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 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.

scholarly journals The effective recruitment for high-risk MSM in the mobile HIV testing through social networking platforms (Preprint)

2020 ◽  
Author(s):  
Piao-Yi Chiou ◽  
Nai-Ying Ko ◽  
Chien-Yu Chien
Keyword(s):  
High Risk ◽  
Social Networking ◽  
Hiv Testing ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Control Group ◽  
Multiple Sexual Partners ◽  
Hiv Test ◽  
The Social ◽  
Sex With Men

BACKGROUND Social networking platforms could be the direct path to recruit high-risk men who have sex with men (MSM) and promote the delivery of voluntary counselling and testing (VCT) as mobile HIV testing (MHT). The structured client recruitment and availability of MHT through social networking platforms need to further evaluate its effectiveness. OBJECTIVE This research aimed to compare the effects of targeting high-risk MSM and HIV case finding between two MHT recruitment and approaches through the website and social networking platforms. METHODS Comparative study design and propensity score matching (PSM) was applied. Traditional VCT model, the control group, recruited MSM on a website and provided a walk-in testing station at a gay zone on Friday and Saturday nights. Social networking VCT mode, the experimental group, recruited MSM from social networking platforms applying the reloading into and online discussion function in dating applications (apps) and Facebook, and referrals to social networks by the mobile phone app, and provided a test at a designated time and place during weekdays. RESULTS A total of 857 MSM were recruited over six months; the completion rate was 8.56% (616/7200) in the traditional VCT model and 20.8% (215/1033) in the social networking VCT mode. After PSM, there were 215 MSM in each group with a mean age of 29.97 (SD=7.609). The social networking model was more likely to reach MSM with HIV risk behaviours: those seeking sex through social media, having multiple sexual partners and unprotected anal intercourse, an experience of recreational drug use, and never having or not regularly having an HIV test than the traditional model. HIV positive rates (IRR=3.395, 95% CI=1.089-10.584, p=0.026) and clinic referred rates (IRR=0.028, 95% CI=0.001-0.585, p=0.006) were significantly higher among those in the social networking VCT model than the traditional VCT model. CONCLUSIONS Through effective recruitment strategies on social networking platforms, the social networking VCT mode can be smoothly promoted compared to traditional VCT model to target high-risk MSM and promote testing outcomes.

Australian men's sexual practices in saunas, sex clubs and other male sex on premises venues

Sexual Health ◽  
2010 ◽  
Vol 7 (2) ◽  
pp. 186 ◽  
Author(s):  
Anthony Lyons ◽  
Anthony M. A. Smith ◽  
Jeffrey W. Grierson ◽  
Henry von Doussa
Keyword(s):  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Sexual Practices ◽  
Anal Sex ◽  
Sexually Transmissible Infections ◽  
Younger Men ◽  
Receptive Anal Sex ◽  
Risky Sexual Practices ◽  
Sexual Encounters ◽  
Sex With Men

Background: Sex on premises venues (SOPVs) where men have sex with men have been implicated in the spread of sexually transmissible infections, but few studies have described men’s sexual encounters in SOPVs, particularly the degree to which men from different backgrounds engage in risky sexual practices. Methods: Interviewer administered surveys were conducted with 186 Australian men who have sex with men (MSM) within 48 h of visiting an SOPV. They reported their sexual practices, the characteristics of their partners and other circumstances surrounding their sexual encounters. Results: All analyses were based on the number of sexual encounters (n = 430). Oral sex was the most common practice, occurring in 74.9% of encounters, followed by massage, frottage or kissing (53.7%), solo or mutual masturbation (36.3%), and anal sex (32.1%). Multivariate analyses revealed age as a significant factor for having protected anal sex (P = 0.001), insertive anal sex (P = 0.004) and receptive anal sex (P < 0.001). These practices were more frequent in encounters among younger men, while masturbation (P = 0.03) was more frequent among older men. When men’s sexual partners were affected by alcohol, encounters were less likely to involve unprotected anal intercourse (P = 0.006) and more likely to involve massage, frottage or kissing (P = 0.009). Men disclosed their HIV status in only 7.7% of encounters. Conclusions: With the likelihood of risky sexual practices varying according to background, results from this study should be used to guide interventions aiming to promote safer sex in SOPVs.

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.

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 Barebacking among men who have sex with men recruited through a Swedish website: associations with sexual activities at last sexual encounter

2013 ◽  
Vol 18 (13) ◽  
Author(s):  
R C Berg ◽  
R Tikkanen ◽  
M W Ross
Keyword(s):  
Multivariate Logistic Regression Analysis ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
The United States ◽  
Sexual Practices ◽  
Sexual Encounter ◽  
Sexual Activities ◽  
Increased Risk ◽  
Sex With Men ◽  
Group Sex

The research topic of barebacking emerged in the mid-1990s. Since then, a multitude of studies, largely from the United States, have produced invaluable knowledge of factors that help explain the behaviour among men who have sex with men (MSM), and that may contribute to HIV risk reduction programming and advice to counsellors working with barebackers. Given the scant empirical research about barebacking among European MSM, we conducted a survey among 3,634 MSM recruited through a web community in Nordic countries. The objectives of the study were twofold: to describe the sexual activities associated with barebacking behaviour at last sexual encounter, and to evaluate the relationship of barebacking with relevant variables. Men who reported barebacking (n=356) and men who did not (n=3,278) were compared. On the basis of the results of the analyses, the socio-sexual profile of barebackers drawn was one that is at increased risk of acquiring human immunodeficiency virus (HIV) and other sexually transmitted infections due to their sexual practices, particularly unprotected anal intercourse, but also group sex and rimming. In a multivariate logistic regression analysis, the likelihood of engaging in barebacking was higher for MSM who reported more frequent HIV testing (odds ratio (OR)=5.16), a higher number of female sex partners (OR=16.80), using gay cruising places (OR=1.51) and gay chat rooms (OR=2.11).

scholarly journals Willingness to Take a Free Home HIV Test and Associated Factors among Internet-Using Men Who Have Sex with Men

2011 ◽  
Vol 10 (6) ◽  
pp. 357-364 ◽  
Author(s):  
Akshay Sharma ◽  
Patrick S. Sullivan ◽  
Christine M. Khosropour
Keyword(s):  
Hiv Prevention ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Hiv Status ◽  
Prevention Study ◽  
Home Test ◽  
Home Testing ◽  
Hiv Test ◽  
Prevention Studies ◽  
Sex With Men

Objectives: Online HIV prevention studies have been limited in their ability to obtain biological specimens to measure study outcomes. We describe factors associated with willingness of men who have sex with men (MSM) to take a free home HIV test as part of an online HIV prevention study. Methods: Between March and April 2009, we interviewed 6163 HIV-negative MSM and assessed the willingness to test for HIV infection using a home collection kit. Results: Men reported being very likely (3833; 62%) or likely (1236; 20%) to accept a home HIV test as part of an online HIV prevention study. The odds of being willing to home test were higher for men who were offered incentives of $10 or $25, were black, had unprotected anal intercourse in the past 12 months, and were unaware of their HIV status. Conclusions: Home testing offered as part of online HIV prevention research is acceptable overall and in important subgroups of high-risk MSM.

Characteristics of gay, bisexual and other men who have sex with men testing and retesting at Australia’s first shop-front rapid point-of-care HIV testing service

Sexual Health ◽  
2016 ◽  
Vol 13 (6) ◽  
pp. 560 ◽  
Author(s):  
Kathleen E. Ryan ◽  
Anna L. Wilkinson ◽  
David Leitinger ◽  
Carol El-Hayek ◽  
Claire Ryan ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Point Of Care ◽  
First Year ◽  
Testing Service ◽  
Testing Frequency ◽  
Hiv Test ◽  
Recent Group ◽  
Sex With Men ◽  
Using Data ◽  
Group Sex

Background: HIV rapid point-of-care (RPOC) testing was approved in Australia in 2012 prompting new testing models. We describe gay, bisexual and other men who have sex with men (GBM) testing in the first year of operations at Australia’s first shop-front, community-based RPOC testing service, PRONTO!, and characterise return testers and first-time testers. Methods: Univariable and multivariable logistic regression using data collected at clients’ first test at PRONTO! from 15 August 2013 to 14 August 2014 examined correlates of: 1) return-testing within 6 months of GBMs first test at PRONTO!; and 2) reporting a first ever HIV test at PRONTO!. Results: In the first year, 1226 GBM tested at PRONTO! (median age = 30.4 years, 60.2% Australian born). Condomless anal sex with casual or regular partners was reported by 45% and 66% of GBM, respectively. Almost one-quarter (23%) of GBM returned within 6 months of their first test. Return-testing was associated with being born overseas (adjusted odds ratio (AOR) = 1.48, 95% confidence interval (CI) = 1.10–2.0), reporting a regular check-up as reason to test (AOR = 1.53, 95% CI = 1.01–2.30) and reporting a HIV test in the 6 months before first testing at PRONTO! (AOR = 1.73, 95% CI = 1.09–2.73). Reporting first testing at PRONTO! (17.9%) was positively associated with younger age (<30 years; AOR = 1.78, 95% CI = 1.18–2.71) and negatively associated with reporting a regular check-up as reason to test (AOR = 0.45, 95% CI = 0.29–0.71) and recent group sex (AOR = 0.37, 95% CI = 0.23–0.59). Conclusion: Despite PRONTO! being designed to reduce barriers to HIV testing, return testing rates in the first year were low and not associated with client risk. Service refinements, including the provision of comprehensive sexually transmissible infection testing, are needed to increase testing frequency and enhance population HIV prevention benefits.

Screening for chlamydia and gonorrhoea in men who have sex with men in clinical and non-clinical settings

Sexual Health ◽  
2006 ◽  
Vol 3 (2) ◽  
pp. 123 ◽  
Author(s):  
Marian J. Currie ◽  
Sarah J. Martin ◽  
Tuck Meng Soo ◽  
Francis J. Bowden
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Outreach Program ◽  
Published Data ◽  
Clinical Settings ◽  
Anatomical Site ◽  
Test Results ◽  
Sex With Men

Background: There are few published data on the rate of chlamydia and gonorrhoea infection in men who have sex with men (MSM). Our aim was to determine the rate of positive chlamydia and gonorrhoea tests in this population in the Australian Capital Territory (ACT). Methods: Results of all chlamydia and gonorrhoea tests generated by Canberra Sexual Health Centre between June 2001 and September 2003, including those from outreach clinics, were reviewed (audit one). Between September 2003 and April 2004, Canberra Sexual Health Centre outreach program staff and a general practitioner with a high caseload of MSM offered screening of the throat, urethra and rectum to all MSM, irrespective of their reported participation in unprotected anal intercourse. Chlamydia and gonorrhoea test results generated during this period were reviewed (audit two). Results: In the first audit, 1086 specimens from 314 individuals were tested and 30/314 (9.6%, 95% CI 6.6–13.4) men were positive for chlamydia in one or more anatomical site. A total of 306 specimens from 118 individuals were tested for gonorrhoea. Of these, eight (6.8%, 95% CI 3.0–12.9) individuals tested positive. In the second audit, 16 of 157 men (10.2%, 95% CI 9.5–16.0) tested positive for chlamydia and 4/155 (2.6%, 95% CI 0.7–6.5) tested positive for gonorrhoea. The rectum was the most commonly infected anatomical site for both infections. The overall proportions of positive chlamydia and gonorrhoea tests were 36/471 (7.6%, 95% CI 5.4–10.4) and 12/273 (4.4%, 95% CI 2.2–7.6) respectively. Conclusions: These data, collected in a range of settings, indicate high rates of chlamydia and gonorrhoea in MSM in the ACT and provide support for annual testing, particularly of the rectum, in this population.

Correlates of recent HIV testing among substance-using men who have sex with men

2016 ◽  
Vol 28 (6) ◽  
pp. 594-601 ◽  
Author(s):  
Christopher Rowe ◽  
Tim Matheson ◽  
Moupali Das ◽  
Erin DeMicco ◽  
Jeffrey H Herbst ◽  
...  
Keyword(s):  
Substance Use ◽  
Hiv Testing ◽  
San Francisco ◽  
Multivariable Analysis ◽  
Anal Intercourse ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hiv Test ◽  
Condomless Anal Intercourse ◽  
Sex With Men

Men who have sex with men are disproportionately impacted by HIV and substance use is a key driver of HIV risk and transmission among this population. We conducted a cross-sectional survey of 3242 HIV-negative substance-using men who have sex with men aged 18 + in the San Francisco Bay Area from March 2009 to May 2012. Demographic characteristics and sexual risk and substance use behaviors in the last six months were collected using structured telephone questionnaires. We used multivariable logistic regression to identify independent demographic and behavioral predictors of recent HIV testing. In all, 65% reported having an HIV test in the last six months. In multivariable analysis, increasing age (aOR = 0.87, 95% CI = 0.84–0.90) and drinking alcohol (<1 drink/day: 0.65, 0.46–0.92; 2–3 drinks/day: 0.64, 0.45–0.91; 4 + drinks/day: 0.52, 0.35–0.78) were negatively associated with recent HIV testing. Having two or more condomless anal intercourse partners (2.17, 1.69–2.79) was positively associated with having a recent HIV test, whereas condomless anal intercourse with serodiscordant partners was not significantly associated with testing. Older men who have sex with men and those who drink alcohol may benefit from specific targeting in efforts to expand HIV testing. Inherently riskier discordant serostatus of partners is not as significant a motivator of HIV testing as condomless anal intercourse in general.

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