Download files
Abstract
At the time this research commenced, there was limited operational or implementation research on the uptake and impact of new HIV testing service models or other service innovations on HIV testing in gay, bisexual and other men who have sex with men (GBM) in Australia. The primary aim of this thesis is to contribute to the evidence base required to support programmatic decisions on the implementation or expansion of innovative HIV testing models for GBM in Australia. The research presented in this thesis has contributed substantially to the knowledge base surrounding the use of innovative HIV testing models in GBM in Australia and internationally. This thesis describes the development, implementation and evaluation of the first community-based HIV testing services in Australia, a fast-track clinic-based testing service and an innovative patient registration system. According to my knowledge, the evaluation of the fast-track clinic-based service is the first study to demonstrate that attendance at such type of service was associated with increased HIV retesting in GBM. Also, the evaluation of the electronic self-registration system is the first study to demonstrate significant improvements in reception processing time and patient journey time, reducing barriers to testing experienced by GBM. The community-based testing service evaluations demonstrated the feasibility and success of such services in attracting untested and less frequently tested GBM, providing new information for Australia. This body of research has had significant influence on programmatic approaches to HIV testing in GBM in Australia. It is acknowledged, however, that there are other innovative testing alternatives, which need to be considered, piloted and rigorously evaluated to determine which ones facilitate more untested and less frequently tested men testing for HIV and which increase the testing frequency of GBM.