Researchers at the University of NSW will today release the results of a unique study into the acceptance of various strategies for reducing HIV among gay men.
The NSW HIV Modelling and Acceptability Project looked at ways to improve the response to HIV among gay men.
Researchers used mathematical computer modelling, and asked gay men about their willingness to adopt a range of HIV prevention and risk reduction strategies.
Those were condom use above current levels; reducing sexual partners; HIV negative men taking HIV drugs to reduce the chance of infection (known as Pre-Exposure Prophylaxis or PrEP); Post-Exposure Prophylaxis (PEP); earlier treatment for HIV positive men to reduce viral loads; increased testing; increased status disclosure; and adult circumcision.
Researchers found it would be difficult to sustain higher levels of condom use, while adult circumcision was unacceptable.
Fewer sexual partners was not a popular option, while PrEP, still in the experimental stage, would be acceptable if more information was available.
Gay men were cautious about PEP due to its side effects. Researchers said education about the reduced side effects of new medication would be necessary.
HIV positive men starting treatment sooner was also among the more effective strategies.
Gay men said they would test more frequently if the process was faster and more convenient — making a strong case for the introduction of rapid testing in Australia.
Increased disclosure could reduce infection rates so long as it was combined with sero-sorting and more frequent testing.
Lead researcher Associate Professor David Wilson from the National Centre in HIV Epidemiology and Clinical Research told the Star Observer the research would go to policy and program committees and community health organisations.
“This is hopefully going to inform what the real practical programs and policies are going to be around community education over the next 12 to 18 months,” he said.
However, Wilson warned the strategies were about reducing risk, not alternatives to condom use.
“Condoms and lube still remain the most effective way of preventing HIV transmission,” he said.
He said PrEP showed promise, with initial research suggesting it might be up to 70 percent effective, but still lower than condom use. People also needed to remember to take the medication every day, otherwise effectiveness could lower to 30 or 40 percent.
Positive Life NSW executive officer Rob Lake welcomed the new research.
“This is a pretty useful piece of work,” he said. “The mix of the modelling and the acceptability research gives us some useful tools.
“We know there is a need to make testing easier and that is one of the more important things that comes out of this. In terms of what strategies are more or less acceptable, it’s given us some stuff to think about.”
ACON CEO Nicolas Parkhill called the research “innovative”.
“Results of mathematical modelling of the potential impact of a number of gay men’s HIV prevention interventions, combined with the attitudes of gay men towards those interventions, offers a pragmatic, realistic and evidence-based framework for developing improved prevention responses,” he said.
“Importantly, the findings show that maintaining high rates of condom use among gay men continues to be essential to ensuring effective prevention outcomes.”