Knight Vickie, Wand Handan, Gray James, Keen Phillip, McNulty Anna, Guy Rebecca
*Sydney Sexual Health Centre, South East Sydney Local Health District, Sydney, Australia; †The Kirby Institute, University of New South Wales, Sydney, Australia; ‡ACON Health, Sydney, Australia; and §School of Public Health and Community Medicine, University of NSW, Kensington, Australia.
J Acquir Immune Defic Syndr. 2015 Aug 15;69(5):e147-55. doi: 10.1097/QAI.0000000000000688.
HIV testing is a cornerstone of the treatment as prevention approach. We assessed which HIV testing service delivery models were more likely to attract untested or infrequent tested gay, bisexual and other men who have sex with men (GBM).
We compared demographics, risk behavior, and HIV testing history among new GBM clients attending 3 different HIV testing service models (fast-track Xpress clinic, fixed-site community-based service, and time-limited community-based shopfront) between August 2013 and May 2014. We used bivariate and multivariate regression to assess factors (including service model) associated with being untested or infrequent testers (not tested within the past 12 months).
Overall, 1704 new GBM attended the services; 19% were untested and 41% were infrequent testers. Across the services, there were significant differences in demographics, risk behavior, and HIV testing history. The overall HIV seropositivity was 1.2% (95% confidence interval: 0.8% to 1.9%) and sexually transmitted infection positivity was 12.4% (95% confidence interval: 11.6 to 17.2) with no significant differences across services. Factors independently associated with being untested were attendance at the 2 community sites, younger age, being born in Asia, living in North Sydney, being bisexual and reporting fewer male sexual partners. Factors independently associated with infrequent testers were attending the fast track Xpress clinic, being older, being born in Asia, and reporting fewer male partners.
The findings suggest both community and fast track testing service models are important to increase HIV testing among GBM with a similar yield of HIV diagnoses at the 3 services. The community models reached more untested men and the fast track model more infrequent testers.
艾滋病毒检测是治疗即预防方法的基石。我们评估了哪种艾滋病毒检测服务提供模式更有可能吸引未接受检测或很少接受检测的男同性恋者、双性恋者以及其他与男性发生性关系的男性（GBM）。
我们比较了2013年8月至2014年5月期间参加3种不同艾滋病毒检测服务模式（快速通道Xpress诊所、固定地点社区服务和限时社区店面）的新GBM客户的人口统计学特征、风险行为和艾滋病毒检测史。我们使用双变量和多变量回归来评估与未接受检测或很少接受检测（过去12个月内未检测）相关的因素（包括服务模式）。
总体而言，1704名新GBM客户接受了服务；19%的人未接受检测，41%的人很少接受检测。在各项服务中，人口统计学特征、风险行为和艾滋病毒检测史存在显著差异。总体艾滋病毒血清阳性率为1.2%（95%置信区间：0.8%至1.9%），性传播感染阳性率为12.4%（95%置信区间：11.6至17.2），各服务之间无显著差异。与未接受检测独立相关的因素包括在两个社区地点就诊、年龄较小、出生在亚洲、居住在北悉尼、为双性恋且报告的男性性伴侣较少。与很少接受检测独立相关的因素包括前往快速通道Xpress诊所、年龄较大、出生在亚洲以及报告的男性伴侣较少。
研究结果表明，社区和快速通道检测服务模式对于增加GBM中的艾滋病毒检测都很重要，这3种服务的艾滋病毒诊断率相似。社区模式接触到更多未接受检测的男性，而快速通道模式接触到更多很少接受检测的男性。
