Knowledge about the evidence for treatment as prevention (TasP) among Australian gay men has not been explored in detail. Methods: TAXI-KAB was a national online survey of Australian gay men recruited during late 2012. 897 men responded to questions about knowledge and beliefs about TasP.
Most men were gay (88.9%) or bisexual (8.8%). Mean age was 39 years. 90.1% had ever been tested for HIV; 171 reported being HIV-positive. Over 90% of all men understood that HIV treatments were effective and improved the health prospects of PLHIV, although 46.3% believed that treatments are toxic and will eventually cause long-term damage. 66.3% of men had no knowledge of the trial evidence for TasP among heterosexual couples; 26.0% believed this trial evidence applied to sex between men. Seemingly contradictorily, while the majority (62.7%) believed that HIV transmission was still likely to occur even when an HIV-positive man is on treatments, two thirds (63.7%) nonetheless believed HIV-positive men should go on treatments to protect their partners from infection. HIV-positive men were somewhat better informed about the evidence for TasP, but nearly half (44.2%) had not heard of this. HIV-positive men were less skeptical about TasP, but were as likely to agree they should use treatments to protect their partners as were non HIV-positive men.
Although most gay men recognise that HIV treatments have improved the health prospects for PLHIV, many are also quite pessimistic about their long-term effects. The majority, including nearly half of HIV-positive men, also appear to be unaware of the trial evidence for TasP and are highly skeptical about the possible effects of treatments on reducing HIV transmission during sex between men. Improved understanding among among gay men of the role of, and evidence for, treatment in prevention is critical to community level implementation of combination prevention.
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.
HIV-associated leishmaniasis, endemic in the Mediterranean basin is a growing problem in India, Brazil and East Africa. Despite surviving for than 20 years, the clinical course of our visceral-leishmania (VL)-HIV co-infected patient illustrates several management challenges including diagnosis, speciation and drug resistance; monitoring burden of disease; access to and use of VL-treatments; end-organ toxicity and the combined immunosuppressive effects of HIV-VL.
Adherence to combination antiretroviral therapy (cART ) plays an important role on treatment outcomes. The TREAT Asia Studies to Evaluate Resistance – Monitoring Cohort Study (TASER-M) collects patients’ adherence based on a Visual Analogue Scale. The aim of this analysis was to assess the rates of, and factors associated with, suboptimal adherence in the first 24 months of initial cART in Asian patients.
REACH was a collaborative research and practice initiative to develop evidence building frameworks, capacity, tools and resources with the Victorian HIV community partnership.
HIV disease is associated with chronic inflammation and activation of the innate immune system. This state, as measured using plasma markers of inflammation, persists following suppression of HIV viremia using antiretroviral therapy, and may increase risk of non-AIDS co-morbidities. The causes of innate immune activation in the setting of virological suppression are unclear. Natural killer (NK) cells are innate immune cells that kill virus-infected and transformed cells without prior sensitization. We have shown that NK cells are activated both phenotypically (elevated expression of HLA-DR) and functionally (increased spontaneous degranulation measured by CD107a surface expression) in virologically suppressed (VS) HIV+ individuals. NK cells also lose expression of CD16, the receptor which mediates antibody-dependent cellular cytotoxicity.
Regular HIV testing is recommended in men who take sexual risks. We assessed the relationship between perceived barriers to HIV testing, and frequency of testing among men who engaged in unprotected anal intercourse with casual partners (UAIC), to inform HIV testing strategies.
In recent years there has been a widespread uptake of smartphones with internet access and location services and the development of mobile ‘apps’ for gay men to meet each other. We reviewed data collected in the Sydney and Melbourne Gay Community Periodic Surveys (GCPS) to identify which men were relying on mobile and internet methods to meet each other and whether these methods were associated with different risk practices.