Does the frequency of HIV and STI testing among men who have sex with men in primary care adhere with Australian guidelines?
- R Guy1,
- J L Goller2,
- T Spelman2,
- C El-Hayek2,
- J Gold2,
- M Lim2,
- D Leslie3,
- B K Tee4,
- N Roth5,
- J Anderson6,
- C K Fairley7,8,
- J Kaldor1,
- M Hellard2
- 1National Centre in HIV Epidemiology and Clinical Research, Sydney, New South Wales, Australia
- 2Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia
- 3Victorian Infectious Diseases Reference Laboratory, North Melbourne, Victoria, Australia
- 4The Centre Clinic, St Kilda, Victoria, Australia
- 5Prahran Market Clinic, Prahran, Victoria, Australia
- 6Northside clinic, Fitzroy North, Victoria, Australia
- 7Melbourne Sexual Health Centre, Carlton, Victoria, Australia
- 8School of Population Health University of Melbourne, Melbourne, Victoria, Australia
- Correspondence to Dr Rebecca Guy, Senior Lecturer, NHMRC Post Doctoral Fellow, National Centre in HIV Epidemiology & Clinical Research, 45 Beach St, Coogee, New South Wales 2034, Australia;
Contributors JG was responsible for overall management of the VPCNSS. CE-H, JG, ML and JG undertook VPCNSS data management. TS in consultation with RG, JG and CE-H carried out the statistical analysis. DL advised on interpretation of the laboratory testing data. JA, BKT, NR and CF were responsible for clinical data collection and also advised on clinical practice and interpretation of results. MH and JK provided methodological advice on the design and analysis of the study. All authors read and approved the final manuscript.
- Accepted 13 February 2010
- Published Online First 10 May 2010
Objectives Australian guidelines recommend annual testing for HIV and sexually transmitted infections (STIs) for all men who have sex with men (MSM) and 3–6 monthly testing for those at higher risk as defined by behavioural criteria. We assessed HIV/STI re-testing rates among MSM attending primary care clinics.
Methods We conducted a retrospective follow-up of HIV negative MSM tested for HIV or STIs (chlamydia or syphilis) at four primary care clinics in the 9-month period: April to December 2006. Re-testing rates for these infections were calculated over 18 months. Logistic regression was undertaken to identify predictors of guideline adherence.
Results Of the MSM requiring annual HIV testing according to the guidelines, the re-testing rates at 1 y were 35% (762/2163). Among the higher risk MSM, 6-monthly HIV re-testing rates were 15% (283/1862). Within the subgroup who reported 11 or more male sexual partners within the past 6 months, HIV re-testing rates within 6 months were 19%. Independent predictors of HIV re-testing within 6 months in higher-risk MSM were reporting 11 or more male sexual partners in the last 6 months (AOR 3.1, 95% CI 1.8 to 4.8); being born overseas (AOR 2.0, 95% CI 1.2 to 3.4); and previous HIV testing more than 12 months earlier (AOR 3.3, 95% CI 1.9 to 5.5).
Conclusion There is poor adherence to national guidelines that recommend regular re-testing of MSM for STIs, particularly among those at higher risk who require more frequent testing. Clinical strategies are urgently needed to encourage more frequent HIV/STI testing among MSM, especially in the higher risk subgroup.
Competing interests None.
Ethics approval This study was conducted with the approval of the Department of Human Services, Victoria, Australia.
Provenance and peer review Not commissioned; externally peer reviewed.