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Younger age, recent HIV diagnosis, no welfare support and no annual sexually transmissible infection screening are associated with nonuse of antiretroviral therapy among HIV ‐positive gay men in A ustralia
Author(s) -
Mao L,
Wit JB,
Kippax SC,
Prestage G,
Holt M
Publication year - 2015
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12169
Subject(s) - medicine , human immunodeficiency virus (hiv) , antiretroviral therapy , welfare , hiv diagnosis , demography , viral load , gerontology , virology , sociology , political science , law
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 A ustralian 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 A ustralian 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 A ustralia 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.