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23. Sustaining success: a qualitative study of gay and bisexual men’s experiences and perceptions of HIV self-testing in a randomized controlled trial

Author

Zhang, Ye, Guy, Rebecca J., Smith, Kirsty S., Jamil, Muhammad S., Prestage, Garrett, Applegate, Tanya L., Conway, Damian P., Holt, Martin, Keen, Phillip, Bavinton, Benjamin, McNulty, Anna M., Batrouney, Colin, Russell, Darren, Vaughan, Matthew, Chen, Marcus, Fairley, Christopher K., Grulich, Andrew E., Kaldor, John M., and Callander, Denton

Published
2021
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24. Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study

Author

Grulich, Andrew E, Zablotska-Manos, Iryna B, Prestage, Garrett P, Jin, Fengyi, Bavinton, Benjamin R, Grinsztejn, Beatriz, Phanuphak, Nittaya, Cooper, David A, Kelleher, Anthony, Emery, Sean, Fairley, Christopher K, Wilson, David, Koelsch, Kersten K, Triffitt, Kathy, Doong, Nicolas, Baker, David, Bloch, Mark, Templeton, David J, McNulty, Anna, Pell, Catherine, Hoy, Jennifer, Tee, Ban Kiem, Moore, Richard, Roth, Norman, Orth, David, Pinto, Angie N, and McNulty, Anna M

Published
2018
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25. Strategies used by gay male HIV serodiscordant couples to reduce the risk of HIV transmission from anal intercourse in three countries

Author

Bavinton, Benjamin R., Prestage, Garrett P., Jin, Fengyi, Phanuphak, Nittaya, Grinsztejn, Beatriz, Fairley, Christopher K., Baker, David, Hoy, Jennifer, Templeton, David J., Tee, Ban K., Kelleher, Anthony, and Grulich, Andrew E.

Subjects
HIV infections -- Risk factors, Disease transmission -- Risk factors, Gays -- Health aspects, Anal intercourse -- Health aspects, Health
Abstract

Introduction: There are few data about the range of strategies used to prevent sexual HIV transmission within gay male serodiscordant couples. We examined HIV prevention strategies used by such couples and compared differences between countries. Methods: Opposites Attract was a cohort study of male serodiscordant couples in Australia, Brazil and Thailand, from May 2014 (Australia) or May 2016 (Brazil/Thailand) to December 2016. At visits, HIV-positive partners had viral load (VL) tested; HIV-negative partners reported sexual behaviour and perceptions of their HIV-positive partner's VL results. Within-couple acts of condomless anal intercourse (CLAI) were categorized by strategy: condom-protected, biomedically protected (undetectable VL and/or pre-exposure prophylaxis [PrEP]), or not protected by either (HIV-negative partners engaging in insertive CLAI, receptive CLAI with withdrawal, or receptive CLAI with ejaculation). Results: A total of 343 couples were included in this analysis (153 in Australia, 93 in Brazil and 97 in Thailand). Three-quarters of HIV-positive partners were consistently virally suppressed ( Keywords: serodiscordant couples; homosexual; gay men; men who have sex with men; HIV prevention; risk reduction strategies; sexual behaviour, 1 INTRODUCTION HIV-negative partners in gay male serodiscordant couples are considered high risk for HIV infection [1], and it is often recommended that serodiscordant couples be a key focus of [...]

Published
2019
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28. Hiding in plain sight: highlighting the research gap on access to HIV and other sexual health services for underrepresented gay men in developed Western countries – insights from a scoping review with a focus on Arab men.

Author

Saliba, Bernard, Kang, Melissa, Wells, Nathanael, Mao, Limin, Prestage, Garrett, and Hammoud, Mohamed A.

Abstract

Background: Strategies pertaining to HIV and sexual health for gay, bisexual, and other men who have sex with men (GBMSM) have shifted focus towards underrepresented subgroups within some developed Western countries. Although emerging research exists on some subgroups, limited attention has been given to the needs of Arab GBMSM in these contexts. Considering they are part of a large diaspora, understanding their access to services is crucial. This paper focuses on Arab GBMSM as a case study within a scoping review, highlighting their hidden status within the broader landscape of HIV and sexual health research for GBMSM in the West. Methods: A multi-method search strategy was employed, including searching four electronic databases using several terms within each of the following search topics: Arab, GBMSM, HIV and other sexual health services, and developed Western countries. Results: Of the 384 articles found, only one addressed the research question and met the inclusion criteria, revealing a stark scarcity of research on access to HIV and sexual health services for this population. Conclusions: This review highlights a paucity of research on access to HIV and sexual health services for underrepresented GBMSM populations in developed Western countries. The literature indicates that, for Arab men, this may be due to a difficulty in participant recruitment and poor data collection efforts. By focusing on one hidden population, we aim to advocate for inclusive policies and interventions that promote equitable sexual health access for all. Addressing this research gap aligns with broader local and global HIV strategies to reduce disparities among underrepresented GBMSM populations. This study uncovers an often-overlooked issue: the limited research on access to sexual health services among gay Arab men in Western countries. Findings in this publication reveal significant gaps in knowledge for this population, particularly in areas where strides have been made in reducing HIV transmission. The implications are far-reaching, as addressing these disparities is essential for ensuring equitable healthcare for underrepresented communities. By shedding light on this hidden population, this study paves the way for targeted interventions and policy changes to promote inclusive and accessible sexual health services for all. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Undiagnosed HIV infections among gay and bisexual men increasingly contribute to new infections in Australia

Author

Gray, Richard T., Wilson, David P., Guy, Rebecca J., Stoove, Mark, Hellard, Margaret E., Prestage, Garrett P., Lea, Toby, de Wit, John, and Holt, Martin

Subjects
HIV infections -- Diagnosis -- Care and treatment -- Research, Disease transmission -- Research, Gay men -- Health aspects, Prevalence studies (Epidemiology) -- Analysis, Bisexuals -- Health aspects, Health
Abstract

Introduction: We determined the contribution of undiagnosed HIV to new infections among gay and bisexual men (GBM) over a 12-year period in Australia where there has been increasing focus on improving testing and HIV treatment coverage. Methods: We generated annual estimates for each step of the HIV cascade and the number of new HIV infections for GBM in Australia over 2004 to 2015 using relevant national data. Using Bayesian melding we then fitted a quantitative model to the cascade and incidence estimates to infer relative transmission coefficients associated with being undiagnosed, diagnosed and not on ART, on ART with unsuppressed virus, or on ART with suppressed virus. Results: Between 2004 and 2015, we estimated the percentage of GBM with HIV in Australia who were unaware of their status to have decreased from 14.5% to 7.5%. During the same period, there was a substantial increase in the number and proportion of GBM living with HIV on treatment and with suppressed virus, with the number of virally suppressed GBM increasing from around 3900 (30.2% of all GBM living with HIV) in 2004 to around 14,000 (73.7% of all GBM living with HIV) in 2015. Despite the increase in viral suppression, the annual number of new infections rose from around 660 to around 760 over this period. Our results have a wide range due to the uncertainty in the cascade estimates and transmission coefficients. Nevertheless, undiagnosed GBM increasingly appear to contribute to new infections. The proportion of new infections attributable to undiagnosed GBM almost doubled from 33% in 2004 to 59% in 2015. Only a small proportion ( Discussion: Our study suggests that an increase in HIV treatment coverage in Australia has reduced the overall risk of HIV transmission from people living with HIV. However, the proportion of infections and the rate of transmission from undiagnosed GBM has increased substantially. These findings highlight the importance of HIV testing and intensified prevention for Australian GBM at high risk of HIV. Keywords: Australia; gay and bisexual men; mathematical model; transmission dynamics; undiagnosed HIV; HIV cascade, 1 | INTRODUCTION People with undiagnosed HIV contribute disproportionately to HIV transmission because the early stages of infection are the most infectious, and without treatment an individual remains infectious [1-7]. [...]

Published
2018
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32. Understanding the Targeting and Uptake of HIV Testing Among Gay and Bisexual Men Attending Sexual Health Clinics

Author

Jamil, Muhammad S., McManus, Hamish, Callander, Denton, Prestage, Garrett, Ali, Hammad, O’Connor, Catherine C., Chen, Marcus, McNulty, Anna M., Knight, Vickie, Duck, Tim, Keen, Phillip, Gray, James, Medland, Nick, Hellard, Margaret, Lewis, David A., Grulich, Andrew E., Kaldor, John M., Fairley, Christopher K., Donovan, Basil, Guy, Rebecca J., and on behalf of ACCESS and NSW Partnership Project Steering Committees

Published
2018
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41. 'It's like I have this weird superpower': experiences of detectable and undetectable viral load among a cohort of recently diagnosed people living with HIV.

Author

Wells, Nathanael, Philpot, Steven, Murphy, Dean, Ellard, Jeanne, Howard, Chris, and Prestage, Garrett

Abstract

Background. By reducing HIV viral load to undetectable levels, HIV treatment slows disease progression and eliminates the possibility of sexual transmission. The promotion of undetectable viral load has also been accompanied by expectations of reducing HIV-related stigma, including self-stigma. Drawing on accounts of people recently diagnosed with HIV, we explored experiences of both detectable and undetectable viral load. Methods. Between January 2019 and November 2021, semi-structured interviews were conducted with 35 people living with HIV (PLHIV) who had received an HIV diagnosis in Australia from 2016 onward. Of these participants, 24 completed follow-up interviews approximately 12months later. Interviews were transcribed verbatim, entered into NVivo (software v12), and thematically analysed. Results. Reflecting on the period in which their viral load was detectable, some participants described feeling 'dirty,' 'viral,' and 'a risk' to sexual partners. During this period, some participants minimised or ceased having sex, sometimes despite being in ongoing romantic relationships. Reaching undetectable viral load was commonly characterised as an important goal in HIV care and signalled a marker of good health and enabled a return to sexual relationships. However, the psychosocial benefits of undetectable viral load were not universally experienced, with some participants highlighting ongoing challenges of living with HIV long term. Conclusions. Increasing awareness of the benefits of undetectable viral load is an important and powerful tool for improving the health and wellbeing of PLHIV; however, the period in which one's HIV viral load is detectable can be challenging, particularly as feelings of being 'unclean' and 'a risk' may be internalised. Ensuring PLHIV are appropriately supported during periods of viral detectability is necessary. [ABSTRACT FROM AUTHOR]

Published
2023
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