Improvements in transition times through the HIV cascade of care among gay and bisexual men with a new HIV diagnosis in New South Wales and Victoria, Australia (2012–19): a longitudinal cohort study

Rates of drug use remain substantially higher among gay and bisexual men (GBM) and people living with HIV (PLHIV) in Sydney, New South Wales, Australia. The use of drugs to enhance sexual pleasure within cultures of Party and Play creates opportunities to discuss sexual health, mental health, consent and wellbeing. Community organisations with a history of HIV prevention, care, treatment are well-placed to respond. ACON’s (formerly the AIDS Council of New South Wales) multi-dimensional response to ‘chemsex’ includes: direct client services support for individuals seeking to manage or reduce their use; health promotion activities that support peer education; partnerships with research institutions to better understand cultures of chemsex; and policy submissions that call for drug use to be approached as a health, rather than a criminal, issue. The approach speaks the language of Party and Play subcultures; employs culturally relevant terminology and imagery; uses content designed, created and delivered by peers; and operates within a pleasure-positive, harm-reduction and community-led framework. These interventions have led to increased service uptake, strong community engagement, robust research partnerships and the recognition of GBM as a priority population in relevant strategies.

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Substantial increase in yield of Neisseria gonorrhoeae testing 2008–2013 at a Sydney metropolitan sexual health clinic: an observational study

Sexual Health ◽

10.1071/sh17080 ◽

2018 ◽

Vol 15 (1) ◽

pp. 79

Author(s):

Preethi Rajagopal ◽

Sian L. Goddard ◽

David J. Templeton

Keyword(s):

Sexual Health ◽

Sex Workers ◽

New South ◽

Gay And Bisexual Men ◽

Health Clinic ◽

Bisexual Men ◽

South Wales ◽

And Bisexual ◽

Generalised Estimating Equations ◽

Hiv Negative

Background A substantial increase in gonorrhoea notifications in New South Wales has been observed in recent years. Methods: We assessed yield of testing and characteristics of those diagnosed with gonorrhoea from January 2008 to December 2013 at RPA Sexual Health in the inner-west of Sydney. Yield was defined as the proportion of testing occasions which were positive for gonorrhoea. Generalised estimating equations were used to calculate trends in yield over time. Results: During the 6-year study period, 6456 individuals (4308 males, 2124 females, 24 transgender individuals) were tested on 12 799 occasions; this included 2441 gay and bisexual men (GBM) who were tested on 6945 occasions. Over the study period there was a significant increase in testing at genital, anorectal and pharyngeal sites (P-trend <0.001 for all). In total, gonorrhoea was detected on 668 testing occasions among 536 individuals (5.2%). Overall, 254/12765 (2.0%) of genital tests, 251/7326 (3.4%) of anorectal tests and 342/8252 (4.1%) of pharyngeal tests were positive. There was a significant increase in overall gonorrhoea yield from 2.2% in 2008 to 7.1% in 2013 (P-trend <0.001). This temporal increase in gonorrhoea yield was observed in heterosexual males (P < 0.001), heterosexual females (P-trend = 0.008), female sex workers (P-trend = 0.006), HIV-positive GBM and HIV-negative GBM (both P < 0.001) and at all anatomical sites (P-trend <0.001 for all). Conclusions: From 2008 to 2013, we observed a greater than threefold increase in yield of gonorrhoea testing disproportionately affecting GBM, although the increase also occurred in other subpopulations and at all anatomic sites. More frequent and comprehensive testing could potentially reduce the high and increasing community prevalence of gonorrhoea.

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Effect of an express testing service for gay and bisexual men on HIV testing frequency in Sydney, Australia: a cohort study

Sexual Health ◽

10.1071/sh18083 ◽

2019 ◽

Author(s):

Vickie Knight ◽

Rebecca Guy ◽

Anna McNulty ◽

Handan Wand

Keyword(s):

Cohort Study ◽

Hiv Testing ◽

Gay And Bisexual Men ◽

Bisexual Men ◽

Testing Service ◽

Testing Frequency ◽

And Bisexual ◽

Sydney Australia

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Relationship cognitions and longitudinal trajectories of sexual risk behavior among young gay and bisexual men: The P18 cohort study

Journal of Health Psychology ◽

10.1177/1359105316671187 ◽

2016 ◽

Vol 23 (14) ◽

pp. 1884-1894

Author(s):

Stephanie H Cook ◽

Perry N Halkitis ◽

Farzana Kapadia

Keyword(s):

Cohort Study ◽

Risk Behavior ◽

Sexual Risk ◽

Romantic Relationship ◽

Emerging Adult ◽

Gay And Bisexual Men ◽

Bisexual Men ◽

Anal Sex ◽

Condomless Anal Sex ◽

And Bisexual

This study examines how romantic relationship cognitions are associated with changes of condomless anal sex among emerging adult gay and bisexual men. The sample was drawn from four waves of a prospective cohort study ( N = 598; Mage = 18.2). Results suggest that condomless anal sex increased over the emerging adulthood period. Romantic relationship fear was associated with increased receptive condomless anal sex. Perceptions of greater romantic relationship control increased the likelihood of having insertive and receptive condomless anal sex. Findings suggest that romantic relationship cognitions are important to consider when understanding longitudinal changes in condomless anal sex in this population.

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Homosexual men in Australia: population, distributionand HIV prevalence

Sexual Health ◽

10.1071/sh07080 ◽

2008 ◽

Vol 5 (2) ◽

pp. 97 ◽

Cited By ~ 65

Author(s):

Garrett Prestage ◽

Jason Ferris ◽

Jeffrey Grierson ◽

Rachel Thorpe ◽

Iryna Zablotska ◽

...

Keyword(s):

New South ◽

Population Based ◽

Hiv Prevalence ◽

Hiv And Aids ◽

Estimation Methods ◽

Homosexual Men ◽

Bisexual Men ◽

Gay Community ◽

South Wales ◽

And Bisexual

Objectives: To assess the size, distribution and changes in the population of homosexual and bisexual men in Australia, and the capacity of available measures to make this estimation. Methods: We used data from five sources: the Australian Study of Health and Relationships, the Gay Community Periodic Surveys, HIV Futures, the Health in Men cohort study, the Australian National HIV and AIDS Registries and the Australian Household Census. Results: We estimated that in 2001 there were ~74 000 homosexual and bisexual men in New South Wales (NSW), ~42 000 in Victoria and ~37 000 in Queensland. There was, however, some discrepancy between datasets in the estimates of the overall proportions and distribution of homosexual and bisexual men across states. We also estimated HIV prevalence rates among homosexual and bisexual men in 2001 at ~8% in NSW, 5% in Victoria and 4% in Queensland. There were insufficient data to estimate whether the state-specific populations of homosexual men were changing with time. Conclusion: There are ~75% more homosexual and bisexual men in NSW than in Victoria and about twice as many as in Queensland. There are about two-thirds as many HIV-positive men in NSW as in Victoria and Queensland combined. Improved collection of population-based data on homosexuality are required.

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An update on the performance of STI services for gay and bisexual men across European cities: results from the 2017 European MSM Internet Survey

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054681 ◽

2020 ◽

pp. sextrans-2020-054681

Author(s):

Jason Doran ◽

Peter Weatherburn ◽

Ford Hickson ◽

Ulrich Marcus ◽

David Reid ◽

...

Keyword(s):

Diagnostic Procedures ◽

Gay And Bisexual Men ◽

Internet Survey ◽

Bisexual Men ◽

Hiv Diagnosis ◽

East Europe ◽

Logistic Regression Models ◽

European Cities ◽

South East Europe ◽

And Bisexual

ObjectivesRectal STIs compromise health and are common in men who have sex with men (MSM). However, the European-MSM-Internet-Survey (EMIS-2010) showed that in 2010, the prevalence of anal swabbing during STI screening by MSM varied widely across 40 European cities. In this paper, we replicate a variety of measures of STI testing performance using 2017–18 data and extending the geographic spread of the analysis.MethodsData were analysed from the EMIS-2017, a 33-language online sexual health survey accessible from 18 October 2017 to 31 January 2018. We focus on a subsample of 38 439 respondents living in the same 40 European cities we reported on in 2010. For a broader perspective, we also included an additional 65 cities in the analysis (combined n=56 661). We compared the prevalence of STI screening in MSM and disclosure of same-sex sexual contacts to the healthcare provider. We applied multivariable logistic regression models to compare the odds of MSM receiving each of four diagnostic procedures, including anal swabbing in the previous 12 months, controlling for age, HIV diagnosis, pre-exposure prophylaxis use and number of sexual partners.ResultsIn 2017, across 40 European cities, the proportion of respondents screened for STIs ranged from under 19% in Belgrade to over 59% in London. At an individual level, in comparison to London, the adjusted OR (AOR) of having received anal swabbing ranged from 0.03 in Belgrade, Bucharest and Istanbul to 0.80 in Oslo, with little evidence for a difference in Amsterdam and Dublin. Since 2010, most cities in West and South-west Europe have substantially narrowed their performance gap with London, but some in East and South-east Europe have seen the gap increase.ConclusionsAlthough comprehensive STI screening in MSM has expanded across many European cities, the low prevalence of anal swabbing indicates that rectal STIs continue to be underdiagnosed, particularly in East/South-east Europe.

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