Abstract
ObjectiveDetermine the acceptability and epidemiological impact of increases in HIV testing in gay men in New South Wales (NSW), Australia– particularly pertinent when considering treatment as prevention and the need to reduce undiagnosed infections.MethodsWe conducted an online survey and focus groups to assess whether increases in HIV testing would be acceptable to gay men in NSW. In parallel, we assessed the potential impact of increases in testing coverage and/or frequency using an individual-based model of HIV transmission.ResultsIf sexual practices and the rate of initiating HIV treatment are unchanged then increasing HIV testing reduces infections. Increasing testing frequency has the largest impact, with a 13.8% reduction in HIV infections over 10 years if the ∼55–75% of men who test at least once per year increased their testing frequency to four times per year. If testing levels decrease from current levels then we expect an increase in HIV infections with a sharply rising trend over time. Increasing HIV testing would be acceptable if testing was more convenient. However, only ∼25% of men surveyed were ‘very likely’ to increase their level of HIV testing. Men delayed or avoided testing due to the slowness in obtaining results and if they believed they had not put themselves at risk.ConclusionsAn increase in HIV testing alone is unlikely to reduce HIV incidence substantially in NSW gay men– however, the relatively high testing levels need to continue to prevent an increase in HIV infections. In jurisdictions with lower levels of HIV testing, increases in testing coverage and frequency are likely to have a larger impact. Successful treatment as prevention interventions will require increases in testing rates; such increases would be acceptable to gay men in NSW but only if more convenient testing and rapid communication of results were available.
Highlights
HIV testing is the foundation of HIV surveillance and health care for HIV-positive individuals
We investigated the potential impact of interventions based on HIV testing on the HIV epidemic among gay men in New South Wales (NSW)
Acceptability Results from Online Survey The online survey sample was broadly similar to what we have found in other surveys of non-positive gay men in Australia [22,23]
Summary
HIV testing is the foundation of HIV surveillance and health care for HIV-positive individuals. It is required to ensure infected individuals enter clinical care and receive appropriate treatment in a timely fashion. Testing is fundamentally important for many HIV prevention initiatives. This is true for populations of men who have sex with men (MSM) in high income settings as some risk reduction strategies rely on accurate knowledge of a potential partners’ HIV status. There has been a renewed emphasis on testing with the focus on treatment as prevention [1,2]. Using treatment for prevention will only have the potential to work if infected people are diagnosed earlier through increased testing rates
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have