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.

 

STI’S on the rise in SA – free campaign resources (SHINE SA media release)

SHINE SA, April 2, 2019

Sexually transmitted infection (STI) rates are on the rise in South Australia, with around 1 in 20 young people infected with chlamydia¹. Left untreated chlamydia can lead to infection of the reproductive systems and long term consequences. Having one STI also increases the risk of being infected with another. As such it’s important that young people in SA are encouraged to practise safer sex as well as getting a sexual health check.

In response to this rise in STIs, SHINE SA is excited to announce the launch of their Sexual Health Check campaign and related resources for use across South Australia. These resources can be used by organisations including universities, secondary schools, youth services, general practice and community health services.

The Sexual Health Check campaign aims to raise awareness of STIs as well as highlight how easy it is to get a sexual health check.
According to the most recent epidemiological report released by SA Health in 2017, STI and blood borne viruses (BBVs) have jumped 14% compared to the previous five years.

In 2017:

  • there were 8,181 new infections of STIs and BBVs, this is a 7% increase compared to 2016
  • 77% of infections were in people aged 15 to 29 years.

SHINE SA encourages young people to receive a sexual health check at a SHINE SA clinic, their local doctor or Aboriginal Health service. SHINE SA offers FREE sexual health checks as well as counselling to South Australians under the age of 30 with a Medicare Card.

Dr Amy Moten, SHINE SA’s Coordinator of Medical Education said:
“STIs are on the rise, so practicing safer sex and having regular testing is vital. Left untreated, serious infection may occur and lead to complications such as infertility, chronic pelvic pain and ectopic pregnancy. As most people don’t have any symptoms, lack of testing contributes to the continued spread of the disease”.

SHINE SA hopes other health and education organisations and media outlets can assist by promoting and sharing the Sexual Health Check campaign. By doing so we can help raise awareness of STIs in the community and encourage young people to access sexual heath checks.

  • The free campaign resources including a Sexual Health + STIs FAQ booklet, posters and social media tiles can be downloaded here
  • For further information contact Tracey Hutt, Director Workforce Education and Development, by email here 
  • Download this media release

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¹ http://www.sti.guidelines.org.au/populations-and-situations/young-people

 

 

STIs in remote Australia

ABC Health Report, Monday 18 March 2019 5:45 PM

Leading Aboriginal researcher Associate Professor James Ward* is calling for action in remote Australia to deal with a preventable epidemic of sexually transmissible infections — including syphilis — in a population that’s no more sexually active than non-Indigenous people of the same age.  

He joined Dr Norman Swan’s Health Report on ABC RN.

Later this month James will present to the National Rural Health Conference about addressing sexually transmitted infections in remote Australia.

*James Ward is Associate Professor, Flinders University; & Head of Infectious Diseases Research, Aboriginal Health, South Australian Health and Medical Research Institute. 

 

 

80% of new HIV cases transmitted by undiagnosed or untreated people

Healio, March 18, 2019

In 2016, more than 80% of new HIV infections in the United States were transmitted by individuals who either did not know they were infected with HIV or had been diagnosed but were not receiving care, according to data released on the first day of the National HIV Prevention Conference in Atlanta.

HIV diagnoses in migrant populations in Australia: a changing epidemiology

PLoS ONE ,14(2): e0212268. https://doi.org/10.1371/journal.pone.0212268

Abstract

Introduction

We conducted a detailed analysis of trends in new HIV diagnoses in Australia by country of birth, to understand any changes in epidemiology, relationship to migration patterns and implications for public health programs.

Methods

Poisson regression analyses were performed, comparing the age-standardised HIV diagnosis rates per 100,000 estimated resident population between 2006–2010 and 2011–2015 by region of birth, with stratification by exposure (male-to-male sex, heterosexual sex–males and females). Correlation between the number of permanent and long-term arrivals was also explored using linear regression models.

Results

Between 2006 and 2015, there were 6,741 new HIV diagnoses attributed to male-to-male sex and 2,093 attributed to heterosexual sex, with the proportion of diagnoses attributed to male-to-male sex who were Australian-born decreasing from 72.5% to 66.5%. Compared with 2006–2010, the average annual HIV diagnosis rate per 100,000 in 2011–15 attributed to male-to-male sex was significantly higher in men born in South-East Asia (summary rate ratio (SRR) = 1.37, p = 0.001), North-East Asia (SRR = 2.18, p<0.001) and the Americas (SRR = 1.37, p = 0.025), but significantly lower as a result of heterosexual sex in men born in South-East Asia (SRR = 0.49, p = 0.002), Southern and Central Asia (SRR = 0.50, p = 0.014) and Sub-Saharan Africa (SRR = 0.39, p<0.001) and women born in South-East Asia (SRR = 0.61, p = 0.002) and Sub-Saharan Africa (SRR = 0.61, p<0.001). Positive associations were observed between the number of permanent and long-term arrivals and HIV diagnoses particularly in relation to diagnoses associated with male-to-male sex in men from North Africa and the Middle East, North Asia, Southern and Central Asia and the Americas.

Conclusion

The epidemiology of HIV in Australia is changing, with an increase in HIV diagnosis rates attributed to male-to-male sex amongst men born in Asia and the Americas. Tailored strategies must be developed to increase access to, and uptake of, prevention, testing and treatment in this group.

 

Update on multi-drug resistant shigella

SHINE SA, 7/3/2019

The shigella outbreak is continuing in South Australia. This is to advise clinicians to be on alert for a potential increase in shigella cases, and to highlight updated recommendations on treatment as released by the Communicable Disease Control Branch (CDCB).

The outbreak is predominantly in men who have sex with men (MSM) and there is a potential for further increase in numbers related to a larger outbreak in Victoria and NSW. We encourage you to be alert for clients who have recently traveled interstate.The CDCB is now recommending that patients with confirmed multi-drug resistant (MDR) shigella (or at risk of MDR shigella while awaiting sensitivities) be treated with five days of Ceftrixaone 1g IV, rather than 1 day (as recommended in the Public Health Alert issued in December 2018).