Comprehensive testing for, and diagnosis of, sexually transmissible infections among Australian gay and bisexual men: findings from repeated, cross-sectional behavioural surveillance, 2003–2012

Abstract

ObjectivesTo analyse changes in testing for sexually transmissible infections (STI) among gay and bisexual men in Melbourne, Sydney and Queensland, Australia, particularly comprehensive STI testing (at least four tests from different anatomical sites in the previous year), and the characteristics of men who had such testing.MethodData were analysed from repeated, cross-sectional, community-based surveys conducted during 2003–2012. Trends in specific STI tests and comprehensive testing were assessed and the characteristics of participants who reported comprehensive STI testing were identified using multivariate logistic regression, stratified by HIV status.ResultsAmong HIV-negative and unknown status men (n=51 009), comprehensive STI and HIV testing increased substantially from 13% in 2003 to 34% in 2012. During the same period, comprehensive STI testing (excluding HIV testing) increased from 24% to 57% among HIV-positive men (n=5532). In both HIV status groups, comprehensive testing was more commonly reported by men who had unprotected anal intercourse with casual partners, and men with higher numbers of partners. Among HIV-negative/unknown status participants, comprehensive STI and HIV testing was also associated with education level, regional location and finding partners online. Among HIV-positive men, comprehensive STI testing was also associated with free time spent with gay men and illicit drug use. Comprehensive testing was related to a high annual rate of diagnosis with STIs (20% of HIV-negative/unknown status men and 38% of HIV-positive men).ConclusionsThere has been a substantial improvement in the proportion of gay and bisexual men in Melbourne, Sydney and Queensland who report comprehensive testing. Comprehensive testing is most likely among men whose practices put them at increased risk of infection, and is associated with a high rate of STI diagnosis. However, opportunities for comprehensive testing are still being missed, suggesting a need for its ongoing promotion.

Self-reported STIs and sexual health checks in a cross-sectional study of gay and bisexual men in New Zealand

“…In combined community-based surveys of MSM in three Australian cities in 2012, 12.0% reported an STI in the previous year 14. In a 2010 study in Scotland, among MSM attending gay bars, 13.2% reported any STI in the past year, somewhat higher than the 9.3% in our comparable group.…”

HIV Testing Behavior and Social Network Characteristics and Functions Among Young Men Who have Sex with Men (YMSM) in Metropolitan Detroit

“…The following demographic factors have been associated with HIV testing behavior among MSM: older age, [6, 9–18]; education level [16, 19, 20]; and socio-economic status (SES) [11, 16, 21]. MSM’s high-risk sexual behavior has also been found to be either negatively associated with timely HIV testing [11, 15, 20, 22], or to be unassociated with it [10, 12, 23].…”

Adapting behavioural surveillance to antiretroviral-based HIV prevention: reviewing and anticipating trends in the Australian Gay Community Periodic Surveys

“…The gradual increase in HIV testing may have contributed to the gradual increase in HIV notifications observed among GBM in Australia. 11,26 However, the proportion of late diagnoses among GBM has not changed in over 10 years, 11 suggesting that the increase in HIV testing coverage is insufficient or failing to effectively engage those at high risk of infection. It is likely to require a substantial ongoing effort to further increase HIV testing uptake and frequency and address ongoing barriers, such as the fear and inconvenience of testing.…”