Abstract
Objectives
With the increasing momentum to maximize the benefits of antiretroviral therapy (ART), better
understanding of opportunities and challenges in increasing ART coverage and promoting early
ART initiation is urgently needed. Key sociodemographic, clinical and behavioural factors
associated with Australian HIV-positive gay men’s current nonuse of ART were systematically
examined.
Methods
Data were based on 1911 responses from HIV-positive men who had participated in the
Australian Gay Community Periodic Surveys (GCPS) between 2010 and 2012. Stratified
univariate analysis and multivariate logistic regression were used.
Results
A majority of the participants were recruited from gay community venues and events and
self-identified as gay or homosexual. On average, they were 44 years old and had been living
with HIV for at least 10 years. Close to 80% (n = 1555) were taking ART, with >90% further
reporting an undetectable viral load at the time of the survey. From 2010 to 2012, there had
been a moderate increase in ART uptake [adjusted odds ratio (AOR) 1.40; 95% confidence
interval (CI) 1.20–1.65]. In addition, younger age (AOR 1.66; 95% CI 1.45–1.92), recent HIV
diagnosis (AOR 1.78; 95% CI 1.59–1.98), not receiving any social welfare payments (AOR 2.20;
95% CI 1.05–2.54) and no annual screening for sexually transmissible infections (AOR 1.55; 95%
CI 1.03–2.34) were independently associated with ART nonuse.
Conclusions
Current ART coverage among HIV-positive gay men in Australia is reasonably high. To further
increase ART coverage and promote early ART initiation in this population, better clinical
care and sustained structural support are needed for HIV management throughout their life
course.