Abstract

OBJECTIVE: HIV diagnoses are increasing in Australia, mostly among men who have sex with men (MSM). Similar to many countries, Australia’s HIV prevention strategies emphasise a ‘seek, test, treat’ approach, including enhancing HIV testing frequency. We describe HIV testing among MSM and correlates of returning for testing within 12 months in the context of new HIV prevention paradigms. METHODS: Testing and behavioural data (2007 to 2013) contributed by MSM aged >/=16 years were included. Total HIV tests by calendar year and repeat tests within 12 months were described, alongside negative binomial regression for trend. A two-level mixed effects logistic regression model examined correlates of testing within 12 months. Median days between HIV tests was compared between MSM diagnosed with HIV and persistently HIV negative MSM. RESULTS: The study included 46,060 tests from 17,904 MSM. There was an increase in annual tests (p<0.01), repeat tests within 12 months (p<0.01) and the proportion of tests within 12 months of an index test (p<0.01), although only to 53.3% in 2013. Return rates were higher in MSM aged 16-29 years (aOR 1.30, 95% CI: 1.1-1.5) and those reporting higher numbers of partners (aOR 3.5, 95% CI: 3.0- 4.0). Median time between tests among MSM diagnosed with HIV (233 days) was greater than for HIV negative MSM (189 days) (p=0.03). CONCLUSION: Although testing has increased, testing frequency among many MSM remains suboptimal. To optimize ‘seek, test, treat’ based HIV prevention strategies new approaches to increase testing uptake and early HIV detection among MSM are needed.

The Victorian Department of Health funds ongoing surveillance projects within the Burnet Institute. The authors thank the NHMRC who provided funding to M.H. as a senior research fellow and to A.L.W. as a public health scholarship recipient. M.S. is supported by the NHMRC Centre for Research Excellence in Injecting Drug Use.