The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000–2009

Holt, Martin; Lee, Evelyn; Prestage, Garrett; Zablotska, Iryna; Wit, John de; Mao, Limin

doi:10.1080/09540121.2012.686598

Cited by 33 publications

(38 citation statements)

References 29 publications

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“…The switch to mobile phone apps as the primary way to find partners (at the expense of gay venues, particularly sex venues) and a greater focus on serial monogamy (rather than non-exclusive relationships) may be contributing factors. 18,38 This is an area worthy of further research. The decline in partner numbers should have contributed to a reduced likelihood of transmission, but (as noted above) annual HIV notifications have not declined.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 This differs from other jurisdictions (such as the United States) in which sex between regular or steady male partners has been reported as the main source of infections. 15 As in other high income countries, 16,17 since the late 1990s, Australia has seen a gradual but steady increase in the proportion of GBM reporting condomless anal intercourse with casual partners, 18,19 and the number of annual HIV diagnoses has also increased, returning to levels not seen since the early 1990s. 11 In 1999, there were 718 new HIV diagnoses in Australia, 73% of which occurred as a result of homosexual sex.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

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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“…3,4,20 The NSW MSM population is also experiencing increases in other STIs, [21][22][23] highlighting the challenge of STI control in this group. 24 With increasing practice of HIV risk-reduction behaviours, 25,26 rates of condom use with casual partners may continue to decline and be accompanied by further increases in STIs. This underscores the importance of regular and frequent asymptomatic STI testing among MSM, as recommended in national guidelines.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of gonorrhoea cases notified in inner and south-western Sydney, Australia: results of population-based enhanced surveillance

et al. 2016

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Abstract. Background: Gonorrhoea disproportionately affects young people and men who have sex with men (MSM). In Australia, the highest notification rates in urban areas occur in MSM, although characteristics of those infected are poorly described. Enhanced surveillance can provide population-based data to inform service delivery and health promotion activities. Methods: An enhanced surveillance and data collection form was sent to the ordering doctor for residents of Sydney and South Western Sydney Local Health Districts with positive gonorrhoea results notified between 1 August 2013 and 28 February 2014. Results: Questionnaires were sent for 777 notifications and 698 (89.8%) were returned. Eighty-five per cent (n = 594) were male. The majority (55.1%) resided in inner city Sydney. Of these, 91.9% were male, and 70.8% of these identified as MSM. Among females, regular partners were the most likely source of infection (44.1%), while MSM and heterosexual men identified casual partners as the likely source of infection (75.4% and 61.1% respectively). General practitioners diagnosed 60.5% of cases. MSM were more commonly diagnosed by sexual health clinics. Females were most commonly tested for contact tracing (35.6%), heterosexual males because of symptoms (86.3%), and MSM as part of sexually transmissible infection screening (40.6%). Conclusions: Our population-based analysis identified differing risk factors and testing characteristics between MSM, heterosexual males and females. Increasing rates of gonorrhoea and concerns over antibiotic resistance highlight the importance of obtaining accurate sexual histories to ensure appropriate testing. Intermittent enhanced surveillance can monitor trends in specific populations and help determine the impact of health promotion strategies.

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“…37,38 In Sydney (NSW, Australia), although only 52.4% of HIV-positive men reported taking ART in 2000, 39 this number had increased to 90.7% by 2015. 40 Thus, most known serodiscordant couples are likely to have low HIV transmission risk due to ART.…”

Section: Discussionmentioning

confidence: 99%

How partnership type and HIV seroconcordance affect HIV transmission risk in regular sexual partnerships: a cross-sectional survey of Australian gay and bisexual men

et al. 2017

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Abstract. Background: Regular sexual partnerships among gay and bisexual men (GBM) who practice condomless anal intercourse (CLAI) have not been well characterised in terms of partnership type, HIV seroconcordance and risk of HIV transmission. Primarily sexual regular partnerships, although commonly reported by gay men, have largely been ignored in research and HIV prevention. Among regular partners reporting CLAI with each other, we determined factors differentiating romantic or committed relationships from partnerships organised primarily around sex ('fuckbuddies') and estimated the proportion of CLAI presenting risk for HIV transmission. Methods: An online, cross-sectional survey of Australian GBM was conducted. Univariate and multivariate generalised estimating equations were used to determine statistical associations. Results: Men reported on 2250 regular sexual partnerships. Over half the partnerships were romantic or committed relationships. Over half the partnerships were HIV-negative seroconcordant (54.9%), 3.1% were HIV-positive seroconcordant, 5.2% were serodiscordant and 36.8% were of unknown seroconcordance. Potential risks presented by CLAI were sometimes mitigated by protective factors, such as having a clear spoken agreement about sex with outside partners, having fewer outside partners, openly discussing HIV risk and having an agreement to reduce risk from outside partners. These protective factors were more often found in romantic or committed relationships than among primarily sexual partnerships, and were less often found in partnerships of unknown seroconcordance. Conclusion: CLAI is more common among regular sexual partnerships considered to be of a romantic, committed nature. However, factors associated with such romantic or committed partnerships can also protect against HIV transmission risk. Unknown seroconcordance, particularly lack of communication about HIV status among primarily sexual partnerships, is a key risk factor that needs to be addressed by HIV education.Additional keywords: HIV prevention, men who have sex with men, relationships.

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The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000–2009

Cited by 33 publications

References 29 publications

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

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

Characteristics of gonorrhoea cases notified in inner and south-western Sydney, Australia: results of population-based enhanced surveillance

How partnership type and HIV seroconcordance affect HIV transmission risk in regular sexual partnerships: a cross-sectional survey of Australian gay and bisexual men

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