Lastest Gay Community Periodic Survey for Adelaide released

Centre for Social Research in Health, UNSW, June 2019

Gay Community Periodic Survey: Adelaide 2018

Authors: Broady, T., Mao, L., Bavinton, B., Jeffries, D., Bartlett, S., Calabretto, H., Narciso, L., Prestage, G., & Holt.

The Adelaide Gay Community Periodic Survey is a cross-sectional survey of gay and homosexually active men recruited at a range of gay community sites in Adelaide, and online throughout South Australia. The major aim of the survey is to provide data on sexual, drug use, and testing practices related to the transmission of HIV and other sexually transmissible infections (STIs) among gay men. The most recent survey, the twelfth in South Australia, was conducted in November and December 2018 to coincide with the Adelaide Feast Festival.

Key points

– The proportion of men who reported ever having been tested for HIV increased from 83% in 2011 to 87% in 2018.

– The percentage of non-HIV-positive men who reported testing for HIV in the 12 months prior to the survey remained stable (and was reported by 71% in 2018), although the percentage reporting three or more HIV tests in the previous year increased (from 11% in 2014 to 22% in 2018).

– The use of HIV treatment by HIV-positive men has remained stable over time (and was reported by 93% of HIV-positive men in 2018). The percentage of men on antiretroviral treatment who reported an undetectable viral load also remained stable (reported by 94% in 2018).

Mobile phone apps remained the most common way that men met male sex partners, reported by 44% in 2018.

– The proportion of men with regular male partners reporting condomless anal intercourse with those partners (CAIR) increased from 55% in 2011 to 65% in 2018.

– The proportion of men with casual male partners reporting condomless anal intercourse with those partners (CAIC) increased from 38% in 2011 to 51% in 2018.

– Most of the recent increase in CAIC appears to be attributable to the growing proportion of HIV-negative men using pre-exposure prophylaxis (PrEP).

STI testing among HIV-negative men has remained stable over time, with 74% reporting any STI test in the year prior to the 2018 survey. The proportion of HIV-positive men reporting any STI test in the previous year decreased from 91% in 2011 to 72% in 2018.

Use of PrEP increased between 2014 and 2018 from 1% to 16% of non-HIV-positive men.

A comparative, retrospective analysis of HIV testing among gay, bisexual and other MSM in Melbourne

Australian and New Zealand Journal of Public Health
First published: 29 May 2019
https://doi.org/10.1111/1753-6405.12903

Abstract

Objective: PRONTO!, a peer‐led rapid HIV‐testing service in Melbourne, Australia, opened to improve HIV testing among gay and bisexual men (GBM). We compared client characteristics and return testing among GBM testing at PRONTO! with GBM testing at Melbourne Sexual Health Centre (MSHC).

Methods: All GBM attending PRONTO! and MSHC for HIV testing between August 2013 and April 2016 were included. We describe the number of tests, percentage of clients who returned during follow‐up, the mean number of tests and median time between tests at the two services.

Results: At PRONTO!, 33% of 3,102 GBM and at MSHC 50% of 9,836 GBM returned for a further HIV test at least once. The mean number of tests per client was 1.7 and 2.5 at PRONTO! and MSHC (p<0.01), respectively. A majority of clients at both services reported behaviours that would recommend up to quarterly testing, however, the median time between tests was 20.0 and 17.0 weeks at PRONTO! and MSHC (p<0.01), respectively.

Conclusions: A greater proportion of clients returned and returned frequently at MSHC compared to PRONTO!, however, at both services HIV testing frequency was suboptimal.

Implications for public health: Novel HIV testing services should provide convenient and comprehensive sexual health services.

Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER)

Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study

The Lancet, Published Online May 2, 2019

Background

The level of evidence for HIV transmission risk through condomless sex in serodifferent gay couples with the HIV-positive partner taking virally suppressive antiretroviral therapy (ART) is limited compared with the evidence available for transmission risk in heterosexual couples. The aim of the second phase of the PARTNER study (PARTNER2) was to provide precise estimates of transmission risk in gay serodifferent partnerships.
Findings
Between Sept 15, 2010, and July 31, 2017, 972 gay couples were enrolled, of which 782 provided 1593 eligible couple-years of follow-up with a median follow-up of 2·0 years (IQR 1·1–3·5). At baseline, median age for HIV-positive partners was 40 years (IQR 33–46) and couples reported condomless sex for a median of 1·0 years (IQR 0·4–2·9). During eligible couple-years of follow-up, couples reported condomless anal sex a total of 76 088 times. 288 (37%) of 777 HIV-negative men reported condomless sex with other partners. 15 new HIV infections occurred during eligible couple-years of follow-up, but none were phylogenetically linked within-couple transmissions, resulting in an HIV transmission rate of zero (upper 95% CI 0·23 per 100 couple-years of follow-up).

Interpretation

Our results provide a similar level of evidence on viral suppression and HIV transmission risk for gay men to that previously generated for heterosexual couples and suggest that the risk of HIV transmission in gay couples through condomless sex when HIV viral load is suppressed is effectively zero. Our findings support the message of the U=U (undetectable equals untransmittable) campaign, and the benefits of early testing and treatment for HIV.

 

Are We Blinded by Desire? Relationship Motivation and Sexual Risk-Taking Intentions during Condom Negotiation

The Journal of Sex Research, Shayna Skakoon-Sparling & Kenneth M. Cramer (2019) DOI: 10.1080/00224499.2019.1579888

ABSTRACT

Effective condom negotiation skills support better sexual health for both men and women. The current study explored relationship motivation (motivation to establish and maintain long-term romantic relationships), gender, and sexual orientation as factors influencing the condom negotiation process.

Participants (177 heterosexual women, 157 heterosexual men, and 106 men who have sex with men) read a vignette describing an encounter with a hypothetical new sexual/romantic partner and responded to embedded items and scales.

Stronger relationship motivation predicted increased willingness to have condomless sex among women who perceived greater familiarity with the hypothetical partner. Gender and sexual orientation predicted different preferences for condom insistence strategies.

The findings suggest that there are a number of conditions that make it more difficult to recognize risk during a sexual encounter and demonstrate how the process of condom negotiation can be impacted by gender, sexual orientation, and relationship motivation.

Australia will never be HIV-free if access to prevention requires a medicare card

The Conversation, January 23, 2019 12.21pm AEDT

by Nicholas Medland, Sexual health physician and senior researcher, UNSW

Australia aims to “virtually eliminate” HIV transmission by 2022, according to the health minister’s new national HIV strategy. This ambitious goal has been made possible by biomedical HIV prevention, a new and highly effective way of preventing HIV using medications.

But new inequalities are emerging between those who can and can’t access these medications because of their Medicare eligibility. These inequalities may undermine the success of HIV elimination in Australia and threaten Australia’s international reputation as a safe place to study, work and live.

Read more of Australia will never be HIV-free if access to prevention requires a medicare card

 

Giving gay men self-test kits increases HIV testing by 50% – but STI tests decrease

aidsmap/nam, 21 August 2018

Gay men who were offered HIV home-testing kits took 50% more tests than men who only took HIV tests at clinics or community organisations, a randomised controlled study from Seattle in the USA has found.

The men who could self-test took fewer tests for sexually transmitted infections (STIs), though it is not completely clear whether this was because they went less often for STI checkups or had fewer STI symptoms.