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 community perspective: On Human Papillomavirus (HPV)-related cancer among women and, trans and gender diverse people

Positive Life NSW & Femfatales, April 2019

Authors: Liz Sutherland, Lance Feeney, Katya Samodurov

Human papillomavirus (HPV) is a common virus which can be passed through skin to skin contact during sexual activity. Evidence to date shows that women living with HIV are 3 to 6 times more likely to develop cervical cancer than the general female population. They are also at greater risk of developing anal, vaginal, oropharyngeal and vulvar cancers.

There are other groups who may have a higher but preventable risk because they are often left out of the conversation about HPV and related cancers. Trans men are less likely to be up-todate with Pap tests to screen for cervical cancer. Furthermore, several studies have highlighted that trans and gender diverse people, and lesbian and bisexual cis-gendered women are often disregarded as not being at risk.

Positive Life and Femfatales developed a cross-sectional study to:

• Assess awareness and knowledge of HPV infection and risk for 4 HPV-related cancers (cervical, vaginal, vulvar, and anal) among women and, trans and gender diverse people in Australia;

• Assess the knowledge gaps to inform the development and implementation of population-specific educational resources to increase community and healthcare professional awareness of HPV and related cancers;

• Assist with the prevention of morbidity and mortality by increasing screening, early detection and treatment of HPV-related cancers, and;

• Assess rates of HPV vaccination in women and, trans and gender diverse people

KEY FINDINGS:

1. The results from this survey highlighted a lack of awareness of risk, prevention,
symptoms, and early detection of HPV-related vaginal, vulvar, and anal cancers.

2. Approximately 28% of HIV-positive respondents were unaware that a vaccination
against HPV exists and 71% of HIV-positive respondents had not been vaccinated
against HPV.

3. Over half (60%) of HIV-positive respondents believe their risk of anal cancer was either‘about the same’, ‘lower’, or ‘much lower’ than the general female population’s risk.

4. While all HIV-positive respondents had screened for cervical cancer at some point in
their lives, 91.7% had never had an anal examination for anal cancer.

5. Among HIV-positive and HIV-negative but immunocompromised respondents who had undergone staging or treatment for either cervical, vaginal, or vulvar cancer, none had ever screened for anal cancer.

6. Of the HIV-positive respondents who do not receive screening reminder notifications, none were aware of the new 3 yearly National Cervical Screening Guidelines and changes.

7. Qualitative responses indicated that respondents generally preferred having clinician-initiated conversations with female doctors or nurses who were non-judgemental, non-dismissive, clear, and made them feel comfortable.

8. In an open-ended short-answer question, more than 25% of qualitative respondents felt that more awareness and normalising talking about HPV in the public realm would help increase their chance of detecting HPV-related cancer early.

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.

Liver cancer death rate rising: study

SBS News, 9/4/19

The rate of liver cancer deaths and diagnoses has increased substantially in the past three decades, yet researchers say little has been done to help Australians most at risk.

While it is considered a relatively rare type of cancer – nearly 2000 people were diagnosed in 2014 – the high mortality rate and increasing incidence of diagnosis has been concerning, researcher Barbara de Graaff says.

Rates were highest in the Northern Territory, mostly due to a higher prevalence of hepatitis B and C.

Rapid HIV testing increases testing frequency among gay and bisexual men: a controlled before–after study

Sexual Health – https://doi.org/10.1071/SH18161

Keen Phillip, Jamil Muhammad, Callander Denton, Conway Damian P., McNulty Anna, Davies Stephen C., Couldwell Deborah C., Smith Don E., Holt Martin, Vaccher Stefanie J., Gray James, Cunningham Philip, Prestage Garrett, Guy Rebecca, (2019)

Published online: 4 April 2019

Abstract:

BackgroundRapid HIV testing was introduced at 12 clinics in New South Wales (NSW) for routine testing and promoted with social marketing. The effect of the availability of rapid HIV testing on testing frequency among gay and bisexual men (GBM) was evaluated.

Methods: An observational design using patient data from 12 clinics was used. The primary outcome was the mean number of HIV tests in 12 months. The intervention group comprised GBM who had one or more rapid tests from October 2013 to September 2014 and this was compared with two control groups; a concurrent group (no rapid test in the same period) and a historical group (attended between July 2011 and June 2012). Independent sample t-tests were conducted to compare mean number of tests among men in the intervention, concurrent and historical groups. Multivariate logistic regression was used to assess the association between rapid HIV testing and testing frequency.

Results: Men in the intervention group (n = 3934) had a mean of 1.8 HIV tests in 12 months, compared with 1.4 in the concurrent group (n = 5063; P < 0.001) and 1.4 in the historical group (n = 5904; P < 0.001); testing frequency was higher among men at increased risk of HIV in the intervention group compared with the other two groups (mean 2.2, 1.6 and 1.5 respectively; P < 0.001). Membership of the intervention group was associated with increased odds of having two or more HIV tests in 12 months (AOR = 2.5, 95%CI 2.2–2.8; P < 0.001) compared with the concurrent group, after controlling for demographic and behavioural factors.

Conclusion: Introducing and promoting rapid HIV testing in clinics in NSW was associated with increased HIV testing frequency among GBM.

 

Cervical cancer self-tests helping to break down barriers and increase screening rates

ABC Health & Wellbeing, Posted Friday 8th March 2019 at 14:54

In Australia, 80 per cent of cervical cancers are found in women who are overdue for screening or have never been screened.

“We know there’s an equity issue in our cervical screening program,” said Dr Saville, executive director of the VCS Foundation, a cervical screening not-for-profit.

“Women from lower socio-economic settings, Aboriginal and Torres Strait Islander women, and women from culturally and linguistically diverse backgrounds do not screen as often … and are more likely to get cancer.”

In a bid to overcome these barriers, a self-testing process was introduced to Australia’s National Cervical Screening Program in 2017.