A new surveillance system for monitoring HIV infection in Victoria, Australia

Sexual Health ◽  
2007 ◽  
Vol 4 (3) ◽  
pp. 195 ◽  
Author(s):  
Rebecca Guy ◽  
Megan S. C. Lim ◽  
Yung-Hsuan J. Wang ◽  
Nicholas Medland ◽  
Jonathan Anderson ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Surveillance System ◽  
Risk Behaviour ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Hiv Positive ◽  
Sexual Risk Behaviour ◽  
Hiv Diagnosis ◽  
Hiv Test

Objectives: To establish a new mechanism for monitoring patterns of HIV infection, in the context of a sustained increase in HIV diagnosis among men who have sex with men (MSM) in Victoria. Methods: Between April 2004 and August 2005, a linked voluntary HIV sentinel surveillance system was implemented at five medical clinics with a high case load of MSM. Using a questionnaire, doctors collected HIV testing history, demographic and sexual risk behaviour information from all clients undergoing voluntary HIV testing. Questionnaires were linked with HIV test results. Logistic regression analysis was conducted to determine factors associated with HIV infection. Results: Of 3435 MSM tested for HIV at participating sites, 1.7%, (95% CI = 1.2–2.2) were newly diagnosed with HIV; between 2004 and 2005 the proportion increased from 1.3% (95% CI = 1.2–1.5) to 2.0% (95% CI = 1.8–2.2), P = 0.107. There was no significant change in the number of HIV tests conducted per month or in demographic characteristics, testing history and sexual behaviour characteristics between time periods. In multivariate analysis, reporting unprotected anal intercourse (UAI) with any partner, UAI with a HIV-positive partner/s and being aged 30–39 years or 40 years or greater were significantly associated with HIV infection. Conclusion: This new surveillance mechanism, based on linked testing at participating clinics, indicates that the increase in HIV notifications in 2005 was unrelated to changes in testing and data from a Melbourne sexual behavioural survey suggests the increase was more likely to be attributed to increases in transmission within the past few years. The sentinel system highlighted UAI, especially with HIV positive partner/s are important transmission factors.

Prevalence and correlates of HIV testing among college students: an exploratory study

Sexual Health ◽  
2005 ◽  
Vol 2 (1) ◽  
pp. 19 ◽  
Author(s):  
Richard A. Crosby ◽  
Kim H. Miller ◽  
Ruth R. Staten ◽  
Melody Noland
Keyword(s):  
College Students ◽  
At Risk ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Exploratory Study ◽  
Sexual Debut ◽  
Sexual Risk Behaviour ◽  
Cross Sectional Survey ◽  
Hiv Test ◽  
Vaginal Sex

Objectives: Whether college students who are most at-risk of HIV infection are being tested is unknown. This exploratory study identified the prevalence and correlates of ever having an HIV test among college students. Methods: A cross-sectional survey was conducted among a probability sample of 903 college students. Measures of sexual risk behaviour were assessed. Results: Of the students surveyed, 22.5% reported they had been tested for HIV. Testing was more likely among those 20 years of age or older (27.8% v. 14.7%; P = 0.0001), females (25.4% v. 17.8%; P = 0.01), and members of racial/ethnic minorities (42.7% v. 20.3%; P = 0.0001). After adjusting for these covariates, those who reported ever having vaginal sex (AOR = 5.5; 95% CI = 3.1–9.6); anal sex (AOR = 2.4; 95% CI = 1.6–3.6), and oral sex (AOR = 6.3; 95% CI = 3.0–13.3) were significantly more likely to report being tested. Students having vaginal sex in the past 12 months were significantly more likely to report testing (AOR = 5.3; 95% CI = 3.1–9.1). Those reporting vaginal sexual debut (AOR = 1.9; 95% CI = 1.2–3.1) or oral sexual debut (AOR = 1.7; 95% CI = 1.1–2.5) ≤age 15 were significantly more likely to be tested. Students reporting four or more sex partners were significantly more likely to be tested than sexually experienced students reporting fewer partners (AOR = 3.2; 95% CI = 2.2–4.6). Finally, those reporting at least one episode of forced vaginal sex (AOR = 3.9; 95% CI = 2.1–7.2) and reporting at least one episode of any forced sex (vaginal, anal, oral) (AOR = 3.0; 95% CI = 1.8–5.0) were significantly more likely to report being tested. Conclusions: Within this population, demographically controlled findings suggest that those most at-risk of HIV infection are indeed being tested for the virus.

scholarly journals Post-test comparison of HIV test knowledge and changes in sexual risk behaviour between clients accessing HIV testing online versus in-clinic

2019 ◽  
Vol 95 (2) ◽  
pp. 102-107 ◽  
Author(s):  
Travis Salway ◽  
Kimberly Thomson ◽  
Darlene Taylor ◽  
Devon Haag ◽  
Elizabeth Elliot ◽  
...  
Keyword(s):  
Sexual Health ◽  
Condom Use ◽  
Hiv Testing ◽  
Sexual Risk ◽  
Risk Behaviour ◽  
Health Clinic ◽  
Sexual Risk Behaviour ◽  
Missed Opportunities ◽  
Hiv Test ◽  
Post Test

ObjectiveInternet-based HIV testing offers the potential to address privacy-related barriers to testing and increase frequency of testing but may result in missed opportunities related to sexual health education and prevention that typically occur in face-to-face encounters. In this study, we assessed the HIV test knowledge and sexual risk behaviour of clients testing for HIV through GetCheckedOnline, an internet-based sexually transmitted and bloodborne infection testing platform inclusive of HIV testing, in comparison to clients testing through a large sexual health clinic.MethodsWe concurrently recruited GetCheckedOnline clients and clinic clients from Vancouver, Canada, over the course of a 10-month period during 2015–2016. Participants completed baseline and 3-month questionnaires, anonymous and online. A six-item score was used to estimate knowledge of HIV test concepts typically conveyed during an HIV pretest encounter in a clinic. We used multiple regression to estimate associations between testing modality (online vs clinic based) and two outcomes—HIV test knowledge and change in condom use pre/post-test—with adjustment for relevant background factors.ResultsAmong 352 participants, online testers demonstrated higher HIV post-test knowledge than clinic-based testers (mean score 4.65/6 vs 4.09/6; p<0.05); this difference was reduced in adjusted analysis (p>0.05). Men who have sex with men, clients with a university degree, those who have lived in Canada >10 years and English speakers had higher HIV post-test knowledge (p<0.05). Eighteen per cent of online testers and 10% of clinic-based testers increased condom use during the 3 months post-test (p>0.05).ConclusionsIn this comparative study between online and clinic-based testers, we found no evidence of decreased HIV test knowledge or decreased condom use following HIV testing through GetCheckedOnline. Our findings suggest that with careful design and attention to educational content, online testing services may not lead to missed opportunities for HIV education and counselling.

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

Sexual Health ◽  
2015 ◽  
Vol 12 (5) ◽  
pp. 373 ◽  
Author(s):  
An-Chieh Lin ◽  
Christopher K. Fairley ◽  
Krishneel Dutt ◽  
Karen M. Klassen ◽  
Marcus Y. Chen ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Paradigm Shift ◽  
Point Of Care ◽  
Health Centre ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Sexual Practices ◽  
Hiv Test ◽  
Sex With Men ◽  
First Time

Background Increasing the frequency of HIV testing in men who have sex with men (MSM) will reduce the incidence of HIV. Trends in HIV testing among MSM in Melbourne, Australia over the last 11 years have been investigated. Methods: A retrospective study was conducted using electronic medical records of the first presentation of MSM who attended the Melbourne Sexual Health Centre between 2003 and 2013. Factors associated with HIV testing (year, demographic characteristics and sexual practices) were examined in multivariable logistic regression analyses. Jonckheere–Terpstra tests were used to examine the significance of trends in the mean time since the last HIV test. Results: Of 17 578 MSM seen; 13 489 attended for the first time during the study period. The proportion of first attendances who had previously tested and reported a HIV test in the last 12 months increased from 43.6% in 2003 to 56.9% in 2013 (adjusted ptrend = 0.030), with a corresponding decrease in median time since the last HIV test from 19 months [interquartile range (IQR) 6–42] in 2003 to 10 months (IQR4–24) in 2013 (ptrend <0.001). The proportion of high-risk MSM (who reported unprotected anal intercourse and/or >20 partners in 12 months) who reported an HIV test in the last 12 months was unchanged (ptrend = 0.242). Conclusions: Despite HIV testing becoming more frequent, the magnitude of change over the last decade is insufficient to substantially reduce HIV incidence. A paradigm shift is required to remove barriers to testing through strategies such as point-of-care rapid testing or access to testing without seeing a clinician.

scholarly journals Findings from within-subjects comparisons of drug use and sexual risk behaviour in men who have sex with men in England

2016 ◽  
Vol 28 (3) ◽  
pp. 250-258 ◽  
Author(s):  
GJ Melendez-Torres ◽  
Ford Hickson ◽  
David Reid ◽  
Peter Weatherburn ◽  
Chris Bonell
Keyword(s):  
Drug Use ◽  
Online Survey ◽  
Multilevel Models ◽  
Risk Behaviour ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Social Contexts ◽  
Sexual Risk Behaviour ◽  
Within Subjects ◽  
Sex With Men

Epidemiological evidence for the encounter-level association between sexualised drug use and unprotected anal intercourse in men who have sex with men is unclear and has not examined men who have sex with men in England. To estimate this association, we compared dyadic sexual encounters within respondents. We used encounter-level data from a longitudinal online survey of men who have sex with men living in England and multilevel models to test univariate and multivariate associations between any respondent or partner drug use, specific respondent drug use, additional situational characteristics and unprotected anal intercourse. Based on 6742 encounters from 2142 men who have sex with men, respondent drug use and respondent use of certain specific drugs were associated with increased unprotected anal intercourse odds. In univariate models, partner drug use was associated with increased unprotected anal intercourse odds, but in multivariate models, only non-specific knowledge of partner drug use was associated with the same. Encounters with non-regular-and-steady partners or that were not HIV-seroconcordant were associated with decreased unprotected anal intercourse odds. This is the first within-subjects comparison of drug use and unprotected anal intercourse conducted on a sample from England, and the largest of its kind. Findings are consistent with other studies, though associations between drug use and unprotected anal intercourse are shaped by social contexts that may change over time.

scholarly journals Are there any differences between different testing sites? A cross-sectional study of a Norwegian low-threshold HIV testing service for men who have sex with men

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017598 ◽  
Author(s):  
Bera Ulstein Moseng ◽  
Vegar Bjørnshagen
Keyword(s):  
Hiv Testing ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Testing Service ◽  
Hiv Test ◽  
Low Threshold ◽  
Sex With Men

ObjectiveTo describe a Norwegian low-threshold HIV testing service targeting men who have sex with men (MSM).Design and settingAfter the HIV testing consultation, all users of the HIV testing service were invited to answer the study questionnaire. The study setting included the sites where testing was performed, that is, the testing service’s office in Oslo, cruising areas, bars/clubs and in hotels in other Norwegian cities.ParticipantsMSM users of the testing service.Primary and secondary outcome measuresData were collected on demographics, HIV testing and sexual behaviour as well as the participant’s motivations for choosing to take an HIV test at this low-threshold HIV testing service. The data are stratified by testing site.Results1577 HIV testing consultations were performed, the study sample consisted of 732 MSM users. 11 tested positive for HIV. 21.7% had a non-western background, 27.1% reported having a non-gay sexual orientation. 21.9% had 10 or more male sexual partners during the last year, 27.9% reported also having had a female sexual partner. 56.4% reported having practised unprotected anal intercourse during the last 6 months. 20.1% had never tested for HIV before. Most of these user characteristics varied by testing sites.ConclusionsThe Norwegian low-threshold testing service recruits target groups that are otherwise hard to reach with HIV testing. This may indicate that the testing service contributes to increase HIV testing rates among MSM in Norway.

Gay men who engage in substance use and sexual risk behaviour: a dual-risk group with unique characteristics

2008 ◽  
Vol 19 (10) ◽  
pp. 698-703 ◽  
Author(s):  
Z Mor ◽  
U Davidovich ◽  
M Mcfarlane ◽  
G Feldshtein ◽  
D Chemtob
Keyword(s):  
Substance Use ◽  
Hiv Transmission ◽  
Risk Group ◽  
Risk Behaviour ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Sexual Risk Behaviour ◽  
Lower Education ◽  
Sex With Men ◽  
First Time

‘Recreational’ substances used among men having sex with men, and their association with risky unprotected anal intercourse (RUAI) were examined – for the first time in Israel – in an internet-based questionnaire assessing knowledge, practices and motivation. Between March and May 2005, 2873 participants completed the entire questionnaire. Of the total, 669 (23%) reported RUAI during the last six months, and 1319 (46%) used substances during sex. Use of substance was significantly higher among those performing RUAI than those who did not (31.5% versus 26.4%, P = 0.03). Involvement in both substance use and RUAI was reported by 366 participants (13%). HIV rates were higher in this dual-risk group ( P < 0.01), and individuals reported more partners in the last six months than those not part of this dual risk (11.6 versus 8.2, P = 0.02). In multivariate analyses, Tel-Aviv residency, lower education, performing receptive RUAI, misperception of HIV transmission and limited negotiation skills were positively associated with this dual-risk behaviour.

scholarly journals Using repeated home-based HIV testing services to reach and diagnose HIV infection among persons who have never tested for HIV, Chókwè health demographic surveillance system, Chókwè district, Mozambique, 2014–2017

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242281
Author(s):  
Carol Lin ◽  
Isabelle Casavant ◽  
Alicia Jaramillo ◽  
Timothy Green
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Surveillance System ◽  
Hiv Prevalence ◽  
Demographic Surveillance System ◽  
Hiv Positive ◽  
Home Based ◽  
Testing Uptake ◽  
Hiv Testing Services ◽  
Testing Coverage

Background HIV prevalence in Mozambique (12.6%) is one of the highest in the world, yet ~40% of people living with HIV (PLHIV) do not know their HIV status. Strategies to increase HIV testing uptake and diagnosis among PLHIV are urgently needed. Home-based HIV testing services (HBHTS) have been evaluated primarily as a 1-time campaign strategy. Little is known about the potential of repeating HBHTS to diagnose HIV infection among persons who have never been tested (NTs), nor about factors/reasons associated with never testing in a generalized epidemic setting. Methods During 2014–2017, counselors visited all households annually in the Chókwè Health and Demographic Surveillance System (CHDSS) and offered HBHTS. Cross-sectional surveys were administered to randomly selected 10% or 20% samples of CHDSS households with participants aged 15–59 years before HBHTS were conducted during the visit. Descriptive statistics and logistic regression were used to assess the proportion of NTs, factors/reasons associated with never having been tested, HBHTS acceptance, and HIV-positive diagnosis among NTs. Results The proportion of NTs decreased from 25% (95% confidence interval [CI]:23%–26%) during 2014 to 12% (95% CI:11% –13%), 7% (95% CI:6%–8%), and 7% (95% CI:6%–8%) during 2015, 2016, and 2017, respectively. Adolescent boys and girls and adult men were more likely than adult women to be NTs. In each of the four years, the majority of NTs (87%–90%) accepted HBHTS. HIV-positive yield among NTs subsequently accepting HBHTS was highest (13%, 95% CI:10%–15%) during 2014 and gradually reduced to 11% (95% CI:8%–15%), 9% (95% CI:6%–12%), and 2% (95% CI:0%–4%) during 2015, 2016, and 2017, respectively. Conclusions Repeated HBHTS was helpful in increasing HIV testing coverage and identifying PLHIV in Chókwè. In high HIV-prevalence settings with low testing coverage, repeated HBHTS can be considered to increase HIV testing uptake and diagnosis among NTs.

Barriers to HIV testing among Australian gay men

Sexual Health ◽  
2012 ◽  
Vol 9 (5) ◽  
pp. 453 ◽  
Author(s):  
Garrett Prestage ◽  
Graham Brown ◽  
Phillip Keen
Keyword(s):  
Hiv Testing ◽  
Gay Men ◽  
Online Survey ◽  
Point Of Care ◽  
Anal Intercourse ◽  
Hiv Positive ◽  
Hiv Diagnosis ◽  
Increased Risk ◽  
To Receive ◽  
Hiv Positive Men

Objective To investigate the barriers to HIV testing among Australian gay men. Methods: An online survey was conducted to explore reasons for avoiding and delaying testing for HIV; 519 non-HIV-positive men completed the online survey. Results: Most non-HIV-positive men (92.9%) had been tested for HIV, with 75.4% indicating they had been tested in the previous year. The most common reasons for avoiding or delaying testing were a belief that they had not done anything risky (41.2%) and the need to return for a second clinic visit to receive results (40.3%). Among men who engaged in unprotected anal intercourse with casual partners (UAIC), those who had not been recently tested were more likely to cite the lack of any symptoms as reasons for not having tested (adjusted odds ratio: 2.34; 95% confidence interval: 1.03–5.31; P = 0.041). Conclusions: For men who do not engage in risky sex, the decision not to test is probably reasonable, but those who engage in noncondom-based risk reduction may be at some increased risk and should be encouraged to test relatively often. Changes to Australia’s national HIV testing policy may ameliorate some of the need to return for second clinic visits to receive results, but the policy still requires full implementation, including the introduction of rapid point-of-care HIV testing to Australia. Among men who engage in UAIC, there appears to be a particular need for information about the benefits of early treatment after HIV diagnosis and about the relative likelihood of experiencing HIV seroconversion illness.

scholarly journals Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050133
Author(s):  
Li Wei Ang ◽  
Matthias Paul Han Sim Toh ◽  
Irving Charles Boudville ◽  
Chen Seong Wong ◽  
Sophia Archuleta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Heterosexual Transmission ◽  
Hiv Positive ◽  
Multivariable Logistic Regression Analysis ◽  
Targeted Prevention ◽  
Hiv Diagnosis ◽  
Factors Associated ◽  
Epidemiological Factors

ObjectiveTo assess the temporal trend and identify risk factors associated with the absence of previous HIV testing prior to their diagnosis among HIV-positive persons in Singapore.Study designCross-sectional.Setting and participantsWe analysed data of HIV-positive persons infected via sexual transmission, who were notified to the National HIV Registry in 2012–2017.OutcomesEpidemiological factors associated with the absence of HIV testing prior to diagnosis were determined separately for two groups of HIV-positive persons: early and late stages of HIV infection at diagnosis.Results2188 HIV-positive persons with information on HIV testing history and CD4 cell count were included in the study. The median age at HIV diagnosis was 40 years (IQR 30–51). Nearly half (45.1%) had never been tested for HIV prior to their diagnosis. The most common reason cited for no previous HIV testing was ‘not necessary to test’ (73.7%). The proportion diagnosed at late-stage HIV infection was significantly higher among HIV-positive persons who had never been tested for HIV (63.9%) compared with those who had undergone previous HIV tests (29.0%). Common risk factors associated with no previous HIV testing in multivariable logistic regression analysis stratified by stage of HIV infection were: older age at HIV diagnosis, lower educational level, detection via medical care and HIV infection via heterosexual transmission. In the stratified analysis for persons diagnosed at early-stage of HIV infection, in addition to the four risk factors, women and those of Malay ethnicity were also less likely to have previous HIV testing prior to their diagnosis.ConclusionTargeted prevention efforts and strategies are needed to raise the level of awareness of HIV/AIDS and to encourage early and regular screening among the at-risk groups by making HIV testing more accessible.

scholarly journals Symptomatic primary HIV infection in a 49-year-old man who has sex with men: beware of the window phase

2009 ◽  
Vol 14 (48) ◽  
Author(s):  
H E van Oosten ◽  
M Damen ◽  
H JC de Vries
Keyword(s):  
Hiv Infection ◽  
Healthcare Providers ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Large Contribution ◽  
Hiv Diagnosis ◽  
Primary Hiv Infection ◽  
History Of ◽  
P24 Antigen ◽  
Sex With Men

A 49-year-old man with a history of receptive unprotected anal intercourse with multiple anonymous men presented with a symptomatic primary HIV infection. Upon his initial visit the rapid HIV antibody screening test was negative but a p24 antigen test suggested a highly infectious phase in the HIV infection. An immunoblot assay confirmed the HIV diagnosis only 14 days later. Recent infections are characterised by a highly infectious phase and, if gone unnoticed, can have a large contribution to the ongoing transmission of HIV. Healthcare providers should be aware of primary HIV infection and the pitfalls in its diagnosis.

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