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Delayed HIV diagnoses among gay and bisexual men in Australia

Delayed HIV diagnoses among gay and bisexual men in Australia

The majority of HIV diagnoses including delayed diagnoses in Australia occur among men who report homosexual contact – hereafter called gay and bisexual men (GBM). Delayed diagnosis is strongly associated with increased HIV-related mortality and morbidity. People who are unaware of their HIV-positive status may also be unwittingly transmitting HIV. We assessed trends in delayed HIV diagnoses among GBM in Australia.

Method: National surveillance data on new HIV diagnoses among GBM in the years 2002-11 were analysed. The number and proportion of diagnoses defined as late (a CD4+ cell count of 200 to 349 cells/μl at diagnosis), and advanced (<200 CD4+ cells/μl at diagnosis) is reported. A Chi-square test was used to assess trends in these two categories.

Results: A total of 6,725 HIV diagnoses in GBM were notified in the 10-years 2002-11. The number of diagnoses in GBM increased over time, from 592 in 2002 to 675 in 2006 and 801 in 2011. Of all diagnoses in GBM, 11.9% were defined as advanced, remaining steady over-time at 11.7% in 2002, to 12.7% in 2006 and 11.1% in 2011, with no significant trend (ptrend=0.593). A lower proportion of diagnoses in GBM were defined as late (9.8%), but diagnoses in this category increased steadily from 8.4% in 2002 to 11.3% in 2006 and 13.1% in 2010, with a decline in 2011 to 6.9%. There was a significant increasing trend in the proportion of HIV diagnoses defined as late over the period 2002-11 (ptrend=0.038).

Conclusion: An increasing proportion of HIV diagnoses among GBM were late diagnoses. The pattern of late diagnosis may be affected by patterns of antibody testing. A CD4+ count of 200-350 generally reflects an average time of around 4-7 years since initial infection. Services that offer more convenient and acceptable options for HIV testing may be needed to reduce delayed diagnoses among GBM.

Speakers: Phillip Keen
Conference: ASHM 2013
Areas of Interest / Categories: AIDS 2013, HIV, Homosexuality

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