A new report from the University of New South Wales has shown that gay and bisexual men are getting tested and using medications to prevent HIV transmission more than ever, with researchers recording an encouraging major shift towards new forms of prevention thanks to government-funded access programs.
Researchers at UNSW’s Centre for Social Research in Health (CSRH) say 92% of HIV-positive gay and bisexual men are taking antiretroviral treatment (ART) and achieving an undetectable viral load. The result is more than 90% of these men can no longer transmit HIV. This is a record high for the third year running.
The Annual Report of Trends in Behaviour 2018 will be released today by the CSRH at UNSW Sydney, alongside The Kirby Institute’s Annual Surveillance Report in HIV, viral hepatitis and sexually transmissible infections in Australia at the Australasian HIV/AIDS Conference in Sydney.
The report finds the proportion of gay men with casual partners who reported using the HIV prevention tool pre-exposure prophylaxis (PrEP) before sex increased from 1% in 2013 to 5% in 2016 and then to 16% in 2017.
Project leader of the Gay Community Periodic Surveys at CSRH, Professor Martin Holt, said this increase was mostly seen during 2016-2017, suggesting PrEP uptake was boosted by access to state-funded PrEP programs in NSW, Victoria and Queensland in 2016. Western Australia’s PrEP program did not commence until late in 2017.
“PrEP and treatment as prevention (TasP) are becoming increasingly popular HIV prevention strategies used by gay and bisexual men, particularly those well connected to the urban gay community networks,” Professor Holt said.
“Now that PrEP is available through the Pharmaceutical Benefits Scheme, the challenge is to achieve greater prevention coverage of all people at risk of HIV, including those who are Medicare-ineligible, in order to achieve targets for the elimination of HIV transmission.”
The latest periodic survey results show that gay men are testing more frequently for HIV. In 2017, over 40% of non-HIV-positive gay men had at least three tests within the previous year.
In recent years testing for the virus has become substantially easier within the introduction of rapid testing which gives immediate results, previously patients had to return to a clinic after a fortnight to find out the result of their test.
Alongside testing for HIV gay and bisexual men are also getting comprehensive testing for other sexually transmitted infections. In 2017, over half of gay and bisexual men reported comprehensive STI testing (a minimum of one blood sample, urine sample, throat swab and rectal swab each) in the previous year.
The results also showed that men who were HIV-positive were having regular health check-ups, with over 60% of HIV-positive gay men having had a quarterly HIV-related clinical visits in the previous year.
Lead author of the CSRH report, Associate Professor Limin Mao, says the report shows there is a continued improvement in the health of people living with HIV, which contributes significantly to eliminating HIV transmission.
“Increased reliance on effective biomedical prevention strategies by both HIV-positive and HIV-negative men have brought successes in driving HIV notifications down,” she said.
“This also brings challenges to our health system to take a more holistic approach to a range of priority populations across different settings.”
According to Associate Professor Christy Newman, also from CSRH, these changes provide an opportunity to expand and prioritise future efforts towards the needs of minority groups.
“Many populations have been less well engaged by existing approaches to HIV prevention, including straight-identified men who have sex with men, people from migrant or refugee backgrounds, women, and adolescents and young people,” Associate Professor Newman said.
“We now have an opportunity to think more creatively about overcoming the stigma and taking alternative approaches to better serve beyond urban communities of gay and bisexual men.”
The Director of CSRH, Professor Carla Treloar, said the report shows that the current approaches taken towards HIV were delivering effective results.
“Our report highlights further efforts are needed to address the HIV/STI epidemic, using more people-centred systematic approaches to engage people still facing stigma and discrimination.” Professor Treloar said.
OIP Staff, photo by Kat Wilcox from Pexels
