Gay and bisexual men test for HIV more often when rapid tests are available at clinics according to a new study from the Kirby Institute at UNSW, presented today at the World HIV and STI 2015 Congress and Australasian HIV and AIDS Conference in Brisbane.
In a study of 4,889 men attending eight sexual health clinics and a private general practice in New South Wales, the availability of rapid HIV testing at the point of care was associated with a significant increase in HIV testing among gay and bisexual men, particularly among men at increased risk of HIV.
Men in the study were offered a ten-minute rapid HIV test using blood from a finger-prick, and were given their test result at their clinic visit. They also had conventional HIV tests, with the results available a few days later. The study was run from June 2013 to December 2014. Researchers measured the number of HIV tests during a 12 month period among men who had rapid tests, compared to men attending the same clinics who had conventional HIV tests only.
Overall, men who had rapid HIV tests tested more often over a twelve month period. On average, men who had rapid tests had 1.8 tests in twelve months compared to 1.4 tests among men who had only conventional tests. Among men with high numbers of partners, those who had rapid HIV tests had an average of 2.2 tests in twelve months compared to 1.6 tests among men having only conventional tests. Men who had rapid HIV tests were three and a half times more likely to have more than two HIV tests over 12 months compared to men who only had conventional tests.
“It is recommended that sexually active gay men test for HIV at least once a year, even if they always use condoms, and that men who have multiple partners or any riskier practices test every three to six months so that infections are picked up early and newly diagnosed people can consider commencing HIV treatment, both for their own health and to help reduce ongoing transmission,” said Phillip Keen, coordinator of the Kirby Institute study. “We have known that gay and bisexual men strongly prefer rapid HIV testing, but our study provides the first evidence that men will also test more often when it is available at clinics, and where this is promoted in marketing. Rapid HIV testing may help achieve and sustain the high testing rates necessary to reach the goal of our State and National HIV strategies for ending HIV.”
In partnership with ACON, sexual health clinics and the State Reference Laboratory at St Vincent’s Hospital, New South Wales Health has now introduced a state-wide quality assurance framework to support the delivery of rapid testing. These services aim to make HIV testing more convenient and deliver fast screening results at convenient times of day.
“We’ve had a great response from our community to our peer-led rapid testing sites across Sydney and NSW,” said Nicolas Parkhill, CEO of ACON. “Our a[TEST] facilities are staffed by gay men and are in places that are easily accessed by gay men, and have provided around 4500 rapid HIV tests over the past two years. Making HIV testing fast, free, convenient and culturally appropriate has been the key to this success. We know that increased testing options lead to increased testing rates.”
Researchers cautioned that rapid tests are not as sensitive as traditional laboratory tests and therefore not as likely to pick up very recent HIV infections.
“Rapid tests should be performed in parallel with conventional laboratory HIV testing to ensure that testing services do not miss diagnosing infections in men who have been recently exposed to HIV,” said Keen.