Barriers to HIV testing among Australian gay men

Prestage, Garrett; Brown, Graham; Keen, Phillip

doi:10.1071/sh12033

Cited by 53 publications

(46 citation statements)

References 9 publications

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“…178,179 To improve access to STI and HIV testing for Australian MSM, strategies such as rapid HIV testing, information technology and the use of social media [180][181][182] should be fully utilised. The testing guidelines outlined in Table 1 aim to guide clinicians in their STI and HIV testing practice for MSM and provide an additional clinical tool to assist in reducing the community prevalence of STIs and HIV among Australian MSM.…”

Section: Resultsmentioning

confidence: 99%

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

et al. 2014

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Abstract.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.

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Section: Resultsmentioning

confidence: 99%

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

et al. 2014

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“…It is likely to require a substantial ongoing effort to further increase HIV testing uptake and frequency and address ongoing barriers, such as the fear and inconvenience of testing. [27][28][29][30] Since 2000, there have been substantial, positive changes in the uptake of HIV treatment and the proportion of Australian HIV-positive GBM with an undetectable viral load. Our data suggest that in 2015, Australia nearly reached the UNAIDS target of 90% of diagnosed, HIV-positive GBM being on treatment and that over 90% achieved viral suppression several years ago.…”

Section: Discussionmentioning

confidence: 99%

Adapting behavioural surveillance to antiretroviral-based HIV prevention: reviewing and anticipating trends in the Australian Gay Community Periodic Surveys

et al. 2017

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Abstract. Background:In Australia, the preventative use of antiretroviral drugs [pre-exposure prophylaxis (PrEP) and treatment as prevention] is being embraced to protect individuals at high risk of HIV and reduce onward transmission. Methods: The adaptation of a behavioural surveillance system, the Gay Community Periodic Surveys, was reviewed to monitor the uptake and effect of new prevention strategies in Australia's primary HIV-affected population (gay and bisexual men, GBM). The national trends in key indicators during 2000-15 were reviewed and a new measure to take account of antiretroviral-based prevention was developed. Results: Between 2000 and 2015, there were significant increases (P < 0.001) in annual HIV testing (56.1-64.8%), condomless sex with casual partners (26.8-38.8%) and the proportion of HIV-positive men on HIV treatment (72.5-88.4%) and with an undetectable viral load (73.7-94.7%). The proportion of casual partners who were HIV negative, not on PrEP and who engaged in receptive condomless sex also increased between 2000 and 2015 from 12.8 to 19.3%. Two scenarios anticipating the effect of PrEP highlighted the need to target GBM who engage in receptive condomless sex while also sustaining condom use at a population level. Conclusions: Behavioural surveillance can be successfully adapted to follow the effect of antiretroviral-based prevention. It is anticipated that HIV testing and HIV treatment will continue to increase among Australian GBM, but to prevent new infections, intervention in the growing proportion of GBM who have condomless sex with casual partners is needed. For PrEP to have its desired effect, condom use needs to be sustained.

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“…However, if rapid HIV testing (RHT) and other novel approaches to testing are adopted, this may reduce barriers to and increase acceptability of HIV testing, and may facilitate more frequent testing for high-risk populations [8,9]. In Australia, HIV testing has traditionally involved venipuncture specimen collection at a clinic with results provided 1 week later in person or by telephone [10]. Finding time to test, inconvenience and having to return for results are recognized barriers to more frequent HIV testing among MSM [10,11].…”

Section: Discussionmentioning

confidence: 99%

“…In Australia, HIV testing has traditionally involved venipuncture specimen collection at a clinic with results provided 1 week later in person or by telephone [10]. Finding time to test, inconvenience and having to return for results are recognized barriers to more frequent HIV testing among MSM [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Effect of testing experience and profession on provider acceptability of rapid HIV testing after implementation in public sexual health clinics in Sydney

et al. 2015

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ObjectivesRapid HIV testing (RHT) is well established in many countries, but it is new in Australia since a policy change in 2011. We assessed service provider acceptability of RHT before and after its implementation in four Sydney public sexual health clinics. MethodsService providers were surveyed immediately after training in RHT and again 6-12 months later. Differences in mean scores between survey rounds were assessed via t-tests, with stratification by profession and the number of tests performed. ResultsRHT was rated as highly acceptable among staff at baseline and acceptability scores improved between survey rounds. Belief in being sufficiently skilled and experienced to perform RHT (P = 0.004) and confidence in the delivery of nonreactive results increased (P = 0.007), while the belief that RHT was disruptive declined (P = 0.001). Acceptability was higher for staff who had performed a greater number of tests regarding comfort with their role in RHT (P = 0.004) and belief that patients were satisfied with RHT (P = 0.007). Compared with nurses, doctors had a stronger preference for a faster rapid test (P = 0.027) and were more likely to agree that RHT interfered with consultations (P = 0.014). ConclusionsDifferences in responses between professions may reflect differences in staff roles, the type of patients seen by staff and the model of testing used, all of which may affect the number of tests performed by staff. These findings may inform planning for how best to implement RHT in clinical services.Keywords: provider acceptability, rapid HIV testing, sexual health clinics, staff attitudes [6,7]. However, if rapid HIV testing (RHT) and other novel approaches to testing are adopted, this may reduce barriers to and increase acceptability of HIV testing, and may facilitate more frequent testing for high-risk populations [8,9]. In Australia, HIV testing has traditionally involved venipuncture specimen collection at a clinic with results provided 1 week later in person or by telephone [10]. Finding time to test, inconvenience and having to return for results are recognized barriers to more frequent HIV testing among MSM [10,11]. In contrast, RHT involves finger-prick blood or oral fluid specimen collection with results provided during the same visit, which may make testing more convenient. Barriers to implementing RHT reported among service providers include: lack of time [12,13]; lack of confidence in their own competency and skills and fear of delivering positive results [14,15]; concern regarding reliability and false positive results [16,17]; and perceiving RHT as too difficult for nonexperts [18].Although many studies have assessed acceptability of RHT in a variety of settings and patient groups, and among providers at various stages of implementation [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], few studies have assessed differences in acceptability between professions [29,30]. To our knowledge, no published studies have examined if the number of tests performed and experience o...

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Barriers to HIV testing among Australian gay men

Cited by 53 publications

References 9 publications

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

Adapting behavioural surveillance to antiretroviral-based HIV prevention: reviewing and anticipating trends in the Australian Gay Community Periodic Surveys

Effect of testing experience and profession on provider acceptability of rapid HIV testing after implementation in public sexual health clinics in Sydney

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