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Canadian Journal of Public Health

, Volume 110, Issue 5, pp 668–674 | Cite as

HIV diagnoses and testing patterns among young gay, bisexual and other men who have sex with men: an analysis of HIV surveillance data in British Columbia, 2008–2015

  • Lauren IlesEmail author
  • Theodora Consolacion
  • Jason Wong
  • Troy Grennan
  • Mark Gilbert
  • Cheryl Prescott
  • David Moore
Quantitative Research
  • 79 Downloads

Abstract

Background

We examined changes in HIV testing indicators following a recent increase in diagnoses among young gay, bisexual and other men who have sex with men (GBMSM) in BC that accompanied implementation of a provincial HIV strategy.

Method

Surveillance and laboratory testing data were used to compare case counts and testing characteristics among GBMSM < 30 and ≥ 30 years diagnosed in 2008–2011 and 2012–2015. We tested differences in the proportion diagnosed on first testing episode, proportion diagnosed at late stage of infection and the median inter-test interval ((ITI) time in months between last negative test and first positive test) using χ2 and Wilcoxon rank-sum tests.

Results

In 2008–2011, 657 diagnoses were made among GBMSM: 24% among men < 30 years and 76% among men ≥ 30 years. In 2012–2015, 590 diagnoses were made: 28% among < 30 years and 28% among ≥ 30 years. Among men < 30 years, diagnoses made on first testing episode decreased (39.4% vs. 28.7% in 2012–2015; p = 0.042) and there were few late-stage diagnoses (5.1% in 2008–2011 vs. 9.1% in 2012–2015). The median ITI was 10 months in both periods. No changes were observed over time among men ≥ 30 years. However, in both periods, late-stage diagnosis was more common in men ≥ 30 years (2008–2011, 18.8%; 2012–2015, 18.6%; p < 0.01 for both). The ITI was also longer for men ≥ 30 years (2008–2011, 24.5 months; 2012–2015, 20 months; p < 0.001 for both).

Conclusion

Testing indicators suggested better testing practices among GBMSM diagnosed at < 30 years compared to those diagnosed at older ages. However, there are clear needs for additional prevention measures in both age groups.

Keywords

HIV HIV testing GBMSM Young GBMSM 

Résumé

Objectif

Nous avons examiné les changements dans les indicateurs de dépistage du VIH à la suite d’une hausse récente des diagnostics chez les jeunes hommes gais, bisexuels et autres hommes ayant des relations sexuelles avec des hommes (gbHARSAH) en Colombie-Britannique ayant accompagné la mise en œuvre d’une stratégie provinciale de lutte contre le VIH.

Méthode

Des données de surveillance et d’épreuves de laboratoire ont servi à comparer le nombre de cas et les caractéristiques du dépistage chez les gbHARSAH de < 30 ans et chez ceux de ≥ 30 ans diagnostiqués entre 2008 et 2011 et entre 2012 et 2015. Nous avons testé les différences dans la proportion de diagnostics au premier test, la proportion de diagnostics au dernier stade de l’infection et l’intervalle inter-dépistage médian [l’IID, en mois, entre le dernier test négatif et le premier test positif] à l’aide des tests du χ2 et de Wilcoxon.

Résultats

En 2008–2011, 657 diagnostics ont été posés chez les gbHARSAH : 24 % chez des hommes de < 30 ans et 76 % chez des hommes de ≥ 30 ans. En 2012–2015, 590 diagnostics ont été posés : 28 % chez des hommes de < 30 ans et 28 % chez des hommes de ≥ 30 ans. Chez les hommes de < 30 ans, les diagnostics posés au premier test ont diminué (39,4 % c. 28,7 % en 2012–2015; p = 0,042), et les diagnostics au dernier stade étaient rares (5,1 % en 2008–2011 c. 9,1 % en 2012–2015). L’IID médian était de 10 mois pour les deux périodes. Aucun changement n’a été observé dans le temps chez les hommes de ≥ 30 ans. Par contre, durant les deux périodes, les diagnostics au dernier stade étaient plus courants chez les hommes de ≥ 30 ans (2008–2011, 18,8 % 2012–2015, 18,6 %; p < 0,01 dans les deux cas). L’IID était aussi plus long chez les hommes de ≥ 30 ans (2008–2011, 24,5 mois; 2012–2015, 20 mois; p < 0,001 dans les deux cas).

Conclusion

Les indicateurs de dépistage indiquent que les pratiques de dépistage sont meilleures chez les gbHARSAH diagnostiqués avant l’âge de 30 ans que chez ceux qui sont diagnostiqués à un âge plus avancé. Des mesures de prévention supplémentaires sont toutefois clairement nécessaires dans les deux tranches d’âges.

Mots-clés

VIH Dépistage du VIH gbHARSAH Jeunes gbHARSAH 

Notes

Acknowledgements

We would like to acknowledge the public health nurses who complete the HIV case report forms, the laboratory technicians who process the HIV tests, and the teams that manage the HAISYS and Laboratory databases.

Funding information

DMM is supported by a Scholar Award from the Michael Smith Foundation for Health Research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Bogowicz, P., Moore, D., Kanters, S., Michelow, W., Robert, W., Hogg, R., …, the ManCount Study Team. (2016). HIV testing behaviour and use of risk reduction strategies by HIV risk category among MSM in Vancouver. Int J STD AIDS, 27(4), 281–287.  https://doi.org/10.1177/0956462415575424.
  2. British Columbia Centre for Disease Control. (2015). HIV in British Columbia: annual surveillance report 2014. Retrieved from Provincial Health Services Authority website: http://www.bccdc.ca/resource-gallery/Documents/Statistics%20and%20Research/Statistics%20and%20Reports/STI/HIV_Annual_Report_2014-FINAL.pdf. Accessed 2017-05-10.
  3. British Columbia Centre for Disease Control. (2016a). Anonymous testing pilot evaluation [Evaluation]. Retrieved from BC Centre for Disease Control website: http://www.bccdc.ca/resource-gallery/Documents/Statistics%20and%20Research/Statistics%20and%20Reports/STI/Anonymous%20Testing%20Pilot%20Evaluation%20March%202016.pdf. Accessed 2017-07-07.
  4. British Columbia Centre for Disease Control. (2016b). Communicable disease control manual: chapter 5 - sexually transmitted infections. Guidelines for testing, follow up, and prevention of HIV. Retrieved from http://www.bccdc.ca/resource-gallery/Documents/Communicable-Disease-Manual/Chapter%205%20-%20STI/HIV_Guidelines_Testing_FollowUp_Prevention.pdf. Accessed 2017-05-03
  5. British Columbia Centre for Excellence in HIV/AIDS. (2016). HIV monitoring quarterly report for British Columbia: Fourth quarter 2015. Retrieved from BC Centre for Excellence in HIV/AIDS website: http://www.cfenet.ubc.ca/publications/centre-documents/hiv-monitoring-quarterly-reports-fourth-quarter-2015. Accessed 017-05-15.
  6. British Columbia Ministry of Health. (2012). From hope to health towards an AIDS-free generation. Retrieved from BC Ministry of Health website: http://www.health.gov.bc.ca/library/publications/year/2012/from-hope-to-health-aids-free.pdf. Accessed 2017-05-12.
  7. Centers for Disease Control and Prevention. (2016). HIV surveillance report, 2015; vol.27. Retrieved from https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2015-vol-27.pdf. Accessed 2017-06-13.
  8. Community Based Research Centre. (2011). Sex now - 2010 survey report. Retrieved from CBRC website: http://cbrc.net/resources/2011/sex-now-2010-survey-report. Accessed 2017-06-05.
  9. Ferlatte, O., Hottes, T. S., Trussler, T., & Marchand, R. (2014). Evidence of a syndemic among young Canadian gay and bisexual men: uncovering the associations between anti-gay experiences, psychosocial issues, and HIV risk. AIDS Behav, 18(7), 1256.  https://doi.org/10.1007/s10461-013-0639-1.CrossRefPubMedGoogle Scholar
  10. Gilbert, M., Hottes, T. S., Lester, R., Gustafson, R., Krajden, M., & Ogilvie, G. (2014). Time since last negative HIV test among men who have sex with men and people who use injection drugs in British Columbia, 2006-2011. Canadian Journal of Public Health = Revue Canadienne De Sante Publique, 105(1), e63–e68.CrossRefGoogle Scholar
  11. Gustafson, R., Ogilvie, G., Moore, D., & Kendall, P. (2014). New HIV testing guidelines in BC. British Columbia Medical Journal, 56(4), 172–173.Google Scholar
  12. Hall, H. I., Song, R., Szwarcwald, C. L., & Green, T. (2015). Brief report: Time from infection with the human immunodeficiency virus to diagnosis, United States. Journal of Acquired Immune Deficiency Syndromes, 69(2), 248.CrossRefGoogle Scholar
  13. Hall, H. I., Song, R., Tang, T., An, Q., Prejean, J., Dietz, P., et al. (2017). HIV trends in the United States: diagnoses and estimated incidence. JMIR Public Health Surveill, 3(1), e8.  https://doi.org/10.2196/publichealth.7051.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Helms, D. J., Weinstock, H. S., Mahle, K. C., & Bernstein, K. T. (2009). HIV testing frequency among men who have sex with men attending sexually transmitted disease clinics: implications for HIV prevention and surveillance. Journal of Acquired Immune Deficiency Syndromes, 50(3), 320.CrossRefGoogle Scholar
  15. Hergenrather, K. C., Emmanuel, D., Durant, S., & Rhodes, S. D. (2016). Enhancing HIV prevention among young men who have sex with men: a systematic review of HIV behavioral interventions for young gay and bisexual men. AIDS Education and Prevention, 28(3), 252.CrossRefGoogle Scholar
  16. Katz, D. A., Dombrowski, J. C., Swanson, F., Buskin, S. E., Golden, M. R., & Stekler, J. D. (2013). HIV intertest interval among MSM in King County, Washington. Sexually Transmitted Infections, 89(1), 32–37  https://doi.org/10.1136/sextrans-2011-050470.CrossRefGoogle Scholar
  17. Lachowsky, N. J., Lin, S. Y., Hull, M. W., Cui, Z., Sereda, P., Jollimore, J., … Moore, D. M. (2016). Pre-exposure prophylaxis awareness among gay and other men who have sex with men in Vancouver, British Columbia, Canada. AIDS and Behavior, 20(7), 1408–1422.  https://doi.org/10.1007/s10461-016-1319-8
  18. Lewnard, J. A., & Berrang-Ford, L. (2014). Internet-based partner selection and risk for unprotected anal intercourse in sexual encounters among men who have sex with men: a meta-analysis of observational studies. Sex Transm Infect, 90(4), 290–296.  https://doi.org/10.1136/sextrans-2013-051332.CrossRefPubMedPubMedCentralGoogle Scholar
  19. MacKellar, D. A., Valleroy, L. A., Secura, G. M., Behel, S., Bingham, T., Celentano, D. D., …, for the Young Men’s Survey Study Group. (2007). Perceptions of lifetime risk and actual risk for acquiring HIV among young men who have sex with men. AIDS and Behavior, 11(2), 263–270.  https://doi.org/10.1007/s10461-006-9136-0.
  20. Moore, D. M., Kanters, S., Michelow, W., Gustafson, R., Hogg, R. S., Kwag, M., et al. (2012). Implications for HIV prevention programs from a serobehavioural survey of men who have sex with men in Vancouver, British Columbia: The ManCount Study. Canadian Journal of Public Health / Revue Canadienne de Sante’e Publique, 103(2), 142–146.CrossRefGoogle Scholar
  21. Mustanski, B., Rendina, H. J., Greene, G. J., Sullivan, P. S., & Parsons, J. T. (2014). Testing negative means I’m lucky, making good choices, or immune: diverse reactions to HIV test results are associated with risk behaviors. Ann Behav Med, 48(3), 371–383.CrossRefGoogle Scholar
  22. Newcomb, M. E. (2013). Moderating effect of age on the association between alcohol use and sexual risk in MSM: evidence for elevated risk among younger MSM. AIDS and Behavior; New York, 17(5), 1746–1754  https://doi.org/10.1007/s10461-013-0470-8.CrossRefGoogle Scholar
  23. Oster, A. M., Johnson, C. H., Le, B. C., & Balaji, A. B. (2014). Trends in HIV prevalence and HIV testing among young MSM: five United States cities, 1994-2011. AIDS and Behavior, 18, 237.  https://doi.org/10.1007/s10461-013-0566-1.CrossRefGoogle Scholar
  24. Public Health Agency of Canada. (2015). Summary: estimates of HIV incidence, prevalence and proportion undiagnosed in Canada, 2014 [research]. Retrieved from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/summary-estimates-hiv-incidence-prevalence-proportion-undiagnosed-canada-2014.html. Accessed 2017-05-24.
  25. Rank, C., Lloyd-Smith, E., & Gilbert, M. (2011). Advanced HIV disease at the time of HIV diagnosis in British Columbia: 1995 to 2008. Retrieved from http://www.bccdc.ca/resource-gallery/Documents/Statistics%20and%20Research/Statistics%20and%20Reports/STI/STI_HIVSpecialReport_20110401.pdf. Accessed 2017-05-24.
  26. SAS Software (Version 9.4). (2013). Retrieved from https://www.sas.com/en_ca/software/sas9.html
  27. Stephenson, R., White, D., Darbes, L., Hoff, C., & Sullivan, P. (2015). HIV testing behaviors and perceptions of risk of HIV infection among MSM with main partners. AIDS and Behavior, 19(3), 553–560.  https://doi.org/10.1007/s10461-014-0862-4.CrossRefPubMedPubMedCentralGoogle Scholar
  28. STOP HIV/AIDS. (2012). STOP HIV/AIDS update. Fall/winter 2012 [update]. Retrieved from BC Centre for Excellence in HIV/AIDS website: http://stophivaids.ca/STOP/wp-content/uploads/Update_FW2012.pdf. Accessed 2017-11-02.

Copyright information

© The Canadian Public Health Association 2019

Authors and Affiliations

  1. 1.Algoma Public HealthBlind RiverCanada
  2. 2.British Columbia Centre for Disease ControlVancouverCanada
  3. 3.Fraser Health AuthorityPopulation and Public HealthSurreyCanada
  4. 4.British Columbia Centre for Excellence in HIV/AIDSVancouverCanada

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