Advanced HIV Diagnoses Among Gay and Bisexual Men in Australia: 2007-2016 Study Analysis
Advanced HIV diagnoses among gay and
bisexual men in Australia 2007-2016
Phillip Keen, Handan Wand, Hamish McManus, Muhammad
Jamil, Skye McGregor, James Ward, Andrew Grulich, Margaret
Hellard, Robert Monaghan, Michelle Tobin, Garrett Prestage,
Rebecca Guy.
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~4 years following seroconversion
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Excludes cases with evidence of primary HIV
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Advanced HIV diagnoses among Australian GBM 2007-2016
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Strongly linked to increased mortality and morbidity,
and reduced life expectancy
(Mocroft, PLOS 2013; Nakagawa,
AIDS, 2012; Sabin, Stocle, HIV Medicine 2012)
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Higher costs to health systems
(NAT, Commissioning HIV Testing
Services in England 2014)
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People with undiagnosed HIV infections may
unwittingly transmit to others
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Advanced HIV diagnoses among Australian GBM 2007-2016
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Advanced HIV diagnoses among Australian GBM 2007-2016
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Advanced HIV diagnoses among GBM are
associated with a small number of factors:
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Age: 30-39, 40-49, 50-59, 60+
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Exposure: Bisexual, MSM + IDU
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Region of birth: South East Asia and North East
Asia
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Men with these characteristics account for most
advanced infections among GBM
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Advanced HIV diagnoses among Australian GBM 2007-2016
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State and territory HIV surveillance officers
Handan Wand
Hamish McManus
Rebecca Guy
Garrett Prestage
Shawn Clackett
Advanced HIV diagnoses among Australian GBM 2007-2016
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Thanks to the conference organisers for the opportunity to present the results of this study today.
I’d like to acknowledge my co-authors, who assisted with this study, and in particular Handan Wand and Hamish McManus who conducted the data analyses.
I would also like to acknowledge the gay and bisexual men with HIV whose data are the focus of this study.
Today I’ll be presenting results of an analysis of factors associated with advanced HIV diagnosis among GBM.
Despite high HIV testing rates in Australia we continue to see many people diagnosed with late and advanced HIV disease, so more attention to this problem is warranted.
This study conducted in Australia from 2007-2016 analyzed advanced HIV diagnoses among gay and bisexual men. The research identified factors like age (30-39, 40-49, 50-59, 60+), exposure type (bisexual, MSM + IDU), and region of birth (South East Asia and North East Asia) as significant contributors to advanced HIV infections. The findings emphasize the importance of targeted interventions and early detection strategies to prevent advanced HIV diagnoses and their associated impacts on mortality and morbidity.
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Presentation Transcript
Advanced HIV diagnoses among gay and bisexual men in Australia 2007-2016 Phillip Keen, Handan Wand, Hamish McManus, Muhammad Jamil, Skye McGregor, James Ward, Andrew Grulich, Margaret Hellard, Robert Monaghan, Michelle Tobin, Garrett Prestage, Rebecca Guy. Phillip Keen | 24th September 2018, Australasian HIV Conference, Sydney
Advanced HIV diagnoses among Australian GBM 2007-2016 Definitions Advanced HIV infection (CD4+ <200 cells/ l) ~8 years following seroconversion (Lodi, CID, 2011) Late HIV diagnoses (CD4+ = 200-349 cells/ l) ~4 years following seroconversion (Lodi, CID, 2011) Excludes cases with evidence of primary HIV infection (<12 months) and seroconversion illness 2
Advanced HIV diagnoses among Australian GBM 2007-2016 Late and Advanced HIV Diagnoses - Impacts Strongly linked to increased mortality and morbidity, and reduced life expectancy (Mocroft, PLOS 2013; Nakagawa, AIDS, 2012; Sabin, Stocle, HIV Medicine 2012) Higher costs to health systems(NAT, Commissioning HIV Testing Services in England 2014) People with undiagnosed HIV infections may unwittingly transmit to others 3
Advanced HIV diagnoses among Australian GBM 2007-2016 Results - Multivariate analysis Factor Advanced HIV Diagnosis Adjusted Odds Ratio 95% CI p-value Age 15-29 30-39 40-49 50-59 60+ 1 - - 1.89 3.49 5.78 8.43 1.49-2.40 2.74-4.43 4.43-7.55 6.05-11.74 <0.001 <0.001 <0.001 <0.001 HIV exposure Homosexual Bisexual MSM + IDU 1 - - 2.41 1.76 1.92-3.01 1.30-2.38 <0.001 <0.001 Region of birth Australia/Oceania South East Asia North West Europe Americas All North East Asia South Central Asia Sub-Saharan Africa Others 1 - - 2.63 0.91 1.36 1.35 0.20 1.03 0.66 2.07-3.33 0.76-1.25 0.92-2.02 0.89-2.05 0.05-0.82 0.53-1.99 0.44-1.01 <0.001 0.562 0.127 0.025 0.025 0.933 0.058
Advanced HIV diagnoses among Australian GBM 2007-2016 Conclusions Advanced HIV diagnoses among GBM are associated with a small number of factors: Age: 30-39, 40-49, 50-59, 60+ Exposure: Bisexual, MSM + IDU Region of birth: South East Asia and North East Asia Men with these characteristics account for most advanced infections among GBM 5
Advanced HIV diagnoses among Australian GBM 2007-2016 Thanks to State and territory HIV surveillance officers Handan Wand Hamish McManus Rebecca Guy Garrett Prestage Shawn Clackett
