Views of Australian men who have sex with men on rapid testing for syphilis and HIV Lee D 1 , Fairley CK 1,2 , Cummings R ...
Background <ul><li>Increased frequency of screening for syphilis and HIV could improve control of these infections among M...
Background <ul><li>Rapid testing has the potential to increase the uptake of syphilis and HIV testing </li></ul><ul><li>Ex...
Aims <ul><li>To ascertain the views of Australian MSM regarding rapid testing for syphilis and HIV </li></ul><ul><li>If ra...
Methods <ul><li>Gay community events – Midsumma and Chill Out in Melbourne and Daylesford 2009 </li></ul><ul><li>Rapid fin...
Determine® Syphilis TP immunoassay
Orasure Oraquick Advance HIV test
Results <ul><li>183 men tested for syphilis </li></ul><ul><li>7 (4.8%) had a reactive result </li></ul><ul><li>6 (3.5%) ha...
Results <ul><li>Mean number of male sex partners for the previous 12 months: 11 (range: 1-200)  </li></ul><ul><li>Among th...
Preference for syphilis testing in a clinic setting
More frequent testing if rapid syphilis testing available in a clinic setting?
Likelihood of self testing for syphilis at home with rapid test
Likelihood of more frequent testing if rapid syphilis test available for home use
Preference for HIV testing in a clinic setting
More frequent testing if rapid HIV tests available in a clinic setting?
Likelihood of self testing for HIV if rapid oral HIV testing available for home use
Likelihood of more frequent testing if rapid HIV test available for home use
Reasons given for preferences on testing <ul><li>Common themes for preference for rapid tests in clinic settings </li></ul...
Conclusions <ul><li>Most MSM expressed a preference for rapid testing for syphilis and HIV over serology if these were ava...
Discussion <ul><li>Strengths: men actually experienced rapid syphilis testing </li></ul><ul><li>Community sample to includ...
Implementing rapid syphilis testing into clinical practice <ul><li>What setting? </li></ul><ul><li>Integration into practi...
Acknowledgments <ul><li>Men who participated in the study </li></ul><ul><li>MSHC nurses and doctors </li></ul><ul><li>Mark...
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Rapid testing for syphilis and HIV

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Views of Australian men who have sex with men on rapid testing for syphilis and HIV. Presentation given by Marcus Chen at the AFAO National Syphilis Forum, 23 October 2009.

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  • Results on HIV testing excluding those reporting to be HIV positive
  • Rapid testing for syphilis and HIV

    1. 1. Views of Australian men who have sex with men on rapid testing for syphilis and HIV Lee D 1 , Fairley CK 1,2 , Cummings R 1 , Bush M 1 , Read T 1 , Chen MY 1,2 1 Melbourne Sexual Health Centre, Alfred Hospital; 2 Melbourne School of Population Health, University of Melbourne, Australia
    2. 2. Background <ul><li>Increased frequency of screening for syphilis and HIV could improve control of these infections among MSM </li></ul><ul><li>Mathematical models suggest more frequent syphilis screening of higher risk MSM could reduce syphilis prevalence 1 </li></ul><ul><li>Models also suggest higher HIV test coverage and test frequency of MSM could reduce HIV incidence 2 </li></ul>1 Gray et al ., STD (in press) 2 Wilson et al ., Sexual Health 2009
    3. 3. Background <ul><li>Rapid testing has the potential to increase the uptake of syphilis and HIV testing </li></ul><ul><li>Extensive use of rapid HIV testing with improved uptake of testing overseas 1 </li></ul><ul><li>Advantages: results at point of care, less anxiety, fewer missed results, testing outside of clinical settings </li></ul><ul><li>Limited data on rapid syphilis testing of MSM; no rapid HIV testing in Australia </li></ul>1 San Antonio Gaddy et al . JAIDS 2006
    4. 4. Aims <ul><li>To ascertain the views of Australian MSM regarding rapid testing for syphilis and HIV </li></ul><ul><li>If rapid testing would result in more frequent testing for syphilis and HIV in clinic and home settings </li></ul>
    5. 5. Methods <ul><li>Gay community events – Midsumma and Chill Out in Melbourne and Daylesford 2009 </li></ul><ul><li>Rapid finger-prick testing using the Determine® Syphilis TP immunoassay </li></ul><ul><li>Questionnaire also included questions on the Orasure Oraquick Advance HIV 1/2 Antibody test </li></ul>
    6. 6. Determine® Syphilis TP immunoassay
    7. 7. Orasure Oraquick Advance HIV test
    8. 8. Results <ul><li>183 men tested for syphilis </li></ul><ul><li>7 (4.8%) had a reactive result </li></ul><ul><li>6 (3.5%) had past treated syphilis </li></ul><ul><li>176 men also completed a questionnaire </li></ul>
    9. 9. Results <ul><li>Mean number of male sex partners for the previous 12 months: 11 (range: 1-200) </li></ul><ul><li>Among those reporting anal sex 48% reported no or inconsistent condom use </li></ul><ul><li>Reported no previous testing for HIV (19%) or syphilis (33%) </li></ul>
    10. 10. Preference for syphilis testing in a clinic setting
    11. 11. More frequent testing if rapid syphilis testing available in a clinic setting?
    12. 12. Likelihood of self testing for syphilis at home with rapid test
    13. 13. Likelihood of more frequent testing if rapid syphilis test available for home use
    14. 14. Preference for HIV testing in a clinic setting
    15. 15. More frequent testing if rapid HIV tests available in a clinic setting?
    16. 16. Likelihood of self testing for HIV if rapid oral HIV testing available for home use
    17. 17. Likelihood of more frequent testing if rapid HIV test available for home use
    18. 18. Reasons given for preferences on testing <ul><li>Common themes for preference for rapid tests in clinic settings </li></ul><ul><ul><li>immediacy of results +++ </li></ul></ul><ul><ul><li>ease and simplicity of testing </li></ul></ul><ul><ul><li>less pain, less invasive </li></ul></ul><ul><li>Concerns about home testing </li></ul><ul><ul><li>prefer health professional to do it </li></ul></ul><ul><ul><li>reliability of result </li></ul></ul><ul><ul><li>but some liked the confidentiality </li></ul></ul>
    19. 19. Conclusions <ul><li>Most MSM expressed a preference for rapid testing for syphilis and HIV over serology if these were available in a clinic </li></ul><ul><li>Use of rapid testing for syphilis and HIV in both clinic and non-clinic settings has the potential to increase the frequency of testing among MSM </li></ul>
    20. 20. Discussion <ul><li>Strengths: men actually experienced rapid syphilis testing </li></ul><ul><li>Community sample to include men not testing </li></ul><ul><li>Limitations: limited explanation regarding performance of rapid HIV testing (window period, specificity) </li></ul><ul><li>Future intent: need to measure actual testing </li></ul>
    21. 21. Implementing rapid syphilis testing into clinical practice <ul><li>What setting? </li></ul><ul><li>Integration into practice: who does testing, staff time, recording of results, confirmatory serology </li></ul><ul><li>Training and quality control </li></ul><ul><li>Medicare </li></ul><ul><li>Should not reduce HIV and STI testing: potential for rapid syphilis & HIV testing </li></ul>
    22. 22. Acknowledgments <ul><li>Men who participated in the study </li></ul><ul><li>MSHC nurses and doctors </li></ul><ul><li>Mark Chung </li></ul><ul><li>Inverness Medical </li></ul><ul><li>Alfred Health Public Relations </li></ul>

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