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Background Gonorrhoea notifications continue to rise among gay and bisexual men in Australia and around the world. More information is needed on infection trends, accounting for testing and complimented by demographics and risk practices.Methods: A retrospective cohort analysis was undertaken using repeat gonorrhoea testing data among gay and bisexual men from 2010 to 2017, which was extracted from a network of 47 sexual health clinics across Australia. Poisson and Cox regression analyses were used to determine temporal trends in gonorrhoea incidence rates, as well as associated demographic and behavioural factors.Results: The present analysis included 46904 gay and bisexual men. Gonorrhoea incidence at any anatomical site increased from 14.1/100 person years (PY) in 2010 to 24.6/100 PY in 2017 (P<0.001), with the greatest increase in infections of the pharynx (5.6-15.9/100 PY, P<0.001) and rectum (6.6-14.8/100 PY, P<0.001). After adjusting for symptomatic and contact-driven presentations, the strongest predictors of infection were having more than 20 sexual partners in a year (hazard ratio (HR)=1.9, 95% confidence interval (CI): 1.7-2.2), using injecting drugs (HR=1.7, 95%CI: 1.4-2.0), being HIV positive (HR=1.4, 95%CI: 1.2-1.6) and being aged less than 30 years old (HR=1.4, 95%CI: 1.2-1.6).Conclusions: Gonorrhoea has increased dramatically among gay and bisexual men in Australia. Enhanced prevention efforts, as well as more detailed, network-driven research are required to combat gonorrhoea among young men, those with HIV and those who use injecting drugs. [ABSTRACT FROM AUTHOR]

Background Rapid HIV testing was introduced at 12 clinics in New South Wales (NSW) for routine testing and promoted with social marketing. The effect of the availability of rapid HIV testing on testing frequency among gay and bisexual men (GBM) was evaluated.Methods: An observational design using patient data from 12 clinics was used. The primary outcome was the mean number of HIV tests in 12 months. The intervention group comprised GBM who had one or more rapid tests from October 2013 to September 2014 and this was compared with two control groups; a concurrent group (no rapid test in the same period) and a historical group (attended between July 2011 and June 2012). Independent sample t-tests were conducted to compare mean number of tests among men in the intervention, concurrent and historical groups. Multivariate logistic regression was used to assess the association between rapid HIV testing and testing frequency.Results: Men in the intervention group (n = 3934) had a mean of 1.8 HIV tests in 12 months, compared with 1.4 in the concurrent group (n = 5063; P < 0.001) and 1.4 in the historical group (n = 5904; P < 0.001); testing frequency was higher among men at increased risk of HIV in the intervention group compared with the other two groups (mean 2.2, 1.6 and 1.5 respectively; P < 0.001). Membership of the intervention group was associated with increased odds of having two or more HIV tests in 12 months (AOR = 2.5, 95%CI 2.2-2.8; P < 0.001) compared with the concurrent group, after controlling for demographic and behavioural factors.Conclusion: Introducing and promoting rapid HIV testing in clinics in NSW was associated with increased HIV testing frequency among GBM. [ABSTRACT FROM AUTHOR]

Background Gay and bisexual men (GBM) with recent HIV infection are a key population to inform HIV-prevention. The National HIV Registry (NHR) provides details about all individuals diagnosed with HIV, but it is unclear how.Methods: Basic sociodemographic characteristics of GBM in the NHR who were diagnosed between 2010 and 2014 were compared with three samples of GBM: men with undiagnosed HIV infection from the Community-Based Study of Undiagnosed HIV and Testing (COUNT) study of HIV prevalence and undiagnosed infection that was conducted during 2013-14; men in the Australian Gay Community Periodic Surveys (GCPS) who were diagnosed with HIV between 2010 and 2014; and men in the HIV Seroconversion Study (SCS) who were also diagnosed in those years.Results: The NHR identified 3629 men who reported male-to-male sex as the exposure risk for their diagnosis between 2010 and 2014. COUNT identified 19 (8.9% of all men who tested HIV positive) men as having undiagnosed HIV. In the GCPS sample, 185 (2.5%) reported being diagnosed with HIV in 2010-14. In total, 367 men in the SCS received their diagnosis during 2010-14. The mean age of men in the NHR (36.8 years) was similar to that in GCPS (36.3 years) and SCS (35.1 years), while undiagnosed men in COUNT were younger (32.6 years), with no other significant differences between the samples.Conclusions: The undiagnosed men were somewhat younger than diagnosed men. To achieve earlier diagnosis of new HIV infections, improved HIV testing frequency is needed among younger men. [ABSTRACT FROM AUTHOR]

Background Gamma-hydroxybutyrate (GHB) use among gay and bisexual men (GBM) has increased in recent years. It is commonly cited as a sexual-enhancement drug. There is, however, little evidence for factors associated with GHB use or the consequences of its use among GBM.Aim: Factors associated with GHB use, its relationship to sexual risk behaviour, and the contexts, consequences, and motivations for its use were examined.Methods: The Following Lives Undergoing Change (Flux) Study is an online prospective observational study of Australian GBM. At baseline, a total of 3190 GBM provided details about their use of GHB. Data on frequency, methods, pleasures and consequences of their drug use, alongside key demographic variables were collected.Results: Mean age was 35.0 years. One in five men (19.5%) had a history of GHB use and 5.4% reported use within the past 6 months, with 2.7% having used it monthly or more frequently. Overdose had been experienced by 14.7%, this was more common among men who used GHB at least monthly. Being HIV-positive, having more gay friends, greater social engagement with gay men who use drugs, a greater number of sexual partners, group sex, and condomless anal intercourse with casual partners were independently associated with GHB use in the past 6 months. Greater social engagement with gay men who use drugs and group sex were independently associated with at least monthly use. More frequent GHB use was independently associated with experiencing overdose among GHB users.Conclusion: Most men used GHB infrequently and it was often used explicitly to enhance sexual experiences, often in the context of intensive sex partying. Men who used GHB frequently, were at greater risk of overdose and other negative health outcomes. GHB use should be considered alongside other drugs that have been implicated in sexual risk behaviour and HIV transmission. Harm-reduction interventions need to consider the particular impact of frequent GHB use. [ABSTRACT FROM AUTHOR]

Background: How gay and bisexual men (GBM) establish partnership agreements may be affected by several factors, including age. The ability to communicate with a partner about sexual agreements has important sexual health implications for GBM.Objective: To assess differences in partnership agreements among GBM.Methods: We surveyed GBM about their partnerships using a national, anonymous online survey in 2013-14. We compared men who had monogamous partnerships with men who had non-monogamous partnerships, according to age and other factors.Results: Regarding the nature of their partnership with their primary regular partner (PRP), younger men were less likely to have an agreement of any sort and were less likely to have discussed it. Younger men were more likely to report having a monogamous partnership, but they were also less likely to report condomless anal intercourse with their PRP. In multivariate analysis of partnership arrangements, having a non-monogamous partnership with their PRP was associated with being older (adjusted odds ratio=1.03; 95% confidence interval=1.02-1.04; P<0.001). Nearly two-thirds (62.9%) of men with monogamous partnerships had a clear spoken agreement with their PRP about whether they could have sex with other men, largely regardless of age. Although slightly fewer than half the men with self-described open partnerships (46.0%) actually described it as a 'relationship', younger men were particularly less likely to do so.Conclusions: Due to less communication with partners about sexual agreements, when young GBM engage in sexual risk behaviour they may be at an increased risk of HIV and other sexually transmissible infections. [ABSTRACT FROM AUTHOR]

Background Among gay and bisexual men (GBM), 'serosorting' is common and involves restricting sex, or at least condomless sex, to partners of the same HIV status. The prevalence of men conveying their serosorting preferences regarding partners they meet online remains unclear.Methods: This study reviewed 57178 Australian online profiles obtained directly from a popular gay website. Logistic regression was used to identify factors associated with preferences for meeting HIV-positive partners.Results: Men could indicate their preferences from a list of 22 types of partners; 4358 profiles (7.6%) indicated an interest in meeting HIV-positive men. There were 1959 profiles (3.4%) listing a preference for 21 of the 22 types of men, including 1498 men (2.6%) that specifically excluded HIV-positive men. Men who specifically excluded HIV-positive men on their profiles were younger (mean age 34.7 years), less likely to identify as gay (25.6%) and more likely to always prefer 'safer sex' (55.3%) than those who specifically included them (mean age 39.6 years; 62.8% gay-identified; 30.9% preferred safer sex; P<0.001). Men who specifically excluded HIV-positive partners on their profiles were also more likely to live outside major capital cities (P<0.001).Conclusions: Being younger, living outside major cities, not identifying as gay, always preferring safer sex and either Caucasian or Asian background were associated with excluding HIV-positive men as potential sex partners. These factors may reflect lower social and community engagement with the gay community. The disinclination to include HIV-positive men as potential sex partners may be due to fear of infection, stigma or poor information about HIV. [ABSTRACT FROM AUTHOR]

Background Regular testing of individuals at higher-risk of HIV is central to current prevention strategies. The aim of the present study was to examine the extent to which confidence in one's perceived ability to undertake various aspects of HIV testing and self-testing (self-efficacy) affected HIV testing outcomes. We assessed factors, including self-efficacy, associated with HIV testing frequency and the likelihood to self-test among gay and bisexual men (GBM).Methods: Participants were HIV-negative GBM at an increased risk of HIV (more than five partners or condomless anal intercourse in the previous 3 months) enrolled in a randomised controlled trial of HIV self-testing. The baseline questionnaire captured data regarding sociodemographic characteristics, HIV and/or sexually transmissible infection testing history, sexual behaviour, beliefs and attitudes towards HIV and eight items capturing confidence in HIV testing ability that were combined as a single broad measure of HIV testing self-efficacy (α=0.81). Factors associated with three or more HIV tests in the past year and the likelihood of self-testing in the future were determined using logistic regression.Results: Of 354 GBM, 34% reported three or more HIV tests in the past year, and 64% reported being 'very likely' to self-test. Factors independently associated with three or more HIV tests in the past year were: higher self-efficacy (adjusted odds ratio (aOR) 1.08 per unit increase; 95% confidence interval (CI) 1.02-1.14; P=0.004); >10 male partners in the past 6 months (aOR 1.79; 95% CI 1.05-3.04; P=0.031) and higher optimism regarding the effects of HIV treatments on HIV transmission (aOR 1.14; 95% CI 1.00-1.29; P=0.044). Only higher self-efficacy was independently associated with reporting a greater likelihood to self-test in the future (aOR 1.10; 95% CI 1.05-1.15; P < 0.001).Conclusions: Improving self-efficacy by enhancing GBM's knowledge and experience may lead to higher testing frequency. The self-efficacy measure used in the present study could be useful in identifying GBM likely to face difficulties with HIV testing and self-testing. [ABSTRACT FROM AUTHOR]

Background In Australia, the preventative use of antiretroviral drugs [pre-exposure prophylaxis (PrEP) and treatment as prevention] is being embraced to protect individuals at high risk of HIV and reduce onward transmission.Methods: The adaptation of a behavioural surveillance system, the Gay Community Periodic Surveys, was reviewed to monitor the uptake and effect of new prevention strategies in Australia's primary HIV-affected population (gay and bisexual men, GBM). The national trends in key indicators during 2000-15 were reviewed and a new measure to take account of antiretroviral-based prevention was developed.Results: Between 2000 and 2015, there were significant increases (P<0.001) in annual HIV testing (56.1-64.8%), condomless sex with casual partners (26.8-38.8%) and the proportion of HIV-positive men on HIV treatment (72.5-88.4%) and with an undetectable viral load (73.7-94.7%). The proportion of casual partners who were HIV negative, not on PrEP and who engaged in receptive condomless sex also increased between 2000 and 2015 from 12.8 to 19.3%. Two scenarios anticipating the effect of PrEP highlighted the need to target GBM who engage in receptive condomless sex while also sustaining condom use at a population level.Conclusions: Behavioural surveillance can be successfully adapted to follow the effect of antiretroviral-based prevention. It is anticipated that HIV testing and HIV treatment will continue to increase among Australian GBM, but to prevent new infections, intervention in the growing proportion of GBM who have condomless sex with casual partners is needed. For PrEP to have its desired effect, condom use needs to be sustained. [ABSTRACT FROM AUTHOR]

Background: With emerging opportunities for preventing human immunodeficiency virus (HIV) transmission, it remains important to identify those at greatest risk of infection and to describe and understand the contexts in which transmissions occur. Some gay and bisexual men with recently diagnosed HIV infection are initially unable to identify high-risk behaviors that would explain their HIV infection. We explored whether Web-based data collection could assist them in identifying the circumstances of their infection. Objective: To assess the capacity of a Web-based survey to collect reliable self-report data on the event to which gay and bisexual men ascribe their HIV infection. Methods: The HIV Seroconversion Study included a Web-based survey of gay and bisexual men with recently diagnosed HIV infection in Australia. Participants were asked if they could identify and describe the event they believe led to their infection. Men were also asked about their sexual and other risk practices during the 6 months before their diagnosis. Results: Most (403/506, 79.6%) gay and bisexual men with newly diagnosed HIV infection were able to identify and describe the circumstances that likely led to their infection. Among those who were initially unable to identify possible exposure events, many could nonetheless provide sensible information that ostensibly explained their seroconversion. Free-text responses allowed men to provide more detailed and contextual information, whereas questions about the totality of their sexual behavior before diagnosis provided opportunities for men to describe their sexual risk behavior in general. Overall, 84.0% indicated having engaged in condomless anal intercourse before their HIV diagnosis, including 71.8% in the receptive position. Conclusions: This study demonstrates the effectiveness of using Internet-based technologies to capture sensitive information about the circumstances in which HIV infection occurs among gay and bisexual men. By providing a range of opportunities for relaying experience, this research reveals some of the complexity in how individuals come to understand and explain their HIV infection. These findings may assist in obtaining detailed sexual history in the clinical setting. [ABSTRACT FROM AUTHOR]

Unlabelled: Background The awareness and previous and intended use of HIV self-testing (HST), and the associated factors, among Australian gay and bisexual men (GBM) was investigated.Methods: An online cross-sectional survey was conducted in Australia during 2012. Of 1410 respondents, 559 non-HIV-positive men answered questions about HST.Results: Men reported reasons for having avoided or delayed HIV testing, most of which could be broadly categorised as: the inconvenience of current testing procedures; concerns about privacy; and a belief that they had not done anything risky. Over one-third of men (39.7%) were aware that HST was available internationally, with 1.6% having accessed HST through online purchase. The majority of men in the study indicated that they would be 'likely' (36.5%) or 'very likely' (34.3%) to use HST if it was available in Australia. Also, 36.7% indicated they would test partners they met at sex-on-site venues, and 73.2% would test partners with whom they were already acquainted. Nearly half (47.6%) indicated that having the capacity to test themselves at home would likely increase their testing frequency. Men who had engaged in unprotected anal intercourse, who were not gay-identified, and who indicated inconvenience issues with using clinic-based HIV testing were more likely to indicate a willingness to use HST. Many men indicated they would be likely to offer HST to at least some of their sex partners.Conclusion: Many GBM who engage in HIV risk behaviours would appreciate HST, and may be encouraged to test more often, as it may alleviate their concerns about testing. [ABSTRACT FROM AUTHOR]

Gay and other men who have sex with men (GMSM) are disproportionally affected by the HIV epidemic in Australia. The study objective is to combine a clinical-based cohort with a community-based surveillance system to present a broader representation of the GMSM community to determine estimates of proportions receiving antiretroviral therapy (ART) and/or with an undetectable viral load. Between 2010 and 2012, small increases were shown in ART uptake (to 70.2%) and proportions with undetectable viral load (to 62.4%). The study findings highlight the potential for significantly increasing ART uptake among HIV-positive GMSM to reduce the HIV epidemic in Australia. [ABSTRACT FROM AUTHOR]

Unlabelled: Background Sexual behaviour and HIV prevention needs of men who have sex with men (MSM) attending suburban Sex on Premises Venues (SOPVs) are understudied.Methods: A cross-sectional survey examining sexual activity, health services utilisation, sexual health services needs and STI knowledge was conducted among MSM over 18 years old attending a SOPV in Western Sydney between June and July 2013.Results: A total of 213 MSM were sampled; approximately half of the respondents (51%) reported that they only had sex with other men, and 46% had sex with both men and women. Condom use varied considerably, with ~50% of responders not using condoms consistently during anal sex. Consistent condom usage was not associated with having regular, casual or a mix of regular and casual partners during anal sex (P=0.09). The majority (59.5%) obtained sexual health screening services from general practitioners; only 15.0% sought services from a local sexual health clinic. Over half of respondents (57.7%) believed that SOPVs should offer on-site and free testing services. Those with the highest level of previous STI diagnoses were gay men (41%), those who only had casual partners (38%) and those who did not complete high school (65%).Conclusions: Sexual health services and non-government organisations should consider targeting bisexual men with rapid HIV testing and condom usage campaigns. Low cost or free on-site HIV and STI testing at SOPVs and stronger partnerships between general practitioners and sexual health services are needed. [ABSTRACT FROM AUTHOR]

Background: Increasing international mobility has led to a growth of cross-border HIV transmission around the world. In Australia, increasing rates of HIV infections acquired overseas have been reported, particularly among men. This qualitative study explored experiences and risk perceptions of 14 Australian men who acquired HIV while living or travelling overseas from the year 2000. Methods: Symbolic interaction provided the study's theoretical perspective and analytical framework. Australian men living with HIV who were aged 18 years and older, believed they had acquired their infection while working or travelling overseas during or after the year 2000, and were diagnosed from 2003 onwards were eligible to participate. A semistructured interview schedule was developed and tested for content validity with the study reference group. Analysis was conducted using an adapted form of grounded theory to form the basis for the development of the experiences domains. Results: Analysis produced four domains of experience: (1) a fantasy realised, (2) escaping and finding a new self or life, (3) living a life less ordinary and (4) living local but still an outsider. The description of the four experience domains highlights how risk generally, particularly sexual risk, did or did not feature in these men's understanding of their experiences. Conclusion: Perceptions and experiences of long-term travel played a decisive role for men who acquired HIV when travelling overseas. Appealing to desired experiences such as connection to local culture or sustaining a new or adventurous life may provide important implications for guiding health promotion programs and policy. [ABSTRACT FROM AUTHOR]

Objectives To report on sexual behaviors and sexually transmitted infections (STIs) among men who have sex with men (MSM) in their teens, when many MSM engage in their first sexual experiences.Methods MSM aged 16 to 20 years were recruited via community and other sources. Men completed a questionnaire about their sexual behaviors and were screened for gonorrhea, chlamydia, syphilis, and HIV.Results Two hundred men were included. The median age was 19 years. The median age at first insertive or receptive anal intercourse was 17 years. Half of men reported sex with mainly older men: these men were more likely to engage in receptive anal intercourse (48% vs. 25%, p < .001) than other men. Most men had engaged in insertive (87%) and receptive (85%) anal intercourse in the prior 12 months with 60% and 53% reporting inconsistent condom use with insertive and receptive anal intercourse partners, respectively. The median number of insertive anal intercourse partners was 3 and 1.5 (p < .001) among men reporting inconsistent and consistent condom use with insertive anal intercourse over the prior 12 months. The median number of receptive anal intercourse partners was 3 and 2 (p = .006) among men reporting inconsistent and consistent condom use with receptive anal intercourse over the prior 12 months. Pharyngeal gonorrhea, rectal gonorrhea, urethral chlamydia, rectal chlamydia, and syphilis were detected in 3.0%, 5.5%, 3.0%, 4%, and 2.0% of men, respectively. All men were HIV negative.Conclusions Many of the teenage MSM in this study were at risk for STI. Preventative messages and STI screening interventions that are age appropriate need to be developed to reduce HIV and STI risk in this under-recognized group. [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been increasing evidence that early initiation of antiretroviral therapy (ART) may provide health benefits for those infected with HIV. There has also been significant discussion about the role of HIV treatment in preventing onward transmission of the virus. Early provision and uptake of ART to people recently diagnosed with HIV could achieve both individual and public health outcomes. The success of such an initiative relies, in part, on the preparedness of those recently diagnosed with HIV to engage with the therapy. Methods: The HIV Seroconversion Study collects both quantitative and qualitative data from people in Australia who have recently been diagnosed with HIV. During 2011-2012, 53 gay or bisexual men recruited across Australia took part in semistructured interviews as part of the study. The men were asked about their knowledge and experience of, and their decisions about whether or not to commence, HIV treatment. Results: The interviews identified differing levels of knowledge about HIV treatments and divergent views about the health and prevention benefits of ART. For some, treatments provided a sense of control over the virus; others were apprehensive and distrustful, and preferred to resist commencing treatments for as long as possible. Conclusions: If early initiation of treatment is to be encouraged, appropriate measures must be in place to ensure recently diagnosed individuals have access to the appropriate information and the support they need to enable them to make informed choices and, if necessary, to address their fears. [ABSTRACT FROM AUTHOR]

The article discusses a study which presents findings from the Gay Community Periodic Surveys from 2007 and 2001 and compares sexual risk practices, drug use and HIV prevalence between Indigenous and Anglo-Australian men having sex with men (MSM). Several studies have reported a higher prevalence of illicit drug use among MSM as compared with heterosexual men citing an analysis by C. G.Lawrence et al which suggests that Indigenous Australian MSM may be higher rates of drug use compared with their nonIndigenous peers. Findings showed significantly higher levels of intercourse with casual male partners (UAIC) and injecting drug use (IDU) among Indigenous men.

Summary: Objectives: Human papillomavirus (HPV) types 6 and 11 are most commonly associated with ano-genital warts. There are few data on the sero-epidemiology of HPV6 and HPV11 among homosexual men. Methods: Behavioural data and sera for antibodies to HPV6 and HPV11 capsid protein L1 were collected annually for 1427 HIV negative and 245 HIV positive homosexual men. For HIV negative men, a combined variable, HPV6/11, was created (HPV 6 and/or 11) to analyse predictors of seroprevalence and seroincidence. Results: High rates of HPV6 and HPV11 seroprevalence were found (39.2–53.2% of men). For HPV6/11 (HIV negative men only), seroprevalence was associated with higher numbers of sexual partners, longer history of sexual activity and seropositivity for several sexually transmissible infections. Each year, 12.6% of men younger than 25 years seroconverted. Seroincidence (5.9/100PY) was associated with younger age, more recent male sexual partners, receptive anal fingering and anal chlamydia. Seropositivity and seroconversion were strongly associated with past and incident anal warts. Conclusions: HPV6 and HPV11 seropositivity were common among homosexual men. Among HIV negative men, HPV6/11 seroprevalence and seroincidence correlated closely with markers of sexual activity. The high numbers of young men seroconverting each year suggests a role for prophylactic vaccination of young gay men. Summary: Ano-genital warts, caused by human papillomavirus, are very common. In a community cohort of Australian homosexual men, HPV6 and 11 seroprevalence and seroincidence were high and were associated with past and incident anal warts and other markers of sexual activity. [Copyright &y& Elsevier]

To assess the changing health promotion needs of human immunodeficiency virus (HIV)-positive gay men in Australia, we analysed the social and behavioural characteristics of HIV-positive men in the Australian Gay Community Periodic Surveys. We looked at change over time in the characteristics of HIV-positive men (from 2000–2001 to 2008–2009) and compared HIV-positive men with their HIV-negative peers within each time period. Multivariate logistic regression analysis was used to assess independent changes over time within each HIV status group. A total of 21,620 responses were included in the analyses; 10,537 in 2000–2001 and 11,083 in 2008–2009. Between the two time periods, HIV-positive and HIV-negative men became more similar in the following areas: paid employment, sexual identity, number of male sex partners, the likelihood of having a regular male partner and having a seroconcordant regular male partner. The two groups diverged in these areas: age, ethnicity, educational level, social engagement with gay men, types of relationship with regular male partners, likelihood of unprotected anal intercourse with casual male partners and likelihood of HIV disclosure to casual male partners. Workforce participation and educational attainment have improved among HIV-positive gay men since 2000, but they still lag behind their HIV-negative peers in these areas. Because HIV-positive men are an ageing cohort, support services will need to increasingly address issues of HIV, sexuality and ageing with HIV-positive men. The increase in unprotected anal intercourse and HIV disclosure with casual partners means that education and support services will increasingly need to address effective HIV disclosure and non-condom-based risk reduction strategies with both HIV-positive and HIV-negative gay men. [ABSTRACT FROM AUTHOR]

The article presents a review of the repeated cross-sectional Gay Community Periodic Surveys (GCPS) which is the human immunodeficiency virus (HIV) and sexually transmissible infection (STI) behavioural surveillance system in Australia. The design, history and methodology of the GCPS are tackled. The review found that about 90% of gay men have undergone HIV testing. It also found an increase in unprotected anal intercourse with regular (UAIR) and casual (UAIC) sex partners over time. According to the authors, the findings suggest that investment in systematic behavioural surveillance improves understanding of the HIV epidemic and HIV prevention strategy.

The article discusses a study on the increasing number of men who have sex with men (MSM) being diagnosed with human immunodeficiency virus (HIV) infection in Australia. The study evaluated notifications of HIV diagnoses and deaths from the Australian National HIV and Acquired Immunodeficiency Syndrome (AIDS) Registry (NHAR) to calculate numbers and ages of MSM living with HIV from 1983 to 2007. It showed a rise in percentage of younger MSM not taking combination antiretroviral therapy (CART) since 1998. It found a significant correlation between the trend of new HIV diagnoses and the total number of HIV-positive MSM and those not taking CART. The authors emphasise that earlier initiation of CART may be beneficial to HIV-positive individuals and may be important for secondary prevention.

The article discusses the results of a study on dental dams and safer oral sex among Australian women based on the 2004 questionnaire distributed to women attending the Sydney Gay and Lesbian Mardi Gras Fair Day and lesbian community venues. It was found that 9.7 percent of the respondents had used a dental dam and 2.1 percent had used one often. That there was reportedly little evidence of dental dam use preventing sexually transmissible infections. Gloves and condoms were found to be used by more Australian women than dental dams.

The article discusses a study which determined the use of drugs among gay men engaging in group sex in Australia. It describes an anonymous, self-complete survey conducted with regards to respondents' most recent occasion of group sex with other men, as well as an in-depth interviews with a number of participants. It notes that 63% of the 746 respondents reported using illicit drugs during group sex encounter in order to enhance their sexual experience and to intensify the pleasure of that experience. The study concludes that increased sexual risk behaviour among men who engage in group sex is associated with the use of methamphetamine and heavy alcohol.

The article describes a study which investigated the incidence and risk factors of syphilis in two community-based cohorts of human immunodeficiency virus (HIV)-negative and HIV-positive gay men in Sydney, New South Wales. It notes that the participants underwent annual face-to-face interviews, and syphilis screening was offered. According to this study, 21 men in the HIV-negative cohort seroconverted to syphillis while in the HIV-positive cohort, eight men seroconverted. The study concludes that syphilis incidence is higher in HIV-positive than in HIV-negative gay men.

The article reports on the results of a study designed to determine the prevalence, incidence and risk factors for genital and anal warts in HIV-negative homosexual men in Sydney, New South Wales. A description of the experimental setup and measurement method is given. The study concluded that anal warts were twice as common as genital warts. Also, fingering and other manual sexual practices may be an important transmission route for anal and genital warts.

Background. Despite increasing reports of herpes simplex virus (HSV) type 1 (HSV-1)-associated anogenital herpes, there are very limited data comparing the seroepidemiological profile of and risk factors for HSV-1 and 0HSV type 2 (HSV-2) infection. Methods. Sexual behaviors were examined as risk factors for prevalent and incident HSV-1 and HSV-2 infections in a community-based cohort of 1427 HIV-negative gay men in Australia. Results. The prevalence of HSV-1 and HSV-2 at baseline was 75% and 23%, respectively. The rate of prevalent infection with HSV-1, as well as the rate of prevalent infection with HSV-2, was much lower in individuals <25 years of age, and each type of infection was associated with a higher number of both male and female sex partners. The median duration of follow-up of the cohort was 2.0 years. Among participants who were susceptible to infection, the incidence rates for HSV-1 and HSV-2 infection were 5.58 and 1.45 cases per 100 person-years, respectively. In multivariate analysis, incident infection with HSV-1 was significantly associated with younger age (P =.027) and reports of frequent insertive oral sex with casual partners (hazard ratio, 3.91 [95% confidence interval, 1.23–12.44]; P = .021 ). Incident infection with HSV-2 was significantly associated with a variety of anal sex practices with casual partners. Conclusions. Both HSV-1 and HSV-2 were commonly sexually transmitted, and there were more HSV-1 than HSV-2 seroconversions. Public-health strategies targeted against anogenital herpes increasingly need to take into account the importance of HSV-1 infection. [ABSTRACT FROM AUTHOR]