REPORT: More men test and treat early for HIV, but fear and stigma remain barriers

News | Published on 09 Jun 2015

Men who have recently tested positive for HIV are more comfortable with the idea of committing to a treatment regimen soon after diagnosis than they were a few years ago, suggest results presented in the latest HIV Seroconverstion Study Report, released today by the Kirby Institute at UNSW Australia.

“In previous years, we found men were very sceptical about starting treatment right away and were more likely to wait until absolutely necessary before committing to treatment,” said Ian Down, lead author of the report. “That appears to have changed in the last few years, with most of the men in this sample reporting they were prepared to initiate treatment soon after diagnosis. This a very positive shift in attitudes which speaks to the success of efforts made both at community and government levels to raise awareness about the individual and community health benefits of testing more and treating early. We expect to see this trend continue and gain momentum following recently released findings from the landmark START study, which provided conclusive evidence that early treatment for HIV extends survival and prevents serious illness in people living with HIV.”

Although attitudes to early treatment appear to have changed, almost a third of men in the study were not yet on treatment. All men surveyed were engaged in monitoring their viral load and many were intending to receive treatment. Of the men not yet on treatment, a quarter had been diagnosed HIV-positive more than one year prior to completing the survey, while a similar proportion reported their last CD4 count as less than 500 copies, the threshold at which treatment initiation is highly recommended.

The study shows that provision of a range of HIV testing options has been embraced bymen, with one in ten men in thesample receiving their diagnosis following a rapid test. All of the men who receivedtheir HIV diagnosis following a rapid testreported being satisfied to receive their result this way.

The report also suggests that stigma and discrimination remain key barriers to address for people living with HIV.

“Fear of testing positive remains a deterrent for almost a third of men, leading to some delays in testing, and although most men reported disclosing their HIV status to others, mainly for altruistic reasons, they continue to report poor responses from some of those to whom they disclose,” said Ian Down.

Down said the study results highlight a need to continue to provide and expand the range of HIV testing opportunities for gay and bisexual men and reduce the psychosocial barriers to testing.

“In particular, support programs are needed to increase factual knowledge about HIV treatment and to counter the misinformation that is the likely basis of much of the fear of HIV testing.Also, efforts to reduce stigma towards, and ignorance about, people with HIV must be supported, so that men need not feel afraid to disclose their status,” said Down.

The Seroconversion Study is led by the Kirby Institute in collaboration with the Australian Research Centre in Sex, Health and Society at La Trobe University, the AIDS Councils and people living with HIV (PLHIV) organisations in each state and territory and the Centre for Social Research in Health at UNSW Australia.

Though the current Seroconversion Study is scheduled to end in June 2015, it remains important to continue to collect data from people in Australia who are newly HIV-diagnosed.

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More about the HIV Seroconversion Study

The HIV Seroconversion Study collects both quantitative and qualitative data, through an online survey questionnaire and in-depth interviews. People who have recently been diagnosed with HIV infection are directed to a study website where they can find out more about the study. Gay and bisexual men can choose to enrol in the study by completing an online questionnaire. On completion of the survey, or if transmission was not through male-to-male sex, respondents are invited to volunteer for a face-to-face in-depth interview.

Since the Seroconversion Study relaunched in December 2007, 637 gay and bisexual men have completed an online survey, while more than 100 have been interviewed in-depth.

Recruitment to the current version of the study is scheduled to end in the middle of 2015, and a comprehensive study report is planned for the end of the year.

Plans are underway to replace the current study with its focus on the risk event/s and initial diagnosis experiences, with a more comprehensive study of recently diagnosed individuals that will be linked directly to community-based interventions providing peer support.

All state and territory health departments have contributed to funding for the study and findings have been used to develop policy and health responses by health departments and community organisations around the country since the mid-1990s.

Stakeholder voice:

“We need to call upon all health departments, HIV agencies and community businesses and organisations to invest in HIV stigma campaigns and programs that aim to build the resilience of PLHIV. We will not get to our aim of ending HIV if we do not invest in efforts to reduce HIV stigma.” - Brent Allan, Executive Officer, Living Positive Victoria


Laurie Legere


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