Amsterdam 2015
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| Abstract #2216 - Mad about the boy - MSM II | ||||
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Session: 41.5: Mad about the boy - MSM II (Parallel) on Thursday @ 16.30-18.00 in C104 Chaired by Hycienth Ahaneku, Jeffrey Kelly Authors: Presenting Author: Prof John de Wit - UNSW Australia, Australia |
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| Additional Authors: | ||||
| Aim: ‘Treatment as Prevention’ holds much promise for HIV epidemics worldwide, and ecological studies have shown that increased HIV testing and treatment uptake have been instrumental in curbing high-level epidemics among gay men in San Francisco and people who inject drugs in Vancouver. In Australia, annual numbers of HIV diagnoses have increased year-on-year since the late 1990s, while the viral load of people with HIV has decreased. To understand these disparate trends we examine HIV testing, treatment uptake and sexual risk among gay men and other men how have sex with men, who account for nearly 80% of HIV diagnoses in Australia. | ||||
| Method / Issue: Data for 2004-2013 were obtained from the Gay Community Periodic Surveys, undertaken annually or biennially in major urban areas of Australia, including Sydney, Melbourne, Brisbane, Perth, Adelaide and Canberra. Participants completed a brief self-report questionnaire at community events, social venues, sex-on-premises venues or clinics/general practitioners. Data for trend analyses are age-standardised and weighted for recruitment source. | ||||
| Results / Comments: Across all surveys conducted between 2004 and 2013, 69,857 responses were collected 53.8% of participants were recruited from community events, 28.3% from social venues, 12.3% from sex-on-premises venues, and 5.6% from clinics/general practitioners. Participants predominantly were gay identified (range: 86.6%-89.3%), Anglo-Australian (range: 65.4%-69.4%), and on average in their mid thirties (range: mean 34.7-36.9 years). Annual self-report rates of ever having tested for HIV were high (range: 86.4%-92.4%). Up to two thirds of non-HIV-positive men reported having tested for HIV in the past 12 months (range: 58.9%-66.5%). Rates of ever and recent HIV testing trended down over the decade, but were stable in the last 3 years (2011-2013). Around 15% of participants were HIV-positive (range: 14.0%-17.9%). The proportion of HIV-positive participants who reported being on HIV treatment increased significantly (from 61.9% in 2004 to 76.4% in 2013), as did the proportion of all HIV-positive men who reported an undetectable viral load (from 56.5% in 2004 to 73.6% in 2013). The proportion of men with regular partners who reported any anal intercourse without a condom with a regular partner in the 6 past months was stable (range: 45.6%-53.4%), as was the proportion of men with regular partners who had any condomless anal intercourse with a regular partner of a different or unknown HIV status in the past 6 months (range: 29.6%-37.9%). The proportion of men who reported any anal intercourse without condoms with casual partners in the past 6 months increased significantly (from 29.7% in 2004 to 36.7% in 2013). | ||||
| Discussion: Despite high rates of HIV testing among and increased uptake of HIV treatment among gay men and other men who have sex with men, annual numbers of new HIV diagnoses have continued to increase in Australia since the late 1990s. Behavioural trends suggest that increases in anal intercourse without condoms may currently be offsetting the prevention benefits of increased treatment uptake. Curbing the HIV epidemic in Australia requires promoting frequent HIV testing to reduce undiagnosed infection, early initiation of treatment to promptly reduce viral load as well as continued sexual risk reduction. | ||||
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