Are men returning? A cohort analysis of HIV testing among MSM in Victoria, 2007-2011
Introduction: Diagnoses of HIV in Australia remain at historic highs with the majority occurring among men who have sex with men (MSM). Frequent HIV testing to reduce undiagnosed infections is an essential component of HIV prevention. This research aims to describe HIV testing among MSM.
Methods: HIV testing data (2007- 2011) from HIV negative MSM attending Victorian Primary Care Network for Sentinel Surveillance (VPCNSS) sites for HIV testing were included. We examined patterns of repeat HIV testing within 365 days of a previous (index) test. Poisson regression was used to assess trends in repeat testing over time and logistic regression used to examine predictors of returning for a test within 365 days.
Results: In total, 32915 tests from 13286 individuals were included. The number of tests increased from 3135 in 2006 to 7010 in 2011 (p<0.01). Younger MSM (16-29 years) accounted for 42.2% of tests in 2011. The number of tests <365 days of an index test increased over the follow up period (p<0.01). A divergence in the rate of tests and the rate of returning for a test <365 days was seen; this effect was greater among older MSM (>=30 years, p<0.01). Younger MSM were more likely to return for a HIV test <365 days (AOR 1.24, 95%CI: 1.13-1.37) and MSM who reported inconsistent condom use less likely to return for testing (AOR 0.93, 95%CI: 0.88- 0.98).
Conclusion: There was an increase in number of HIV tests among MSM; however the number returning for testing <365 days remained stable at around half of all tests. Younger MSM returned for testing in the analysis, however the data suggests infrequent testing among other risk groups. Current guidelines recommend three monthly testing for high risk MSM. Future research should be aimed at informing strategies for increased testing among high risk groups.
