"Seek, Test, Treat" Lessons From Australia: A Study of HIV Testing Patterns From a Cohort of Men Who Have Sex With Men.

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 emphasize 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 behavioral data (2007-2013) 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 2-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 (adjusted odds ratio 1.30, 95% confidence interval: 1.1 to 1.5) and those reporting higher numbers of partners (adjusted odds ratio 3.5, 95% confidence interval: 3.0 to 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).

CONCLUSIONS

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.