Opt-out and opt-in testing increases syphilis screening of HIV-positive men who have sex with men in Australia.
BACKGROUND: Since 2005, Australian clinicians were advised to undertake quarterly syphilis testing for all sexually active HIV-positive men who have sex with men (MSM). We describe differences in syphilis testing frequency among HIV-positive MSM by clinic testing policies since this recommendation....
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3751889?pdf=render |
| _version_ | 1828779817551527936 |
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| author | Rebecca Guy Carol El-Hayek Christopher K Fairley Handan Wand Andrew Carr Anna McNulty Jenny Hoy Christopher Bourne John McAllister B K Tee David Baker Norman Roth Mark Stoove Marcus Chen |
| author_facet | Rebecca Guy Carol El-Hayek Christopher K Fairley Handan Wand Andrew Carr Anna McNulty Jenny Hoy Christopher Bourne John McAllister B K Tee David Baker Norman Roth Mark Stoove Marcus Chen |
| author_sort | Rebecca Guy |
| collection | DOAJ |
| description | BACKGROUND: Since 2005, Australian clinicians were advised to undertake quarterly syphilis testing for all sexually active HIV-positive men who have sex with men (MSM). We describe differences in syphilis testing frequency among HIV-positive MSM by clinic testing policies since this recommendation. METHODS: Three general practices, two sexual health clinics and two hospital HIV outpatient clinics provided data on HIV viral load and syphilis testing from 2006-2010. Men having ≥1 viral load test per year were included; >95% were MSM. We used Chi-2 tests to assess changes in syphilis testing frequency over time, and differences by clinic testing policy (opt-out, opt-in and risk-based). RESULTS: The proportion of men having HIV viral loads with same-day syphilis tests increased from 37% in 2006 to 63% in 2007 (p<0.01) and 68-69% thereafter. In 2010, same-day syphilis testing was highest in four clinics with opt-out strategies (87%, range:84-91%) compared with one clinic with opt-in (74%, p = 0.121) and two clinics with risk-based strategies (22%, range:20-24%, p<0.01). The proportion of men having ≥3 syphilis tests per year increased from 15% in 2006 to 36% in 2007 (p<0.01) and 36-38% thereafter. In 2010, the proportion of men having ≥3 syphilis tests in a year was highest in clinics with opt-out strategies (48%, range:35-59%), compared with opt-in (39%, p = 0.121) and risk-based strategies (8.4%, range:5.4-12%, p<0.01). CONCLUSION: Over five years the proportion of HIV-positive men undergoing syphilis testing at recommended frequencies more than doubled, and was 5-6 times higher in clinics with opt-out and opt-in strategies compared with risk-based policies. |
| first_indexed | 2024-12-11T17:08:30Z |
| format | Article |
| id | doaj.art-dbc31d9433d84d35b6bdfa5603489e01 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T17:08:30Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-dbc31d9433d84d35b6bdfa5603489e012022-12-22T00:57:37ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0188e7143610.1371/journal.pone.0071436Opt-out and opt-in testing increases syphilis screening of HIV-positive men who have sex with men in Australia.Rebecca GuyCarol El-HayekChristopher K FairleyHandan WandAndrew CarrAnna McNultyJenny HoyChristopher BourneJohn McAllisterB K TeeDavid BakerNorman RothMark StooveMarcus ChenBACKGROUND: Since 2005, Australian clinicians were advised to undertake quarterly syphilis testing for all sexually active HIV-positive men who have sex with men (MSM). We describe differences in syphilis testing frequency among HIV-positive MSM by clinic testing policies since this recommendation. METHODS: Three general practices, two sexual health clinics and two hospital HIV outpatient clinics provided data on HIV viral load and syphilis testing from 2006-2010. Men having ≥1 viral load test per year were included; >95% were MSM. We used Chi-2 tests to assess changes in syphilis testing frequency over time, and differences by clinic testing policy (opt-out, opt-in and risk-based). RESULTS: The proportion of men having HIV viral loads with same-day syphilis tests increased from 37% in 2006 to 63% in 2007 (p<0.01) and 68-69% thereafter. In 2010, same-day syphilis testing was highest in four clinics with opt-out strategies (87%, range:84-91%) compared with one clinic with opt-in (74%, p = 0.121) and two clinics with risk-based strategies (22%, range:20-24%, p<0.01). The proportion of men having ≥3 syphilis tests per year increased from 15% in 2006 to 36% in 2007 (p<0.01) and 36-38% thereafter. In 2010, the proportion of men having ≥3 syphilis tests in a year was highest in clinics with opt-out strategies (48%, range:35-59%), compared with opt-in (39%, p = 0.121) and risk-based strategies (8.4%, range:5.4-12%, p<0.01). CONCLUSION: Over five years the proportion of HIV-positive men undergoing syphilis testing at recommended frequencies more than doubled, and was 5-6 times higher in clinics with opt-out and opt-in strategies compared with risk-based policies.http://europepmc.org/articles/PMC3751889?pdf=render |
| spellingShingle | Rebecca Guy Carol El-Hayek Christopher K Fairley Handan Wand Andrew Carr Anna McNulty Jenny Hoy Christopher Bourne John McAllister B K Tee David Baker Norman Roth Mark Stoove Marcus Chen Opt-out and opt-in testing increases syphilis screening of HIV-positive men who have sex with men in Australia. PLoS ONE |
| title | Opt-out and opt-in testing increases syphilis screening of HIV-positive men who have sex with men in Australia. |
| title_full | Opt-out and opt-in testing increases syphilis screening of HIV-positive men who have sex with men in Australia. |
| title_fullStr | Opt-out and opt-in testing increases syphilis screening of HIV-positive men who have sex with men in Australia. |
| title_full_unstemmed | Opt-out and opt-in testing increases syphilis screening of HIV-positive men who have sex with men in Australia. |
| title_short | Opt-out and opt-in testing increases syphilis screening of HIV-positive men who have sex with men in Australia. |
| title_sort | opt out and opt in testing increases syphilis screening of hiv positive men who have sex with men in australia |
| url | http://europepmc.org/articles/PMC3751889?pdf=render |
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