Background: Recent Australian regulatory approval of rapid HIV tests (RHT) was specific to clinical use. While individuals may import RHT for personal use there is no regulatory provision for self-testing. Home testing kits are licensed for use in some countries and are increasingly available online. Australian gay men may access these test kits during travel overseas or through online purchasing.
Methods: TAXI-KAB was a national online survey of Australian gay men recruited during late 2012, mostly prior to Australian approval of any rapid HIV test. 567 non HIV-positive men responded to questions about rapid HIV home test kits.
Results: Most men were gay (86.9%). Mean age was 38 years. 88.4% had been tested for HIV. The majority (53%) were aware of RHT and 33.1% knew they were available for home use overseas. Most (84.1%) indicated they would likely use RHT (in any setting) and 12% had already done so, mainly (7%) while overseas. Most (70.8%) men indicated they would likely use a rapid home test kit if it was available. Nine men had already tested themselves at home, seven of whom had purchased the test kit online. Most men believed that the customer should pay at least some (48.1%) or all (31.3%) of the cost of home test kits.
Conclusion: Many gay men are keen to have access to rapid HIV home testing, and a small number have already done so. Prior to RHT becoming available in Australia, some gay men had already used this technology overseas. Gay men are increasingly likely to access home testing, regardless of official policy. Without appropriate guidelines for reliable methods of sourcing and using this technology, and interpreting results, gay men may use poor quality, unapproved test kits, thereby risking inaccurate test results and uninformed responses to test results.
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.
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.
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.
Early first sexual intercourse has been proposed as an important marker of later sexual and reproductive health. Discussions of what constitutes early sexual debut in this context, however, have been limited.