Wilkinson Anna L, Pedrana Alisa E, El-Hayek Carol, Vella Alyce M, Asselin Jason, Batrouney Colin, Fairley Christopher K, Read Tim R H, Hellard Margaret, Stoové Mark
From the *Centre for Population Health, Burnet Institute, Melbourne, Australia; †School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia; ‡Department Nutrition, Harvard School of Public Health, Boston, MA; §Victorian AIDS Council/Gay Men's Health Service, South Yarra, Australia; ¶Alfred Health, Melbourne Sexual Health Centre, Melbourne, Australia; ∥Central Clinical School Monash University, Alfred Hospital, Melbourne, Australia; and **Alfred Health, Infectious Disease Department, Alfred Hospital, Australia.
Sex Transm Dis. 2016 Jan;43(1):49-56. doi: 10.1097/OLQ.0000000000000380.
In response to increasing HIV and other sexually transmissible infection (HIV/STI) notifications in Australia, a social marketing campaign Drama Downunder (DDU) was launched in 2008 to promote HIV/STI testing among men who have sex with men (MSM). We analyzed prospective data from (1) an online cohort of MSM and (2) clinic-level HIV/STI testing to evaluate the impact of DDU on HIV, syphilis, gonorrhea, and chlamydia testing.
(1) Cohort participants who completed 3 surveys (2010-2014) contributed to a Poisson regression model examining predictors of recent HIV testing.(2) HIV, syphilis, gonorrhea, and chlamydia tests among MSM attending high caseload primary care clinics (2007-2013) were included in an interrupted time series analysis.
(1) Although campaign awareness was high among 242 MSM completing 726 prospective surveys, campaign recall was not associated with self-reported HIV testing. Reporting previous regular HIV testing (adjusted incidence rate ratio, 2.4; 95% confidence interval, 1.3-4.4) and more than 10 partners in the previous 6 months (adjusted incidence rate ratio, 1.2; 95% confidence interval, 1.1-1.4) was associated with recent HIV testing. (2) Analysis of 257,023 tests showed increasing monthly HIV, syphilis, gonorrhea, and chlamydia tests pre-DDU. Post-DDU, gonorrhea test rates increased significantly among HIV-negative MSM, with modest and nonsignificant increasing rates of HIV, syphilis, and chlamydia testing. Among HIV-positive MSM, no change in gonorrhea or chlamydia testing occurred and syphilis testing declined significantly.
Increasing HIV/STI testing trends among MSM occurred pre- and post-DDU, coinciding with other plausible drivers of testing. Modest changes in HIV testing post-DDU suggest that structural changes to improve testing access may need to occur alongside health promotion to increase testing frequency.
为应对澳大利亚报告的艾滋病毒及其他性传播感染(HIV/STI)病例数量增加的情况,2008年发起了一项社会营销活动“澳洲风云”(DDU),以促进男男性行为者(MSM)进行HIV/STI检测。我们分析了来自(1)一个MSM在线队列和(2)诊所层面的HIV/STI检测的前瞻性数据,以评估DDU对艾滋病毒、梅毒、淋病和衣原体检测的影响。
(1)完成3次调查(2010 - 2014年)的队列参与者参与了一个泊松回归模型,该模型用于研究近期HIV检测的预测因素。(2)在高病例负荷初级保健诊所就诊的MSM中的艾滋病毒、梅毒、淋病和衣原体检测(2007 - 2013年)被纳入中断时间序列分析。
(1)在完成726次前瞻性调查的242名MSM中,尽管活动知晓率很高,但活动回忆与自我报告的HIV检测无关。报告之前定期进行HIV检测(调整发病率比,2.4;95%置信区间,1.3 - 4.4)以及在过去6个月中有超过10个性伴侣(调整发病率比,1.2;95%置信区间,1.1 - 1.4)与近期HIV检测有关。(2)对257,023次检测的分析表明,在DDU之前,每月的艾滋病毒、梅毒、淋病和衣原体检测呈上升趋势。在DDU之后,HIV阴性的MSM中淋病检测率显著增加,而艾滋病毒、梅毒和衣原体检测率有适度增加但不显著。在HIV阳性的MSM中,淋病或衣原体检测没有变化,梅毒检测显著下降。
在DDU前后,MSM中HIV/STI检测趋势均在上升,这与其他可能的检测驱动因素一致。DDU之后HIV检测的适度变化表明,在进行健康促进的同时,可能需要进行结构调整以改善检测机会,从而提高检测频率。