HIV/STI behavioural surveillance among gay men in Australia: findings and policy implications

Abstract

Background: The Australian HIV/STI behavioural surveillance system (repeated cross-sectional Gay Community Periodic Surveys, GCPS) has been conducted regularly since 1998 and covers six main Australian jurisdictions. In this paper, we reviewed its history and methodology, as well as the available indicators, their trends and their use. Methods: We described the design and history of GCPS. For analyses of indicators, we used Pearson–s chi-squared test and test for trend where appropriate. Results: About 90% of gay men in Australia have been tested for HIV; 60% to 70% of men, who were not HIV-positive, have been tested as recommended in the preceding 12 months. STI testing levels (~70% in the preceding 12 months) are high, but remain insufficient for STI prevention. In general, unprotected anal intercourse with regular (UAIR) and casual (UAIC) sex partners have increased over time. The prevalence and increasing trends in UAIR were similar across jurisdictions (p trend <0.01), while trends in UAIC differed across the states: during 2001-2008, UAIC declined in NSW (p trend <0.01) and increased elsewhere (p trend <0.01). Trends in UAIC were associated with HIV diagnoses. Conclusion: This review of the design, implementation and findings of the Australian HIV/STI behavioural surveillance highlights important lessons for HIV/STI behavioural surveillance among homosexual men, particularly the need for consistent and dedicated data collection over time and across jurisdictions. Investment in systematic HIV/STI behavioural surveillance appears to result in a better understanding of the HIV epidemic, availability of a warning system and a better targeted HIV prevention.