Incidence and predictors of HIV, chlamydia and gonorrhoea among men who have sex with men attending a peer-based clinic
Linda A. Selvey A E , Claudia Slimings B , Emma Adams C and Justin Manuel D
+ Author Affiliations
- Author Affiliations
A School of Public Health, The University of Queensland, Herston, Qld 4006, Australia.
B School of Medicine, Australian National University, Acton, ACT 2601, Australia.
C Telethon Kids Institute, Nedlands, WA 6009, Australia.
D M Clinic, Western Australian AIDS Council, West Perth, WA 6005, Australia.
E Corresponding author. Email: l.selvey@uq.edu.au
Sexual Health 15(5) 451-459 https://doi.org/10.1071/SH17181
Submitted: 22 September 2017 Accepted: 27 June 2018 Published: 21 September 2018
Abstract
Introduction: Despite a range of interventions, annual numbers of new diagnoses of HIV infection among men who have sex with men (MSM) in Australia have not declined in recent years. Peer-based sexual health clinics targeting MSM, such as the M Clinic in Perth (WA, Australia), have been put in place to provide safe sex counselling and to increase testing rates among MSM and who are at high risk of HIV infection. The aim of this study was to assess the incidence of HIV, chlamydia and gonorrhoea among men attending the M Clinic. Methods: This was a historical cohort study of repeated M Clinic clients from January 2011 to June 2015 inclusive. Testing and risk factor data from M Clinic client software were used to estimate the incidence of HIV, chlamydia and gonorrhoea and associated factors. Results: The incidence of HIV, chlamydia and gonorrhoea was 1.87, 13.58 and 6.48 per 100 person-years respectively. Older men had a higher incidence of HIV infection but a lower incidence of chlamydia and gonorrhoea than younger men. Conclusions: The HIV incidence was higher than found in similar studies in other Australian sexual health clinics, but the incidence of chlamydia and gonorrhoea was similar. The high HIV incidence among clients of the M Clinic points to the importance of making pre-exposure HIV prophylaxis available to clients of the M Clinic and similar services.
Additional keywords: Australia, cohort study, sexually transmissible infections.
References
[1] Feigin A, El-Hayek C, Hellard M, Pedrana A, Donnan E, Fairley C, Tee BK, Stoove M. Increases in newly acquired HIV infections in Victoria, Australia: epidemiological evidence of successful prevention? Sex Health 2013; 10 166–70.| Increases in newly acquired HIV infections in Victoria, Australia: epidemiological evidence of successful prevention?Crossref | GoogleScholarGoogle Scholar |
[2] Read TRH, Hocking J, Sinnott V, Hellard M. Risk factors for incident HIV infection in men having sex with men: a case-control study. Sex Health 2007; 4 35–9.
| Risk factors for incident HIV infection in men having sex with men: a case-control study.Crossref | GoogleScholarGoogle Scholar |
[3] Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2017. Sydney: Kirby Institute, UNSW Sydney 2017.
[4] Minas BC, Giele CM, Laing SC, Bastian L, Burry AW, Sales KJ, Mak DB. Early diagnosis of HIV among men who have sex with men in Western Australia: impact of a peer-led sexually transmissible infection testing service. Sex Health 2015; 12 360–3.
| Early diagnosis of HIV among men who have sex with men in Western Australia: impact of a peer-led sexually transmissible infection testing service.Crossref | GoogleScholarGoogle Scholar |
[5] Conway DP, Holt M, Couldwell DL, Smith DE, Davies SC, McNulty A, Keen P, Cunningham P, Guy R. Barriers to HIV testing and characteristics associated with never testing among gay and bisexual men attending sexual health clinics in Sydney. J Int AIDS Soc 2015; 18 20221
| Barriers to HIV testing and characteristics associated with never testing among gay and bisexual men attending sexual health clinics in Sydney.Crossref | GoogleScholarGoogle Scholar |
[6] Wand H, Guy R, Law M, Wilson DP, Maher L. High rates of late HIV diagnosis among people who inject drugs compared to men who have sex with men and heterosexual men and women in Australia. AIDS Behav 2013; 17 235–41.
| High rates of late HIV diagnosis among people who inject drugs compared to men who have sex with men and heterosexual men and women in Australia.Crossref | GoogleScholarGoogle Scholar |
[7] Cohen MS. HIV and sexually transmitted diseases: lethal synergy. Top HIV Med 2004; 12 104–7.
[8] Sullivan PS, Carballo-Diéguez 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 |
[9] 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 |
[10] Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS 2006; 20 1447–50.
| Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA.Crossref | GoogleScholarGoogle Scholar |
[11] Hall HI, Holtgrave DR, Maulsby C. HIV transmission rates from persons living with HIV who are aware and unaware of their infection. AIDS 2012; 26 893–6.
| HIV transmission rates from persons living with HIV who are aware and unaware of their infection.Crossref | GoogleScholarGoogle Scholar |
[12] Mayer KH, Vanderwarker R, Grasso C, Boswell SL. Emerging models of clinical services for men who have sex with men: focused versus comprehensive approaches. Sex Health 2017; 14 133–8.
| Emerging models of clinical services for men who have sex with men: focused versus comprehensive approaches.Crossref | GoogleScholarGoogle Scholar |
[13] Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, Wood AM, Carpenter JR. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ 2009; 338 b2393
| Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls.Crossref | GoogleScholarGoogle Scholar |
[14] Guy RJ, Wand H, Franklin N, Fairley CK, Chen MY, O’Connor CC, Marshall L, Grulich AE, Kaldor JM, Hellard ME, Donovan B, Access Collaboration Chlamydia trends in men who have sex with men attending sexual health services in Australia, 2004–2008. Sex Transm Dis 2011; 38 339–46.
| Chlamydia trends in men who have sex with men attending sexual health services in Australia, 2004–2008.Crossref | GoogleScholarGoogle Scholar |
[15] Lee E, Mao L, Creamer M, Laing S, Comfort J, Prestage G, Zablotska I, de Wit J, Holt M. Gay Community Periodic Survey: Perth 2016. Sydney: Centre for Social Research in Health, UNSW Australia; 2016.
[16] Race K, Lea T, Murphy D, Pienaar K. The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men. Sex Health 2017; 14 42–50.
| The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[17] Lea T, Mao LM, Hopwood M, Prestage G, Zablotska I, de Wit J, Holt M. Methamphetamine use among gay and bisexual men in Australia: Trends in recent and regular use from the Gay Community Periodic Surveys. Int J Drug Policy 2016; 29 66–72.
| Methamphetamine use among gay and bisexual men in Australia: Trends in recent and regular use from the Gay Community Periodic Surveys.Crossref | GoogleScholarGoogle Scholar |
[18] 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. J 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 |
[19] Cheung KT, Fairley CK, Read TR, Denham I, Fehler G, Bradshaw CS, Chen MY, Chow EP. HIV incidence and predictors of incident hiv among men who have sex with men attending a sexual health clinic in Melbourne, Australia. PLoS One 2016; 11 e0156160
| HIV incidence and predictors of incident hiv among men who have sex with men attending a sexual health clinic in Melbourne, Australia.Crossref | GoogleScholarGoogle Scholar |
[20] Marinelli T, Chow EP, Tomnay J, Fehler G, Bradshaw CS, Chen MY, Forcey DS, Fairley CK. Rate of repeat diagnoses in men who have sex with men for Chlamydia trachomatis and Neisseria gonorrhoeae: a retrospective cohort study. Sex Health 2015; 12 418–24.
| Rate of repeat diagnoses in men who have sex with men for Chlamydia trachomatis and Neisseria gonorrhoeae: a retrospective cohort study.Crossref | GoogleScholarGoogle Scholar |
[21] Wilkinson A, El-Hayek C, Fairley CK, Leslie D, Roth N, Tee BK, Hellard ME, Stoove M. Incidence and risk factors associated with chlamydia in men who have sex with men: a cohort analysis of Victorian Primary Care Network for Sentinel Surveillance data. Sex Transm Infect 2012; 88 319–24.
| Incidence and risk factors associated with chlamydia in men who have sex with men: a cohort analysis of Victorian Primary Care Network for Sentinel Surveillance data.Crossref | GoogleScholarGoogle Scholar |
[22] Chow EP, Tomnay J, Fehler G, Whiley D, Read TR, Denham I, Bradshaw CS, Chen MY, Fairley CK. Substantial increases in chlamydia and gonorrhea positivity unexplained by changes in individual-level sexual behaviors among men who have sex with men in an Australian sexual health service from 2007 to 2013. Sex Transm Dis 2015; 42 81–7.
| Substantial increases in chlamydia and gonorrhea positivity unexplained by changes in individual-level sexual behaviors among men who have sex with men in an Australian sexual health service from 2007 to 2013.Crossref | GoogleScholarGoogle Scholar |
[23] Lim MS, Goller JL, Guy R, Gold J, Stoove M, Hocking JS, Fairley CK, Henning D, McNamee K, Owen L, Sheehan P, Hellard ME. Correlates of Chlamydia trachomatis infection in a primary care sentinel surveillance network. Sex Health 2012; 9 247–53.
| Correlates of Chlamydia trachomatis infection in a primary care sentinel surveillance network.Crossref | GoogleScholarGoogle Scholar |
[24] Jin F, Grulich AE, Mao LM, Zablotska I, O’Dwyer M, Poynten M, Prestage GP. Sexual partner’s age as a risk factor for HIV seroconversion in a cohort of HIV-negative homosexual men in Sydney. AIDS Behav 2013; 17 2426–9.
| Sexual partner’s age as a risk factor for HIV seroconversion in a cohort of HIV-negative homosexual men in Sydney.Crossref | GoogleScholarGoogle Scholar |
