Early diagnosis of HIV among men who have sex with men in Western Australia: impact of a peer-led sexually transmissible infection testing service

Sexual Health ◽  
2015 ◽  
Vol 12 (4) ◽  
pp. 360 ◽  
Author(s):  
Byron C. Minas ◽  
Carolien M. Giele ◽  
Sue C. Laing ◽  
Lisa Bastian ◽  
Andrew W. Burry ◽  
...  

Background In July 2010, the Western Australian AIDS Council established the ‘M Clinic’, a peer-led STI testing service for MSM. This study describes trends in HIV notifications among MSM in WA from 2004 to 2013, particularly the impact of the M Clinic on newly acquired HIV diagnoses. Methods: The number and proportion of MSM HIV cases with newly acquired infection were compared for the 2004–2006, 2007–2009 and 2011–2013 time periods. Data from 2010 were excluded as the M Clinic opened in July 2010. Results: Between the 2004–2006 and 2007–2009 periods, the number of MSM with newly acquired HIV increased by 50% (23 to 33 cases) and the number of newly acquired cases as a proportion of all new HIV diagnoses among MSM increased from 27% to 35% (30% increase) (P = 0.25). In the 2011–2013 period, the number of newly acquired HIV cases among MSM more than doubled to 70 cases and comprised 53% of all new HIV diagnoses among MSM (P < 0.05). Of the 70 newly acquired HIV cases in the 2011–2013 period, 30% (n = 21) were diagnosed at the M Clinic. Conclusions: The proportion of MSM HIV notifications that were newly acquired increased between 2004 and 2013 in WA, with the greatest increase seen after the M Clinic commenced operation. A peer-led approach to HIV testing should be considered in order to achieve early diagnosis and treatment of HIV among MSM.

Sexual Health ◽  
2013 ◽  
Vol 10 (4) ◽  
pp. 363 ◽  
Author(s):  
Guoyu Tao ◽  
Karen W. Hoover

Background Men who have sex with men (MSM) experience disparities in access to healthcare and have specific healthcare needs. Methods: We analysed data from the 2006–10 National Survey of Family Growth (NSFG) to examine differences in access to healthcare and HIV and sexually transmissible infection (STI) related health services by MSM and non-MSM among men in the United States aged 15–44 years who have ever had sex. MSM and sexually active MSM were identified in the NSFG as men who had ever had oral or anal sex with another man, or who had sex in the past 12 months with another man, respectively. Access was measured by the type of health insurance, having a usual place for receiving healthcare and type of usual place. Results: Of men aged 15–44 years who have ever had sex, there were no significant differences between MSM and non-MSM in the three access measures. MSM were more likely than non-MSM to receive HIV counselling (22.5% v. 8.3%) and STI testing (26.2% v. 15.6%) in the past 12 months, or to ever have had HIV testing (67.8% v. 44.6%). STI testing in the past 12 months was reported by 38.7% of sexually active MSM. Conclusion: Our findings show no significant differences in access to healthcare between MSM and non-MSM. MSM were more likely to receive HIV- and STI-related preventive services than non-MSM. However, the low STI testing rate among MSM highlights the need for interventions to increase STI testing, and HIV and STI counselling for MSM.


Sexual Health ◽  
2018 ◽  
Vol 15 (4) ◽  
pp. 325 ◽  
Author(s):  
Carmen H. Logie ◽  
Kathleen S. Kenny ◽  
Ashley Lacombe-Duncan ◽  
Ying Wang ◽  
Kandasi Levermore ◽  
...  

Background Men who have sex with men (MSM) are at elevated risk for sexually transmissible infection (STI) acquisition globally. Yet, limited research has explored STI testing practices among MSM in contexts where same-sex practices are criminalised, such as in Jamaica. Methods: A cross-sectional, tablet-based survey with MSM in Kingston, Ocho Rios and Montego Bay, Jamaica, was conducted. Multivariable logistic regression analyses were conducted to determine the adjusted risk ratio for lifetime STI testing and lifetime STI diagnosis. Multinomial logistic regression analyses were conducted to determine the relative odds of having had an STI test 3–5 months ago and 6–12 months ago in comparison with <3 months ago. Results: Three-quarters (74.8%) of the 556 participants reported receiving an STI test (44% <3 months ago; 32% 3–5 months ago; 13% 6–12 months ago; 10% >12 months ago); 12.1% reported ever receiving an STI diagnosis. In adjusted multivariable analyses, STI testing was associated with sociodemographic (education, location), individual (depression, perceived risk), social (relationship status, sexual stigma) and structural (healthcare provider access) factors. In multinomial analysis, reporting a less recent STI test (>3 months ago) versus <3 months ago was associated with increased likelihood of sexual stigma and food insecurity. Lifetime STI diagnosis was associated with sociodemographic (location), individual (HIV infection) and social (lower social support) factors. Conclusions: Findings document associations between structural factors and delayed timing of STI testing. Further research is necessary to explore how to address social ecological factors in sexual health interventions with MSM in Jamaica.


Sexual Health ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 96
Author(s):  
David J. Templeton ◽  
Phillipe C. G. Adam ◽  
Rajesh Varma ◽  
Phillip Read ◽  
Chistopher Bourne ◽  
...  

The Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men were updated in 2014. An evaluation study targeting Sydney-based general practitioners was conducted among 85 clinicians. Respondents with knowledge of guideline recommendations were significantly more likely to feel comfortable asking men who have sex with men about their sexual history (98.1% vs 81.3%, P = 0.039), and to recommend at least annual testing (94.0% vs 68.8%, P = 0.015), 3-month retesting after chlamydia or gonorrhoea treatment (96.2% vs 73.3%, P = 0.017) and syphilis testing with routine HIV monitoring bloods (90.2% vs 57.1%, P = 0.037). Familiarity with the guidelines was associated with a range of positive outcomes on general practitioners’ clinical practice. Novel approaches are required to ensure more widespread distribution of future guidelines.


Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 273 ◽  
Author(s):  
Sara K. Head ◽  
Richard A. Crosby ◽  
Lydia A. Shrier ◽  
Gregory R. Moore

Background: This exploratory study investigated young women’s perceptions of sexually transmissible infection (STI) testing received during gynaecological care. Correlates of the incorrect perception that STI testing occurred were assessed. Methods: Cross-sectional study of sexually active young women, age 18–24 years, attending a university healthcare setting for gynaecological care (n = 109). Two hundred and four women were approached and 87 were ineligible; of the remaining 117, 93.2% chose to enrol. Results: Of the women enrolled, 25.7% falsely perceived that they were STI tested (labelled ‘clean and clear’). Only approximately one in seven (14.7%) accurately understood the STI for which they were tested. In multivariate analyses, controlling for race, STI symptoms, depression, number of lifetime visits to the gynaecologist, and suspicion of current STI, three variables were significant: minority race (adjusted odds ratio (AOR) = 4.84, confidence interval (CI) = 1.38–16.96, P = 0.01), earlier age at sexual debut (AOR = 4.67, CI = 1.73–12.57, P = 0.002), and previous STI diagnosis (AOR = 3.38, CI = 1.07–10.66, P = 0.04). Comment: The findings suggest that many young women may have an inaccurate understanding of the STI testing they undergo during gynaecological care and may operate under the misperception they are ‘clean and clear’ of STI. Women with said misperception were more likely to be of minority race and report relatively earlier age of sexual debut and previous STI diagnosis. Further investigation is warranted to determine whether the ‘clean and clear’ misperception influences young women’s sexual risk behaviour.


Sexual Health ◽  
2007 ◽  
Vol 4 (1) ◽  
pp. 75 ◽  
Author(s):  
Danielle Esler ◽  
Catriona Ooi

Australian guidelines for sexual history taking and sexually transmissible infection (STI) screening of HIV-positive patients do not exist. An audit was conducted to assess current practices of sexual history taking and STI testing of HIV-positive patients attending Hunter New England Sexual Health Unit.


Sexual Health ◽  
2014 ◽  
Vol 11 (3) ◽  
pp. 217 ◽  
Author(s):  
David J. Templeton ◽  
Phillip Read ◽  
Rajesh Varma ◽  
Christopher Bourne

Men who have sex with men (MSM) in Australia and overseas are disproportionately affected by sexually transmissible infections (STIs), including HIV. Many STIs are asymptomatic, so regular testing and management of asymptomatic MSM remains an important component of effective control. We reviewed articles from January 2009–May 2013 to inform the 2014 update of the 2010 Australian testing guidelines for asymptomatic MSM. Key changes include: a recommendation for pharyngeal chlamydia (Chlamydia trachomatis) testing, use of nucleic acid amplification tests alone for gonorrhoea (Neisseria gonorrhoeae) testing (without gonococcal culture), more frequent (up to four times a year) gonorrhoea and chlamydia testing in sexually active HIV-positive MSM, time required since last void for chlamydia first-void urine collection specified at 20 min, urethral meatal swab as an alternative to first-void urine for urethral chlamydia testing, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.


Sexual Health ◽  
2014 ◽  
Vol 11 (6) ◽  
pp. 592
Author(s):  
Christina A. Muzny ◽  
Richa Kapil ◽  
Erika L. Austin ◽  
Edward W. Hook ◽  
William M. Geisler

Background Sexually transmissible infection (STI) history, prevalence and seroprevalence among lifetime exclusive women who have sex with women (WSW) and an age-matched group of women who have sex with women and men (WSWM) was evaluated. Methods: Participants completed a study questionnaire and had genital specimens and sera collected for STI testing. Results: Twenty-one lifetime exclusive WSW and 42 WSWM were included. WSWM were more likely to report a history of prior STIs and be seropositive for chlamydia and HSV-2. Prevalent STIs were less common among WSW. Conclusions: While lifetime exclusive WSW are at risk of contracting STIs, WSWM are disproportionally affected. Healthcare providers should consider routine STI screening among WSW.


2020 ◽  
pp. sextrans-2020-054623
Author(s):  
Rayner Kay Jin Tan ◽  
Yin Ying Chan ◽  
Muhamad Alif Bin Ibrahim ◽  
Lai Peng Ho ◽  
Oliver Zikai Lim ◽  
...  

ObjectivesThis study draws on qualitative insights on the barriers and facilitators to HIV testing, as well as perceptions of HIV self-testing (HIVST), to propose a framework to understand not only the benefits but also potential knock-on implications of introducing HIVST in the context of other STI testing.MethodsWe conducted semistructured, in-depth interviews with 30 gay, bisexual and other men who have sex with men aged 18 and 39 years old in Singapore. Interview topics included barriers and facilitators to HIV and other STI testing, as well as perceptions of HIVST. Interviews were audio-recorded, transcribed, coded and analysed using thematic analysis.ResultsFor HIV testing, participants cited the perceived risk of acquiring, susceptibility to and symptoms of HIV as internal motivators, while social influence and accessibility of HIV testing services were external motivators. For STI testing, perceived symptoms and partner notification of STI were reported as internal and external motivators, respectively. Availability of bundle tests, starting a new relationship and instances of mandatory testing motivated both simultaneous HIV and other STI testing. The fear of a positive diagnosis and lack of confidentiality were cited as internal and external barriers to HIV testing, respectively, while low perceived severity of other STI and the cost of STI tests were cited as internal and external barriers to other STI testing, respectively. We identified pathways to HIV and other STI testing and discussed how the introduction of HIVST may reduce opportunities for other STI testing.ConclusionsThe findings of this study suggest that introducing HIVST might weaken linkages to other STI testing if alternative strategies of promoting other STI testing are not simultaneously implemented. We recommend that future interventions address both the risks of HIV and other STI simultaneously, and that structural interventions promoting HIV and other STI preventions be balanced accordingly.


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