Uptake of HIV testing may increase with convenience and speed of receiving results. We determined the popularity of receiving HIV test results by SMS and compared this with rapid HIV point-of-care testing (POCT).
From October 2011, North Shore Sexual Health Service (NSSHS) has offered rapid HIV POCT to men-who-have-sex-with-men (MSM). From December 2012, NSSHS has offered the option of receiving traditional HIV serology results (if negative) by SMS to mobile phone one business day after venipuncture.
Clinicians determined if MSM needed to return in person for a result. Otherwise, after discussing the options with their clinician, MSM were able to choose between having a POCT, receiving their result by phone 5-7 days after venipuncture, or sent by SMS to their mobile phone. We evaluated patient satisfaction with the SMS method by follow- up phone survey.
From December 2012 to May 2013, 271 HIV tests were performed in 234 MSM. Of these tests, 4.7% were POCT, 7.3% were received in person, 21% by phone, and 61% were sent by SMS. SMS was sent by the next business day in 96% of those electing the SMS method. Opinions about receiving HIV results by SMS were: 94% satisfied, 85% would choose this method for the next test, and 91% were satisfied with the privacy of SMS. Of 48 MSM who had previously had a POCT, 35 elected a result by SMS. Feedback from clinicians indicated that MSM valued the better performance of traditional HIV serology, and a longer visit time hindered the popularity of POCT.
The majority of our MSM patients elected HIV test result by SMS compared with phone or POCT, were satisfied with this method and would choose it again for future testing. Our patients appeared to value the better accuracy of traditional HIV serology over POCT.
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.
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.