Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

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.

Resumen

Encuestamos a hombres australianos gay y bisexuales, evaluando la creencia en el tratamiento como prevención del VIH (TaSP – por sus siglas en ingles) y apoyo al tratamiento temprano. Se identificaron las características de los participantes que creyeron en (TasP) y tratamiento temprano mediante regresión logística multivariante. En el 2013, participaron 1.316 hombres; en el 2015 participaron 1.251. La creencia en (TasP) aumentó de 2.6 % en el 2013 a 13.1 % en el 2015 (p < 0.001). El aumento fue más notable entre los hombres VIH-positivos (de 9.7 % a 46.2 %). Apoyo al tratamiento temprano aumentó de 71.8 % a 75.3 % (p = 0.02). La creencia en TasP se asoció con ser VIH-positivo, con tener una educación terciaria, con tener coito anal recientemente sin condón con parejas casuales y con haber tomado, por lo menos alguna vez, la profilaxis posexposición. El apoyo al tratamiento temprano del VIH se asoció con ser más joven, con vivir en Nueva Gales del Sur y con tener empleo remunerado. Se recomienda el monitoreo continuo de la creciente brecha acerca de la creencia en TasP entre hombres VIH-positivos y VIH-negativo/no comprobado.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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

    Article  PubMed  Google Scholar 

  3. 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.

  4. 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.

    Article  PubMed  Google Scholar 

  5. 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.

    Article  PubMed  Google Scholar 

  6. 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.

    Google Scholar 

  7. 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  Google Scholar 

  8. 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.

    Article  PubMed  Google Scholar 

  9. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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  Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

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

    Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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  Google Scholar 

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

    Article  PubMed  Google Scholar 

  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.

    Chapter  Google Scholar 

Download references

Acknowledgments

We thank the survey participants for their time and Susan Kippax (who advised on the conduct of the study but did not participate in the writing of this article). The Centre for Social Research in Health (CSRH), National Drug Research Institute and Australian Research Centre in Sex, Health and Society receive funding from the Australian Government Department of Health. ACON and Positive Life NSW receive funding from the New South Wales (NSW) Ministry of Health. In 2013 the PrEPARE Project was supported by a research promotion grant from CSRH and in 2015 by the Blood borne viruses and sexually transmissible infections Research, Intervention and Strategic Evaluation (BRISE) program, funded by the NSW Ministry of Health.

Author information

Authors and Affiliations

  1. Centre for Social Research in Health, UNSW Australia, Level 2, John Goodsell Building, Sydney, NSW, 2052, Australia

    Martin Holt, Toby Lea, Dean Murphy, Marsha Rosengarten & John de Wit

  2. New South Wales Ministry of Health, Sydney, Australia

    Heather-Marie Schmidt

  3. National Drug Research Institute, Curtin University, Melbourne, Australia

    Dean Murphy

  4. Goldsmiths, University of London, London, UK

    Marsha Rosengarten

  5. Positive Life NSW, Sydney, Australia

    David Crawford

  6. Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia

    Jeanne Ellard

  7. ACON, Sydney, Australia

    Johann Kolstee

Authors
  1. Martin Holt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toby Lea
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Heather-Marie Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dean Murphy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marsha Rosengarten
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David Crawford
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jeanne Ellard
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Johann Kolstee
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. John de Wit
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin Holt.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Holt, M., Lea, T., Schmidt, HM. et al. Increasing Belief in the Effectiveness of HIV Treatment as Prevention: Results of Repeated, National Surveys of Australian Gay and Bisexual Men, 2013–15. AIDS Behav 20, 1564–1571 (2016). https://doi.org/10.1007/s10461-016-1306-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-016-1306-0

Keywords

Search

Navigation