Factors associated with declining to report the number of sexual partners using computer-assisted self-interviewing: a cross-sectional study among individuals attending a sexual health centre in Melbourne, Australia

Abstract

The number of sexual partners is one of the most important risk factors for sexually transmissible infections (STIs), including HIV. The aim of the present study was to examine the association between declining to report the number of partners using computer-assisted self-interviewing (CASI) and HIV or STI positivity at a public sexual health centre in Melbourne, Australia, in 2016. Individuals were categorised into three risk populations: women, men who have sex with women only (MSW) and men who have sex with men (MSM). Logistic regression analysis was used to examine the association between declining to report the number of sexual partners in the past 12 months and HIV or STI positivity for women and MSW, with generalised estimating equations (GEE) used for estimation in MSM to address repeated-measures within individuals. In all, 18085 individuals (5579 women, 6013 MSW, 6493 MSM) were included in the final analysis. There was no association between chlamydia positivity and declining to respond among women and MSW. MSM who declined to respond were more likely to be chlamydia positive (adjusted odds ratio1.21; 95% confidence interval (CI) 1.01-1.43). Known HIV-positive MSM and MSM newly diagnosed with HIV had 3.31-fold (95% CI 2.48-4.42) and 2.82-fold (95% CI 1.84-4.32) greater odds respectively of declining to respond compared with HIV-negative MSM. Gonorrhoea and syphilis positivity in MSM were not associated with declining to respond. There was no association between declining to report the number of partners and chlamydia positivity among women and MSW. However, MSM who declined to report the number of partners were slightly more likely to have chlamydia and substantially more likely to be HIV positive.

Disparities in characteristics in accessing public Australian sexual health services between Medicare‐eligible and Medicare‐ineligible men who have sex with men

“…It is important to note that Medicare‐ineligible MSM were more likely to decline to report their sexual history (e.g. the number of partners and condom use) in comparison to Medicare‐eligible MSM, 13 and this may due to different cultural backgrounds or language barriers. This is concerning, as men who decline to report their sexual history are found to have a higher risk of acquiring HIV or an STI 13 .…”

“…the number of partners and condom use) in comparison to Medicare‐eligible MSM, 13 and this may due to different cultural backgrounds or language barriers. This is concerning, as men who decline to report their sexual history are found to have a higher risk of acquiring HIV or an STI 13 . Third, there was a small proportion (1.8%; n=145) of MSM who were Medicare‐eligible but did not want to use Medicare for the consultation.…”

Risk factors for urethral gonorrhoea infection among heterosexual males in Melbourne, Australia: 2007–17

“…The MSHC is the largest public sexual health centre located in the State of Victoria, Australia, providing approximately 45 000 consultations a year, 6 of which approximately 28% are for heterosexual males. 7 Demographic information, including questions on sexual contact with individuals overseas, is recorded for patients at each visit using a computer-assisted self-interview (CASI) or added to a patient's medical file by the clinician during the consultation.…”

Are genital examinations necessary for STI screening for female sex workers? An audit of decriminalized and regulated sex workers in Melbourne, Australia

“…We conducted a retrospective audit of all consultations of FSW attending MSHC between 1 st January and 31 st December 2018. MSHC is the major public sexual health clinic in Melbourne that provides over 50,000 consultations annually [5]. MSHC operates as a walk-in triage service.…”