Top

Published in:

01-07-2016 | Original Paper

Increasing Belief in the Effectiveness of HIV Treatment as Prevention: Results of Repeated, National Surveys of Australian Gay and Bisexual Men, 2013–15

Authors: Martin Holt, Toby Lea, Heather-Marie Schmidt, Dean Murphy, Marsha Rosengarten, David Crawford, Jeanne Ellard, Johann Kolstee, John de Wit

Published in: AIDS and Behavior | Issue 7/2016

Abstract

We surveyed Australian gay and bisexual men, assessing belief in HIV treatment as prevention (TasP) and support for early treatment. We identified the characteristics of participants who believed in TasP and supported early treatment using multivariate logistic regression. In 2013, 1316 men participated; 1251 participated in 2015. Belief in TasP increased from 2.6 % in 2013 to 13.1 % in 2015 (p < 0.001). The increase was most noticeable among HIV-positive men (from 9.7 % to 46.2 %). Support for early treatment increased from 71.8 % to 75.3 % (p = 0.02). Belief in TasP was associated with being HIV-positive, having a tertiary education, having recent condomless anal intercourse with casual male partners, and ever having taken post-exposure prophylaxis. Support for early HIV treatment was associated with being younger, living in New South Wales and being in paid employment. We recommend continued monitoring of the growing gap in belief about TasP between HIV-positive men and HIV-negative/untested men.

Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.CrossRefPubMedPubMedCentral

Montaner JSG. Treatment as prevention—a double hat-trick. Lancet. 2011;378(9787):208–9.CrossRefPubMed

Rodger A, Bruun T, Cambiano V, Vernazza P, Estrada V, Van Lunzen J, et al. HIV transmission risk through condomless sex if HIV+ partner on suppressive ART: PARTNER study. Conference on Retroviruses and Opportunistic Infections; Mar 6; Boston, USA 2014.

Baggaley R, Doherty M, Ball A, Ford N, Hirnschall G. The strategic use of antiretrovirals to prevent HIV infection: a converging agenda. Clin Infect Dis. 2015;60(suppl 3):S159–60.CrossRefPubMed

Cairns G, Baker AC, Dedes N, Zakowicz A, West B. Treatment as prevention: arriving at community consensus. Clin Infect Dis. 2014;59(suppl 1):S35–40.CrossRefPubMed

World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. Geneva: World Health Organization; 2013.

Holt M. HIV pre-exposure prophylaxis and treatment as prevention: a review of awareness and acceptability among men who have sex with men in the Asia-Pacific region and the Americas. Sex Health. 2014;11(2):166–70.PubMed

Young I, McDaid L. How acceptable are antiretrovirals for the prevention of sexually transmitted HIV? A review of research on the acceptability of oral pre-exposure prophylaxis and treatment as prevention. AIDS Behav. 2014;18(2):195–216.CrossRefPubMed

Rodger A, Phillips A, Speakman A, Gilson R, Fisher M, Wilkins E, et al. Attitudes of people in the UK with HIV who are antiretroviral (ART) naïve to starting ART at high CD4 counts for potential health benefit or to prevent HIV transmission. PLoS ONE. 2014;9(5):e97340.CrossRefPubMedPubMedCentral

10.

Holt M, Lea T, Murphy DA, Ellard J, Rosengarten M, Kippax SC, et al. Australian gay and bisexual men’s attitudes to HIV treatment as prevention in repeated, national surveys, 2011–2013. PLoS ONE. 2014;9(11):e112349.CrossRefPubMedPubMedCentral

11.

Carter A, Lachowsky N, Rich A, Forrest JI, Sereda P, Cui Z, et al. Gay and bisexual men’s awareness and knowledge of treatment as prevention: findings from the Momentum Health Study in Vancouver, Canada. J Int AIDS Soc. 2015;. doi:10.7448/IAS.18.1.20039.

12.

Newman CE, de Wit J, Persson A, Holt M, Slavin S, Kidd MR, et al. Understanding concerns about treatment-as-prevention among people with HIV who are not using antiretroviral therapy. AIDS Behav. 2015;19(5):821–31.CrossRefPubMed

13.

Persson A. “The world has changed”: pharmaceutical citizenship and the reimagining of serodiscordance among couples with mixed HIV status in Australia. Sociol Health Illn. 2015;. doi:10.1111/1467-9566.12347.PubMed

14.

Commonwealth of Australia. Seventh National HIV Strategy 2014–2017. Canberra: Australian Government Department of Health; 2014.

15.

NSW Ministry of Health. NSW HIV strategy 2012–2015: a new era. Sydney: NSW Ministry of Health; 2012.

16.

Health Queensland. Queensland HIV strategy 2013–2015. Brisbane: Queensland Department of Health; 2013.

17.

Australasian Society for HIV Medicine. Australian Commentary on the US Department of Health and Human Services Guidelines for the use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Sydney: Australasian Society for HIV Medicine; 2015. http://arv.ashm.org.au/.

18.

Mao L, Adam PCG, Kippax S, Crooks L, Post JJ, Kidd MR, et al. Evolving views and practices of antiretroviral treatment prescribers in Australia. Med J Aust. 2015;202(5):258–60.CrossRefPubMed

19.

Holt M, Murphy D, Callander D, Ellard J, Rosengarten M, Kippax S, et al. HIV-negative and HIV-positive gay men’s attitudes to medicines, HIV treatments and antiretroviral-based prevention. AIDS Behav. 2013;17(6):2156–61.CrossRefPubMed

20.

Zablotska I, Kippax S, Grulich A, Holt M, Prestage G. Behavioural surveillance among gay men in Australia: methods, findings and policy implications for the prevention of HIV and other sexually transmissible infections. Sex Health. 2011;8(3):272–9.CrossRefPubMed

21.

Holt M, Murphy DA, Callander D, Ellard J, Rosengarten M, Kippax SC, et al. Willingness to use HIV pre-exposure prophylaxis and the likelihood of decreased condom use are both associated with unprotected anal intercourse and the perceived likelihood of becoming HIV positive among Australian gay and bisexual men. Sex Transm Infect. 2012;88:258–63.CrossRefPubMed

22.

Chen Y. Treatment-related optimistic beliefs and risk of HIV transmission: a review of recent findings (2009–2012) in an era of treatment as prevention. Curr HIV/AIDS Rep. 2013;10(1):79–88.CrossRefPubMedPubMedCentral

23.

Poynten IM, Smith DE, Cooper DA, Kaldor JM, Grulich AE. The public health impact of widespread availability of nonoccupational postexposure prophylaxis against HIV. HIV Med. 2007;8(6):374–81.CrossRefPubMed

24.

Grulich AE, de Visser RO, Badcock PB, Smith AMA, Heywood W, Richters J, et al. Homosexual experience and recent homosexual encounters: the Second Australian Study of Health and Relationships. Sex Health. 2014;11(5):439–50.CrossRefPubMed

25.

Poynten IM, Jin FY, Mao LM, Prestage GP, Kippax SC, Kaldor JM, et al. Nonoccupational postexposure prophylaxis, subsequent risk behaviour and HIV incidence in a cohort of Australian homosexual men. AIDS. 2009;23(9):1119–26.CrossRefPubMed

26.

Holt M, Lea T, Mao L, Zablotska I, Prestage G, de Wit J. HIV prevention by Australian gay and bisexual men with casual partners: the emergence of undetectable viral load as one of a range of risk reduction strategies. J Acquir Immune Defic Syndr. 2015;70(5):545–8.CrossRefPubMed

27.

Australian Federation of AIDS Organisations. Gay men & HIV disclosure. Sydney: Australian Federation of AIDS Organisations; 2014.

28.

Van Den Boom W, Stolte I, Witlox R, Sandfort T, Prins M, Davidovich U. Undetectable viral load and the decision to engage in unprotected anal intercourse among HIV-positive MSM. AIDS Behav. 2013;17(6):2136–42.CrossRef

29.

Davis M. The ‘loss of community’ and other problems for sexual citizenship in recent HIV prevention. Sociol Health Illn. 2008;30(2):182–96.CrossRefPubMed

30.

Smit PJ, Brady M, Carter M, Fernandes R, Lamore L, Meulbroek M, et al. HIV-related stigma within communities of gay men: a literature review. AIDS Care. 2012;24(4):405–12.PubMed

31.

Imrie J, Elford J, Kippax S, Hart GJ. Biomedical HIV prevention—and social science. Lancet. 2007;370(9581):10–1.CrossRefPubMed

32.

de Wit JBF, Adam PCG. Revolution or evolution? What can approaches based on the use of antiretroviral drugs contribute to HIV prevention in gay communities in high-income countries? In: Eaton LA, Kalichman SC, editors. Biomedical advances in HIV prevention. New York: Springer; 2014. p. 181–204.CrossRef

Title: Increasing Belief in the Effectiveness of HIV Treatment as Prevention: Results of Repeated, National Surveys of Australian Gay and Bisexual Men, 2013–15
Authors: Martin Holt
Toby Lea
Heather-Marie Schmidt
Dean Murphy
Marsha Rosengarten
David Crawford
Jeanne Ellard
Johann Kolstee
John de Wit
Publication date: 01-07-2016
Publisher: Springer US
Published in: AIDS and Behavior / Issue 7/2016
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-016-1306-0

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Increasing Belief in the Effectiveness of HIV Treatment as Prevention: Results of Repeated, National Surveys of Australian Gay and Bisexual Men, 2013–15

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 7/2016

Repeat Use of Post-exposure Prophylaxis for HIV Among Nairobi-Based Female Sex Workers Following Sexual Exposure

Attitudes Toward HIV Pre-Exposure Prophylaxis in a United States Urban Clinic Population

Self-reported Recent PrEP Dosing and Drug Detection in an Open Label PrEP Study

Pre-exposure Prophylaxis Adherence Measured by Plasma Drug Level in MTN-001: Comparison Between Vaginal Gel and Oral Tablets in Two Geographic Regions

Relationship Dynamics and Partner Beliefs About Viral Suppression: A Longitudinal Study of Male Couples Living with HIV/AIDS (The Duo Project)

Framing HIV Pre-Exposure Prophylaxis (PrEP) for the General Public: How Inclusive Messaging May Prevent Prejudice from Diminishing Public Support

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page