 0.00025). Conclusion: Asking the 83% of heterosexual men who have an extremely low risk of HIV to return in person for their results is expensive for sexual health clinics and inconvenient for clients. We have changed our policy to permit heterosexual men without risk factors to obtain their HIV-negative results by phone.
Additional keywords: HIV testing, results.
Acknowledgements
Matiu Bush was supported by the Nurse Practitioner Scholarship Scheme funded by the Department of Health and Ageing. The views expressed in this article are not representative of the Department of Health and Ageing. Thank you to David Lee for his statistical assistance.
[1] Chan E, McNulty A, Tribe K. Who returns for HIV screening test results? Int J STD AIDS 2007; 18 171–4.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
![](../../media/share/OpenURL_Image.gif)
[2] Hopkins C, Cummings RA, Read TR, Fairley CK. Characteristics of Australian women who test positive for HIV: implications for giving test results. Med J Aust 2007; 186 327.
| PubMed |
![](../../media/share/OpenURL_Image.gif)
[3] Wright SJ, Kell PD, Tobin R, Breen E. A review of policy change regarding how patients access their HIV test results at two genitourinary medicine services in Central London. Int J STD AIDS 2006; 17 753–4.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
![](../../media/share/OpenURL_Image.gif)
[4] Fairley CK, Williams H, Lee DM, Cummings R. A plea for more research on access to sexual health services. Int J STD AIDS 2007; 18 75–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
![](../../media/share/OpenURL_Image.gif)
[5] Harry TC. Quality and resource management in genitourinary medicine service delivery. Int J STD AIDS 1999; 10 751–4.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
![](../../media/share/OpenURL_Image.gif)
[6] Ross JDC, Copas A, Stephenson J, Fellows L, Gilleran G. Optimizing information technology to improve sexual health-care delivery: public and patient preferences. Int J STD AIDS 2007; 18 440–5.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
![](../../media/share/OpenURL_Image.gif)
[7] Pittrof R, McLellan J. Test not talk: screening for asymptomatic men. Int J STI AIDS 2007; 18 274–5.
| Crossref | GoogleScholarGoogle Scholar | CAS |
![](../../media/share/OpenURL_Image.gif)
[8] Guy R, McDonald A, Bartlett M, Murray J, Giele C, Davey T, et al. HIV diagnoses in Australia: diverging epidemics within a low-prevalence country. Med J Aust 2007; 187 437–40.
| PubMed |
![](../../media/share/OpenURL_Image.gif)
[9] McDonald AM, Crofts N, Blumer CE, Gertig DM, Patten JJ, Roberts M, et al. The pattern of diagnosed HIV infection in Australia, 1984–1992. AIDS 1994; 8 513–20.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
![](../../media/share/OpenURL_Image.gif)
[10] Hutchinson AB, Branson BM, Kim A, Farnham PG. A meta-analysis of the effectiveness of alternative HIV counselling and testing methods to increase knowledge of HIV status. AIDS 2006; 20 1597–604.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
![](../../media/share/OpenURL_Image.gif)
[11] Mercer CH, Copas AJ, Sonnenberg P, Johnson AM, McManus S, Erens B, et al. Who has sex with whom? Characteristics of heterosexual partnerships reported in a national probability survey and implications for STI risk. Int J Epidemiol 2009; 38 206–14.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
![](../../media/share/OpenURL_Image.gif)
[12] Wright S, Kell P, Tobin R. How do clients access their HIV results from genitourinary medicine services in the UK? A time for change! Int J STD AIDS 2004; 15 584–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
![](../../media/share/OpenURL_Image.gif)
[13] Tsu RC, Burm ML, Gilhooly JA, Sells CW. Telephone vs. face-to-face notification of HIV results in high-risk youth. J Adolesc Health 2002; 30 154–60.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
![](../../media/share/OpenURL_Image.gif)
[14] Devroey D, Van Casteren V, Sasse A. How are patients informed about their HIV test results? Fam Pract 2002; 19 125–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
![](../../media/share/OpenURL_Image.gif)
[15] Brown L, Copas A, Stephenson J, Gilleran G, Ross JDC. Preferred options for receiving sexual health screening results: a population and patient survey. Int J STI AIDS 2008; 19 184–7.
| Crossref | GoogleScholarGoogle Scholar | CAS |
![](../../media/share/OpenURL_Image.gif)
[16] Schluter WW, Judson FN, Baro’n AE, McGill WL, Marine WM, et al. Usefulness of human immunodeficiency virus post test counselling by telephone for low-risk clients of an urban sexually transmitted diseases clinic. Sex Transm Dis 1996; 23 190–7.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
![](../../media/share/OpenURL_Image.gif)