SUBSTANTIAL shifts in condom usage rates among men who have sex with men (MSM), the growing popularity of mobile applications and a lacklustre result in men reporting ever being tested for HIV are some of the key results from the 2013 Queensland Gay Periodic Health Survey.
The survey, commissioned by the Kirby Institute at the University of New South Wales, was conducted last year and facilitated by HIV and AIDS education and support organisation Queensland Positive People (QPP). Results that were released last month have been mixed with some indicating more work is needed to tackle the issue.
One of the major findings from the survey was that the number of respondents who reported being tested for HIV had remained at a stable 87.5 per cent.
HIV Foundation Queensland (HIVFQ) chair Dr Darren Russell urged for higher testing rates but said that while numbers from this survey had remained stable, there had been a “significant” increase in men testing for HIV since 2009.
“Since 2009 the proportion of non-HIV-positive men who reported testing for HIV in the previous 12 months has increased significantly from 68.7 per cent to 75.8 per cent in 2013. Increased testing may lead to the speedier diagnosis of new HIV cases,” Dr Russell told the Star Observer.
The introduction of rapid HIV testing has had an impact on the ease and willingness for men to start testing for the first time and/or more regularly.
Queensland AIDS Council (QuAC) executive director John Mikelsons highlighted QuAC’s Testing Point Clinic as being a part of the process.
“Roughly one in three of the guys accessing our Testing Point clinic have either never been tested before or haven’t tested in the past 12 months,” he said.
“It is critically important that we ramp up this clinic in the weeks and months ahead and continue our focus on testing.”
Being formally introduced by the Queensland Government in June last year, Dr Russell said that he felt the survey needed more time to determine a more accurate result on the overall take up of rapid HIV testing.
“The [survey] represents a sample of men who have sex with men and their testing frequency, it does not answer questions about testing behaviours,” he said.
“It is possible, that some men do not test for HIV ever or frequently for a range of reasons including cost, access and knowledge of testing. The HIVFQ are working toward increasing access to voluntary testing, particularly for MSM.”
One of the major findings of the 2013 survey was the shift in condom usage and for the first time in five years, with the number of MSM respondents who reported that they “sometimes do not use a condom” outnumbering those “always use a condom”.
The 2013 survey recorded the highest ever amount of unprotected anal intercourse with a casual partner (UAIC) in the survey’s history.
Both Dr Russell and Mikelsons expressed concern with this change and said that maintaining a strong message about condom usage was still at the forefront of keeping transmission rates down.
“The HIVFQ is concerned about the sustained rise in unprotected anal intercourse with casual partners and how this may negate improvements in the frequency of HIV testing and the uptake of antiretroviral treatment as key outcomes of the Queensland HIV Strategy 2012-2015,” Dr Russell said.
While the rates of UAIC were the highest on record, the survey also found that the rates of serosorting practises within the MSM community continued to trend, with over 52 per cent of HIV positive respondents making themselves aware of their viral loads and 25 per cent only engaging in UAIC with others who were serosorting.
The survey also indicated that HIV-negative respondents were also actively engaged in serosorting practices, with 34.7 per cent saying that they always make sure their partners were also negative before they had UAIC.
Mikelsons said that serosorting has become an active strategy between some in the MSM community and that these men along with the rest of the LGBTI community and health organisations need to continue working on risk reduction strategies together.
“We know that serosorting is a strategy that gay men use to reduce the risk of transmitting or contracting HIV, along with a bunch of other strategies. How gay men and community organisations understand safe sex is evolving and this is reflected in the data,” he told the Star Observer.
The survey also found that there had been a substantial uptake in treatment undertaken by positive respondents, with many reporting undetectable viral loads. However, Dr Russell expressed concern over men not on treatment.
“HIV-positive men in the survey report a very high level of HIV-treatment uptake (89 per cent in 2013) and nearly all the men on treatment reported an undetectable viral load (92 per cent in 2013),” he said.
“Whilst being on treatment is likely to mitigate the risk of transmission, the minorities of HIV-positive men not on treatment or with a detectable viral load are just as likely as their peers to report UAIC.”
Dr Russell was “encouraged” to see that knowledge of post exposure prophylaxis (PEP) was on the increase, highlighting that a number of prevention activities during the year aimed to raise awareness.
“It is encouraging to see the increased number of HIV-positive men on antiretroviral treatment (ART) and that nine out of 10 men on ART who report an undetectable viral load.”
Drug use within the MSM community continues to be an issue for health organisations, with the survey showing that out of the respondents, more HIV-positive men were likely to use drugs for recreational and sexual purposes.
One in five positive respondents reported using party drugs such as crystal meth for sex and slightly more than one in 10 reported drug usage prior or during group sex situations.
“Any behaviour that influences people’s decisions around practising safe sex is of a concern to the HIVFQ,” Dr Russell said.
“Knowledge of these behaviours will be used in prevention messages and through ongoing development of the E.N.D. H.I.V. campaign and related prevention activities, including the Community HIV Education and Prevention Program.”
The survey also found that there had been a “rapid” increase in the way that MSM meet partners for sex through mobile app technology, with 38.5 per cent reporting having used apps as opposed to 26.2 per cent in 2012.
Mikelsons said this demonstrated the need for new approaches in HIV education as the sexual and social behaviour of gay men and MSM shifted over time.
QPP were also contacted for comment but no response was received at the time of print.