Increasing HIV diagnoses in Australia among men who have sex with men correlated with the growing number not taking antiretroviral therapy

Abstract

Abstract. Background: Australia has experienced rising notifications of HIV diagnoses despite widely available combination antiretroviral therapy (CART). New HIV diagnoses have also been younger than the average age of those living with HIV. We investigated the degree to which several risk factors could explain this rise in notifications and the younger age profile. Methods: Numbers and ages of men who have sex with men (MSM) living with HIV in Australia from 1983 to 2007 were calculated from notifications of HIV diagnoses and deaths. We compared the trend over time as well as the average ages of MSM newly diagnosed with HIV infection from 1998 to 2007 with those for: notifications of gonorrhoea and syphilis, total MSM living with HIV infection, and the component not on CART. Results: The percentage of younger MSM not taking CART has increased since 1998 (aged <30 years P < 0.001; 30-39 years P = 0.004). The trend of new HIV diagnoses was most significantly correlated with the total number of MSM living with HIV infection and the sector not taking CART (P < 0.0001). Based on similarity of average ages, MSM living with HIV infection and not taking CART was the best predictor of the increasing trend in new HIV diagnoses (99.9999% probability, Akaike information criterion). Conclusions: Our analyses suggest MSM living with HIV infection and not taking CART could be the source of the increase in HIV infections. Consequently, greater CART enrolment should decrease HIV incidence, especially in younger MSM.

HIV Treatment as Prevention: The Utility and Limitations of Ecological Observation

“…The comparative lack of reports investigating the ecological effects of population-level ART in settings where rising incidence rates have been detected [84],[85] suggests potential publication bias. It is also noteworthy that ecological studies of ART for HIV prevention are almost exclusively from developed western settings, likely because of the limited availability of surveillance data, viral load measurements, or registry data in resource-constrained settings.…”

Risk Factors of HIV Co-Infection and Sexual Behaviours in Patients with Gonococcal Infection in a STI′s Clinic in Madrid

“…This increase in the number of gonococcal infections is in line with the increase of gonococcal infections reported in Spain and in other European countries in the last years [14][15][16]. Various factors could have influenced this phenomenon, including 1) the impact of highly active antiretroviral therapies (HAART) on high-risk sexual behaviours, which has minimised the perception of STI transmission and associated morbidity burden and thereby reduced safe sexual behaviours [17], and 2) the possible increase of population of MSM [18].…”

Innovative uses of communication technology for HIV programming for men who have sex with men and transgender persons

“…Millett and colleagues [ 10 ] found black MSM more likely to be HIV positive and less likely to initiate antiretroviral therapy when compared to other MSM, despite being more likely to report HIV prevention behaviour. Additionally, the UK [ 11 ], Western Europe [ 2 ], Australia [ 12 ] and sub-Saharan Africa [ 13 ] have all seen increases in HIV incidence among MSM in the past few years.…”