Trends and predictors of recent HIV testing over 22 years among a clinic sample of men who have sex with men in South Australia
Bin Li A B E , Peng Bi A , Alison Ward B , Charlotte Bell B and Christopher K. Fairley C DA School of Public Health, The University of Adelaide, 178 North Terrace, Adelaide, SA 5000, Australia.
B South Australia Specialist Sexual Health, Infectious Disease Unit, Royal Adelaide Hospital, 275 North Terrace, Adelaide, SA 5000, Australia.
C Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 89 Commercial Road, Melbourne, Vic. 3004, Australia.
D Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Vic. 3053, Australia.
E Corresponding author. Email: Bin.Li@sa.gov.au
Sexual Health 14(2) 164-169 https://doi.org/10.1071/SH16091
Submitted: 26 May 2016 Accepted: 10 October 2016 Published: 11 November 2016
Abstract
Increasing the frequency of HIV testing is crucial for effective HIV prevention and care. The aim of the present study was to determine whether there has been a change in HIV testing among men who have sex with men (MSM) at the South Australia Specialist Sexual Health (SASSH) clinic over the past two decades. Methods: Computerised medical records of MSM who attended the SASSH at their first visit between 1994 and 2015 were used to determine whether HIV testing had changed among MSM. First HIV tests in each calendar year and return tests within 12 months were analysed. Factors associated with recent HIV testing were also examined. Results: There were 24 036 HIV tests conducted among 8163 individual MSM over the study period. The proportion of newly registered MSM who reported ever being tested for HIV declined (Ptrend = 0.030), the proportion who reported recent HIV testing did not change (Ptrend = 0.955) and the proportion who have had current HIV testing increased (Ptrend = 0.008). The proportion of MSM who returned to the clinic for HIV testing within 12 months did not change (Ptrend >0.05), with less than 40% of MSM returning for HIV testing. Factors independently associated with recent HIV testing included MSM aged ≥20 years, (odds ratio (OR) 1.79; 95% confidence interval (CI) 1.53–2.10), higher education (OR 1.28; 95% CI 1.12–1.45), non-Caucasian (African OR 1.68; 95% CI 1.30–2.17), having multiple sex partners (OR 1.47; 95% CI 1.29–1.69), having had sex interstate (OR 1.61; 95% CI 1.42–1.82) or overseas (OR 1.53; 95% CI 1.33–1.76) and injecting drug use (OR 1.56; 95% CI 1.29–1.88). Conclusions: HIV testing rate among MSM attending SASSH was suboptimal. New approaches are needed to increase the uptake and early detection of HIV infection among the high-priority MSM population.
References
[1] Beyrer C, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, Brookmeyer R. Global epidemiology of HIV infection in men who have sex with men. Lancet 2012; 380 367–77.| Global epidemiology of HIV infection in men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[2] Jaffe HW, Valdiserri RO, De Cock KM. The reemerging HIV/AIDS epidemic in men who have sex with men. JAMA 2007; 298 2412–14.
| The reemerging HIV/AIDS epidemic in men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2sXhtlyjtbzL&md5=123c10af961ed65981246d7bdf77c6b4CAS |
[3] Grulich AE, Kaldor JM. Trends in HIV incidence in homosexual men in developed countries. Sex Health 2008; 5 113–8.
| Trends in HIV incidence in homosexual men in developed countries.Crossref | GoogleScholarGoogle Scholar |
[4] Sullivan PS, Carballo-Dieguez A, Coates T, Goodreau SM, McGowan I, Sanders EJ, Smith A, Goswami P, Sanchez J. Successes and challenges of HIV prevention in men who have sex with men. Lancet 2012; 380 388–99.
| Successes and challenges of HIV prevention in men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[5] Baral S, Sifakis F, Cleghorn F, Beyrer C. Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries 2000–2006: a systematic review. PLoS Med 2007; 4 e339
| Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries 2000–2006: a systematic review.Crossref | GoogleScholarGoogle Scholar |
[6] Department of Health. Seventh National HIV Strategy 2014–2017. 2014. Available online at: http://www.ashm.org.au/Documents/Seventh_HIV-Strategy2014-v3.pdf [verified 21 October 2016].
[7] Lucas A, Armbruster B. The cost-effectiveness of expanded HIV screening in the United States. AIDS 2013; 27 795–801.
| The cost-effectiveness of expanded HIV screening in the United States.Crossref | GoogleScholarGoogle Scholar |
[8] Templeton DJ, Read P, Varma R, Bourne C. Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence. Sex Health 2014; 11 217–29.
| Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence.Crossref | GoogleScholarGoogle Scholar |
[9] The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia, annual surveillance report, 2015. Sydney: UNSW Australia; 2015.
[10] Holt M, Lea T, Asselin J, Hellard M, Prestage G, Wilson D, de Wit J, Stoove M. The prevalence and correlates of undiagnosed HIV among Australian gay and bisexual men: results of a national, community-based, bio-behavioural survey. J Int AIDS Soc 2015; 18 20526
| The prevalence and correlates of undiagnosed HIV among Australian gay and bisexual men: results of a national, community-based, bio-behavioural survey.Crossref | GoogleScholarGoogle Scholar |
[11] Birrell F, Staunton S, Debattista J, Roudenko N, Rutkin W, Davis C. Pilot of non-invasive (oral fluid) testing for HIV within a community setting. Sex Health 2010; 7 11–6.
| Pilot of non-invasive (oral fluid) testing for HIV within a community setting.Crossref | GoogleScholarGoogle Scholar |
[12] Pedrana AE, Hellard ME, Wilson K, Guy R, Stoove 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 |
[13] Guy RJ, Prestage GP, Grulich A, Holt M, Conway DP, Jamil MS, Keen P, Cunningham P, Wilson DP. Potential public health benefits of HIV testing occurring at home in Australia. Med J Aust 2015; 202 529–31.
| Potential public health benefits of HIV testing occurring at home in Australia.Crossref | GoogleScholarGoogle Scholar |
[14] Tan WS, Chow EP, Fairley CK, Chen MY, Bradshaw CS, Read TR. Sensitivity of HIV rapid tests compared with fourth-generation enzyme immunoassays or HIV RNA tests. AIDS 2016; 30 1951–60.
| Sensitivity of HIV rapid tests compared with fourth-generation enzyme immunoassays or HIV RNA tests.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC28Xht1Wntb3E&md5=8935d78e09f6f0bf8979c4037778040dCAS |
[15] Li B, Bi P, Waddell R, Chow EP, Donovan B, McNulty A, Fehler G, Loff B, Shahkhan H, Fairley CK. Was an epidemic of gonorrhoea among heterosexuals attending an Adelaide sexual health services associated with variations in sex work policing policy? Sex Transm Infect 2016; 92 377–9.
| Was an epidemic of gonorrhoea among heterosexuals attending an Adelaide sexual health services associated with variations in sex work policing policy?Crossref | GoogleScholarGoogle Scholar |
[16] StataCorp. Stata Statistical Software: Release 14. College Station, TX: StataCorp LP; 2015.
[17] Lee ELT, Mao L, Hanan L, O’Brien R, Narciso L, Prestage G, Zablotska I, de Wit J, Holt M. Gay Community Periodic Survey: Adelaide 2014. Sydney: Centre for Social Research in Health, UNSW Australia; 2014.
[18] Lin AC, Fairley CK, Dutt K, Klassen KM, Chen MY, Fehler G, Law M, Bradshaw CS, Denham I, Read TR, Chow EP. Testing for HIV among men who have sex with men needs a paradigm shift in Australia, given the minimal increase between 2003 and 2013 in Melbourne, Australia. Sex Health 2015; 12 373–82.
| Testing for HIV among men who have sex with men needs a paradigm shift in Australia, given the minimal increase between 2003 and 2013 in Melbourne, Australia.Crossref | GoogleScholarGoogle Scholar |
[19] Jin FY, Prestage G, Law MG, Kippax S, Van de Ven P, Rawsthorne P, Kaldor JM, Grulich AE. Predictors of recent HIV testing in homosexual men in Australia. HIV Med 2002; 3 271–6.
| Predictors of recent HIV testing in homosexual men in Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38noslymsA%3D%3D&md5=d124c0eadb4332fcb90eed865bd069ddCAS |
[20] Wilkinson AL, El-Hayek C, Spelman T, Fairley C, Leslie D, McBryde E, Hellard M, Stoove M. "Seek, test, treat" lessons from Australia: a study of HIV testing patterns from a cohort of men who have sex with men. Acquir Immune Defic Syndr 2015; 69 460–5.
| "Seek, test, treat" lessons from Australia: a study of HIV testing patterns from a cohort of men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[21] Prestage G, Brown G, Keen P. Barriers to HIV testing among Australian gay men. Sex Health 2012; 9 453–8.
| Barriers to HIV testing among Australian gay men.Crossref | GoogleScholarGoogle Scholar |
[22] MacKellar DA, Hou SI, Whalen CC, Samuelsen K, Sanchez T, Smith A, Denson D, Lansky A, Sullivan P. Reasons for not HIV testing, testing intentions, and potential use of an over-the-counter rapid HIV test in an internet sample of men who have sex with men who have never tested for HIV. Sex Transm Dis 2011; 38 419–28.
| Reasons for not HIV testing, testing intentions, and potential use of an over-the-counter rapid HIV test in an internet sample of men who have sex with men who have never tested for HIV.Crossref | GoogleScholarGoogle Scholar |
[23] Zablotska I, Holt M, de Wit J, McKechnie M, Mao L, Prestage G. Gay men who are not getting tested for HIV. AIDS Behav 2012; 16 1887–94.
| Gay men who are not getting tested for HIV.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC38rosVyltA%3D%3D&md5=956ede6f689fb7dce7c039166589f4ecCAS |
[24] Prestage G, Ferris J, Grierson J, Thorpe R, Zablotska I, Imrie J, Smith A, Grulich AE. Homosexual men in Australia: population, distribution and HIV prevalence. Sex Health 2008; 5 97–102.
| Homosexual men in Australia: population, distribution and HIV prevalence.Crossref | GoogleScholarGoogle Scholar |
