Ryan Kathleen E, Wilkinson Anna L, Leitinger David, El-Hayek Carol, Ryan Claire, Pedrana Alisa, Hellard Margaret, Stoové Mark
Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia.
Sex Health. 2016 Nov;13(6):560-567. doi: 10.1071/SH16027.
HIV rapid point-of-care (RPOC) testing was approved in Australia in 2012 prompting new testing models. We describe gay, bisexual and other men who have sex with men (GBM) testing in the first year of operations at Australia's first shop-front, community-based RPOC testing service, PRONTO!, and characterise return testers and first-time testers.
Univariable and multivariable logistic regression using data collected at clients' first test at PRONTO! from 15 August 2013 to 14 August 2014 examined correlates of: 1) return-testing within 6 months of GBMs first test at PRONTO!; and 2) reporting a first ever HIV test at PRONTO!.
In the first year, 1226 GBM tested at PRONTO! (median age=30.4 years, 60.2% Australian born). Condomless anal sex with casual or regular partners was reported by 45% and 66% of GBM, respectively. Almost one-quarter (23%) of GBM returned within 6 months of their first test. Return-testing was associated with being born overseas (adjusted odds ratio (AOR)=1.48, 95% confidence interval (CI)=1.10-2.0), reporting a regular check-up as reason to test (AOR=1.53, 95% CI=1.01-2.30) and reporting a HIV test in the 6 months before first testing at PRONTO! (AOR=1.73, 95% CI=1.09-2.73). Reporting first testing at PRONTO! (17.9%) was positively associated with younger age (<30 years; AOR=1.78, 95% CI=1.18-2.71) and negatively associated with reporting a regular check-up as reason to test (AOR=0.45, 95% CI=0.29-0.71) and recent group sex (AOR=0.37, 95% CI=0.23-0.59).
Despite PRONTO! being designed to reduce barriers to HIV testing, return testing rates in the first year were low and not associated with client risk. Service refinements, including the provision of comprehensive sexually transmissible infection testing, are needed to increase testing frequency and enhance population HIV prevention benefits.
2012年,澳大利亚批准了艾滋病毒即时检测(RPOC),这促使了新的检测模式出现。我们描述了澳大利亚首个基于社区的店面式RPOC检测服务机构PRONTO!运营第一年中男同性恋者、双性恋者及其他与男性发生性行为者(GBM)的检测情况,并对回访检测者和首次检测者进行了特征描述。
使用2013年8月15日至2014年8月14日在PRONTO!接受首次检测的客户所收集的数据进行单变量和多变量逻辑回归分析,以研究以下因素的相关性:1)GBM在PRONTO!首次检测后6个月内进行回访检测;2)在PRONTO!报告首次进行艾滋病毒检测。
在运营的第一年,有1226名GBM在PRONTO!接受了检测(中位年龄 = 30.4岁,60.2%出生于澳大利亚)。分别有45%和66%的GBM报告与临时或固定性伴侣有无保护肛交。近四分之一(23%)的GBM在首次检测后6个月内进行了回访检测。回访检测与出生在海外相关(调整后的优势比(AOR)= 1.48,95%置信区间(CI)= 1.10 - 2.0),将定期体检作为检测原因相关(AOR = 1.53,95% CI = 1.01 - 2.30),以及在PRONTO!首次检测前6个月内进行过艾滋病毒检测相关(AOR = 1.73,95% CI = 1.09 - 2.73)。在PRONTO!报告首次检测(17.9%)与年龄较小(<30岁;AOR = 1.78,95% CI = 1.18 - 2.71)呈正相关,与将定期体检作为检测原因呈负相关(AOR = 0.45,95% CI = 0.29 - 0.71),与近期群体性行为呈负相关(AOR = 0.37,95% CI = 0.23 - 0.59)。
尽管PRONTO!旨在降低艾滋病毒检测的障碍,但第一年的回访检测率较低,且与客户风险无关。需要对服务进行优化,包括提供全面的性传播感染检测,以提高检测频率并增强对人群艾滋病毒预防的益处。