The Kirby Institute, University of New South Wales, Sydney, Australia.
PLoS One. 2013;8(2):e55449. doi: 10.1371/journal.pone.0055449. Epub 2013 Feb 15.
Determine 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.
We 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.
If 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.
An 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.
确定在澳大利亚新南威尔士州（NSW）增加男同性恋者 HIV 检测的可接受性和流行病学影响 - 尤其是在考虑治疗即预防以及减少未确诊感染的必要性时。
我们进行了在线调查和焦点小组，以评估在 NSW 的男同性恋者中增加 HIV 检测是否可接受。同时，我们使用 HIV 传播的个体模型评估了增加检测覆盖率和/或频率的潜在影响。
如果性行为和开始 HIV 治疗的比率保持不变，那么增加 HIV 检测会减少感染。增加检测频率的影响最大，如果每年至少检测一次的 ∼55-75%的男性将其检测频率增加到每年四次，那么在 10 年内 HIV 感染将减少 13.8%。如果检测水平从当前水平下降，那么我们预计 HIV 感染会增加，并且随着时间的推移呈急剧上升趋势。如果检测更加方便，增加 HIV 检测将是可以接受的。然而，只有 ∼25%的调查男性表示“非常可能”增加他们的 HIV 检测水平。由于获取结果的速度较慢，以及如果他们认为自己没有将自己置于风险之中，男性会延迟或避免检测。
仅增加 HIV 检测不太可能大幅降低 NSW 男同性恋者的 HIV 发病率-但是，相对较高的检测水平需要继续预防 HIV 感染的增加。在 HIV 检测水平较低的司法管辖区，增加检测覆盖率和频率可能会产生更大的影响。成功的治疗即预防干预措施将需要增加检测率；如果提供更方便的检测和快速的结果沟通，这种增加将在 NSW 男同性恋者中是可以接受的。
