Combination prevention and HIV: a cross-sectional community survey of gay and bisexual men in London, October to December 2016

Background Men who have sex with men (MSM) are at risk of HIV and are an important population to monitor and ameliorate combination prevention efforts. Aim To estimate HIV prevalence and identify factors associated with frequent HIV testing (≥ 2 HIV tests in the last year) and pre-exposure prophylaxis (PrEP) use among MSM in London. Methods For this cross-sectional study, MSM recruited from 22 social venues provided oral-fluid samples for anonymous HIV antibody (Ab) testing and completed a questionnaire. Factors associated with frequent HIV testing and PrEP use were identified through logistic regression. Results Of 767 men recruited, 545 provided an eligible oral specimen. Among these, 38 MSM (7.0%) were anti-HIV positive including five (13.2%; 5/38) who reported their status as negative. Condomless anal sex within the previous 3 months was reported by 60.1% (412/685) men. Frequent HIV testing was associated with, in the past year, a reported sexually transmitted infection (adjusted odds ratio (AOR): 5.05; 95% confidence interval (CI): 2.66–9.58) or ≥ 2 casual condomless partners (AOR 2–4 partners: 3.65 (95% CI: 1.87–7.10); AOR 5–10 partners: 3.34 (95% CI: 1.32–8.49). Age ≥ 35 years was related to less frequent HIV testing (AOR 35–44 years: 0.34 (95% CI: 0.16–0.72); AOR ≥ 45 years: 0.29 (95% CI: 0.12–0.69). PrEP use in the past year was reported by 6.2% (46/744) of MSM and associated with ≥ 2 casual condomless sex partners (AOR: 2.86; 95% CI: 1.17–6.98) or chemsex (AOR: 2.31; 95% CI: 1.09–4.91). Conclusion This bio-behavioural study of MSM found high rates of behaviours associated with increased risk of HIV transmission. Combination prevention, including frequent HIV testing and use of PrEP, remains crucial in London.

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Multi-Dimensional Factors Associated with Illegal Substance Use Among Gay and Bisexual Men in Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16224476 ◽

2019 ◽

Vol 16 (22) ◽

pp. 4476 ◽

Cited By ~ 5

Author(s):

Dian-Jeng Li ◽

Shiou-Lan Chen ◽

Cheng-Fang Yen

Keyword(s):

Substance Use ◽

Logistic Regression ◽

Early Adulthood ◽

Gay And Bisexual Men ◽

Stepwise Logistic Regression ◽

Childhood And Adolescence ◽

Bisexual Men ◽

Cross Sectional ◽

Factors Associated ◽

And Bisexual

Illegal substance use in sexual minorities is an important health issue worldwide. The present cross-sectional study aimed to investigate the multi-dimensional factors associated with illegal substance use among gay and bisexual men in Taiwan. This questionnaire-survey study recruited 500 gay or bisexual men aged between 20 and 25 years. Their experiences of using eight kinds of illegal substances in the preceding month were collected. Their previous experiences of homophobic bullying, satisfaction with academic performance, truancy, perceived family and peer support in childhood and adolescence, and social-demographic characteristics, were also collected. Potential factors associated with illegal substance use were identified using univariate logistic regression, and further selected into a forward stepwise logistic regression model to identify the factors most significantly related to illegal substance use. A total of 22 (4.4%) participants reported illegal substance use in the preceding month, and mean age was 22.9 ± 1.6. Forward stepwise logistic regression revealed that being victims of homophobic cyberbullying in childhood and adolescence (odds ratio (OR) = 1.26; p = 0.011), disclosure of sexual orientation at junior high school (OR = 4.67; p = 0.001), and missing classes or truancy in senior high school (OR = 2.52; p = 0.041) were significantly associated with illegal substance use in early adulthood. Multi-dimensional factors in childhood and adolescence that were significantly associated with illegal substance use in early adulthood among gay and bisexual men were identified. Besides traditional bullying, the effect of cyberbullying and school performance on illegal substance use should not be ignored. This study is limited to the cross-sectional design and possible recall bias. Mental health professionals must routinely assess these significant factors to prevent and intervene in illegal substance use among gay and bisexual men.

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Factors associated with recent HIV testing among younger gay and bisexual men in New Zealand, 2006-2011

BMC Public Health ◽

10.1186/1471-2458-14-294 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 9

Author(s):

Nathan J Lachowsky ◽

Peter JW Saxton ◽

Nigel P Dickson ◽

Anthony J Hughes ◽

Alastair JS Summerlee ◽

...

Keyword(s):

New Zealand ◽

Hiv Testing ◽

Gay And Bisexual Men ◽

Bisexual Men ◽

Factors Associated ◽

And Bisexual

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Which Gay and Bisexual Men Attend Community-Based HIV Testing Services in Australia? An Analysis of Cross-Sectional National Behavioural Surveillance Data

AIDS and Behavior ◽

10.1007/s10461-019-02435-6 ◽

2019 ◽

Vol 24 (2) ◽

pp. 387-394 ◽

Cited By ~ 1

Author(s):

Evelyn Lee ◽

Limin Mao ◽

Ben Bavinton ◽

Garrett Prestage ◽

Martin Holt

Keyword(s):

Hiv Testing ◽

Gay And Bisexual Men ◽

Surveillance Data ◽

Bisexual Men ◽

Community Based ◽

Cross Sectional ◽

Behavioural Surveillance ◽

Hiv Testing Services ◽

And Bisexual

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HIV testing self-efficacy is associated with higher HIV testing frequency and perceived likelihood to self-test among gay and bisexual men

Sexual Health ◽

10.1071/sh16100 ◽

2017 ◽

Vol 14 (2) ◽

pp. 170 ◽

Cited By ~ 4

Author(s):

Muhammad S. Jamil ◽

Rebecca J. Guy ◽

Benjamin R. Bavinton ◽

Christopher K. Fairley ◽

Andrew E. Grulich ◽

...

Keyword(s):

Hiv Testing ◽

Self Efficacy ◽

Gay And Bisexual Men ◽

Bisexual Men ◽

The Past ◽

Testing Frequency ◽

Self Testing ◽

The Future ◽

Self Test ◽

And Bisexual

Background Regular testing of individuals at higher-risk of HIV is central to current prevention strategies. The aim of the present study was to examine the extent to which confidence in one’s perceived ability to undertake various aspects of HIV testing and self-testing (self-efficacy) affected HIV testing outcomes. We assessed factors, including self-efficacy, associated with HIV testing frequency and the likelihood to self-test among gay and bisexual men (GBM). Methods: Participants were HIV-negative GBM at an increased risk of HIV (more than five partners or condomless anal intercourse in the previous 3 months) enrolled in a randomised controlled trial of HIV self-testing. The baseline questionnaire captured data regarding sociodemographic characteristics, HIV and/or sexually transmissible infection testing history, sexual behaviour, beliefs and attitudes towards HIV and eight items capturing confidence in HIV testing ability that were combined as a single broad measure of HIV testing self-efficacy (α = 0.81). Factors associated with three or more HIV tests in the past year and the likelihood of self-testing in the future were determined using logistic regression. Results: Of 354 GBM, 34% reported three or more HIV tests in the past year, and 64% reported being ‘very likely’ to self-test. Factors independently associated with three or more HIV tests in the past year were: higher self-efficacy (adjusted odds ratio (aOR) 1.08 per unit increase; 95% confidence interval (CI) 1.02–1.14; P = 0.004); >10 male partners in the past 6 months (aOR 1.79; 95% CI 1.05–3.04; P = 0.031) and higher optimism regarding the effects of HIV treatments on HIV transmission (aOR 1.14; 95% CI 1.00–1.29; P = 0.044). Only higher self-efficacy was independently associated with reporting a greater likelihood to self-test in the future (aOR 1.10; 95% CI 1.05–1.15; P < 0.001). Conclusions: Improving self-efficacy by enhancing GBM’s knowledge and experience may lead to higher testing frequency. The self-efficacy measure used in the present study could be useful in identifying GBM likely to face difficulties with HIV testing and self-testing.

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Previous and future use of HIV self-testing: a survey of Australian gay and bisexual men

Sexual Health ◽

10.1071/sh15099 ◽

2016 ◽

Vol 13 (1) ◽

pp. 55 ◽

Cited By ~ 9

Author(s):

Garrett Prestage ◽

Iryna Zablotska ◽

Ben Bavinton ◽

Andrew Grulich ◽

Phillip Keen ◽

...

Keyword(s):

Hiv Testing ◽

Gay And Bisexual Men ◽

Anal Intercourse ◽

Unprotected Anal Intercourse ◽

Bisexual Men ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Testing Procedures ◽

Self Testing ◽

And Bisexual

Background The awareness and previous and intended use of HIV self-testing (HST), and the associated factors, among Australian gay and bisexual men (GBM) was investigated. Methods: An online cross-sectional survey was conducted in Australia during 2012. Of 1410 respondents, 559 non-HIV-positive men answered questions about HST. Results: Men reported reasons for having avoided or delayed HIV testing, most of which could be broadly categorised as: the inconvenience of current testing procedures; concerns about privacy; and a belief that they had not done anything risky. Over one-third of men (39.7%) were aware that HST was available internationally, with 1.6% having accessed HST through online purchase. The majority of men in the study indicated that they would be ‘likely’ (36.5%) or ‘very likely’ (34.3%) to use HST if it was available in Australia. Also, 36.7% indicated they would test partners they met at sex-on-site venues, and 73.2% would test partners with whom they were already acquainted. Nearly half (47.6%) indicated that having the capacity to test themselves at home would likely increase their testing frequency. Men who had engaged in unprotected anal intercourse, who were not gay-identified, and who indicated inconvenience issues with using clinic-based HIV testing were more likely to indicate a willingness to use HST. Many men indicated they would be likely to offer HST to at least some of their sex partners. Conclusion: Many GBM who engage in HIV risk behaviours would appreciate HST, and may be encouraged to test more often, as it may alleviate their concerns about testing.

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Factors associated with reporting antibiotic use as STI prophylaxis among HIV PrEP users: findings from a cross-sectional online community survey, May–July 2019, UK

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054592 ◽

2020 ◽

pp. sextrans-2020-054592

Author(s):

Charlotte O'Halloran ◽

Sara Croxford ◽

Hamish Mohammed ◽

Owen Noel Gill ◽

Gwenda Hughes ◽

...

Keyword(s):

Drug Use ◽

Online Community ◽

Community Sample ◽

Antibiotic Use ◽

Bisexual Men ◽

Transmitted Infection ◽

Cross Sectional ◽

Sti Prevention ◽

Factors Associated ◽

The Past

ObjectivesThe use of antibiotics as pre-exposure or postexposure prophylaxis for sexually transmitted infection (STI) prevention (STI prophylaxis) is not currently recommended in the UK, but there is evidence that self-prescribing occurs among those at greatest risk. We present the prevalence and factors associated with STI prophylaxis among a community sample of HIV pre-exposure prophylaxis (PrEP) users.MethodsThe 2019 online PrEP User Survey ran between 17 May and 1 July. Eligible participants included UK residents reporting HIV PrEP use or having tried to obtain HIV PrEP since January 2017. STI prophylaxis use was defined as reporting buying antibiotics to prevent STIs, either privately or through the internet; this question was only asked to HIV PrEP users. Factors associated with STI prophylaxis use were assessed using univariable and multivariable logistic regression.ResultsOverall, 9% (167/1856) of HIV PrEP users reported STI prophylaxis use; 97% were gay or bisexual men, 84% reported white ethnicity, 55% resided in London and 69% were aged ≥35 years. Factors associated with STI prophylaxis included: reporting ≥5 compared with 1–4 condomless sex partners in the past 6 months (12% vs 5.6%, adjusted odds ratio (aOR)=1.80; 95% CI 1.22 to 2.64), reporting chemsex drug use compared with no sexualised drug use in the past 12 months (13% vs 6.0%, aOR=1.88; 95% CI 1.20 to 2.93) and reporting an STI diagnosis in the past 12 months (12% vs 6.6%, aOR=1.54; 95% CI 1.08 to 2.18). Variables not significant in multivariable analyses included: ethnicity, age, residence and HIV PrEP sourcing.ConclusionsApproximately 1 in 10 HIV PrEP users from this community sample reported self-prescribed STI prophylaxis. STI prophylaxis was associated with sexual behaviour known to facilitate STI transmission and with a history of recent STIs acquisition. Given the potential risk of antimicrobial resistance, sexual health clinicians should consider asking attendees, especially HIV PrEP users, about the use of antibiotics as STI prophylaxis, to inform appropriate counselling, testing and management.

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Intensive sex partying with gamma-hydroxybutyrate: factors associated with using gamma-hydroxybutyrate for chemsex among Australian gay and bisexual men – results from the Flux Study

Sexual Health ◽

10.1071/sh17146 ◽

2018 ◽

Vol 15 (2) ◽

pp. 123 ◽

Cited By ~ 9

Author(s):

Mohamed A. Hammoud ◽

Adam Bourne ◽

Lisa Maher ◽

Fengyi Jin ◽

Bridget Haire ◽

...

Keyword(s):

Social Engagement ◽

Risk Behaviour ◽

Gay And Bisexual Men ◽

Sexual Risk Behaviour ◽

Bisexual Men ◽

Factors Associated ◽

The Past ◽

Gamma Hydroxybutyrate ◽

And Bisexual ◽

Group Sex

Background Gamma-hydroxybutyrate (GHB) use among gay and bisexual men (GBM) has increased in recent years. It is commonly cited as a sexual-enhancement drug. There is, however, little evidence for factors associated with GHB use or the consequences of its use among GBM. Aim: Factors associated with GHB use, its relationship to sexual risk behaviour, and the contexts, consequences, and motivations for its use were examined. Methods: The Following Lives Undergoing Change (Flux) Study is an online prospective observational study of Australian GBM. At baseline, a total of 3190 GBM provided details about their use of GHB. Data on frequency, methods, pleasures and consequences of their drug use, alongside key demographic variables were collected. Results: Mean age was 35.0 years. One in five men (19.5%) had a history of GHB use and 5.4% reported use within the past 6 months, with 2.7% having used it monthly or more frequently. Overdose had been experienced by 14.7%, this was more common among men who used GHB at least monthly. Being HIV-positive, having more gay friends, greater social engagement with gay men who use drugs, a greater number of sexual partners, group sex, and condomless anal intercourse with casual partners were independently associated with GHB use in the past 6 months. Greater social engagement with gay men who use drugs and group sex were independently associated with at least monthly use. More frequent GHB use was independently associated with experiencing overdose among GHB users. Conclusion: Most men used GHB infrequently and it was often used explicitly to enhance sexual experiences, often in the context of intensive sex partying. Men who used GHB frequently, were at greater risk of overdose and other negative health outcomes. GHB use should be considered alongside other drugs that have been implicated in sexual risk behaviour and HIV transmission. Harm-reduction interventions need to consider the particular impact of frequent GHB use.

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Reasons why gay and other bisexually active men attend different community testing services in Sydney; a cross-sectional survey

Sexual Health ◽

10.1071/sh15079 ◽

2015 ◽

Vol 12 (5) ◽

pp. 465 ◽

Cited By ~ 1

Author(s):

Vickie Knight ◽

Timmy Lockwood ◽

Terry Walkinshaw ◽

Philip Keen ◽

Rebecca Guy ◽

...

Keyword(s):

Hiv Testing ◽

Scale Up ◽

Gay And Bisexual Men ◽

Bisexual Men ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Hiv Testing Services ◽

And Bisexual ◽

New Community ◽

Community Site

In 2013, two new community HIV testing services were implemented in Sydney, Australia, to increase testing options for gay men. Participants were asked to complete an 8-item questionnaire to select one primary and up to three secondary reasons for attending the testing service. Over one-third of gay and bisexual men (GBM) selected getting their HIV result at the same visit as the main reason they attended at both testing services (38% and 34%, respectively; P = 0.5). GBM at the Shopfront were more likely to say that the convenient location was the main reason they attended, compared with men at the Community site (15% vs 7%, P < 0.01). These findings can inform future scale-up of HIV testing in Sydney and other places.

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