ArticleJournal of the International AIDS Society2018
Undiagnosed HIV infections among gay and bisexual men increasingly contribute to new infections in Australia.
Article in Journal of the International AIDS Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- HIV cascade, key indicators, and other epidemiological metrics in Australia (2004-2023): a retrospective analysis.The Lancet regional health. Western Pacific · 2026Article
- Evaluating the impact of COVID-19 on the HIV epidemic among MSM in Australia.AIDS (London, England) · 2025Article
- National Surveillance of Home-Based HIV Testing Among Australian Gay and Bisexual Men, 2018-2020: Uptake After Commercial Availability of HIV Self-Tests.AIDS and behavior · 2023Article
- A Retrospective Cohort Study of Women and Men Living with HIV, Attending an HIV Clinic in Australia.Women's health reports (New Rochelle, N.Y.) · 2022Article
- Preferences for HIV Testing Services and HIV Self-Testing Distribution Among Migrant Gay, Bisexual, and Other Men Who Have Sex With Men in Australia.Frontiers in medicine · 2022Article
- Online HIV Self-Testing (HIVST) Dissemination by an Australian Community Peer HIV Organisation: A Scalable Way to Increase Access to Testing, Particularly for Suboptimal Testers.International journal of environmental research and public health · 2021Article
- Subtype-specific differences in transmission cluster dynamics of HIV-1 B and CRF01_AE in New South Wales, Australia.Journal of the International AIDS Society · 2021Article
- HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community-based HIV testing services.Journal of the International AIDS Society · 2020Article
- Observational
- Observational
- Assessment of service refinement and its impact on repeat HIV testing by client's access to Australia's universal healthcare system: a retrospective cohort study.Journal of the International AIDS Society · 2019Article
- Estimates of the HIV undiagnosed population in Belgium reveals higher prevalence for MSM with foreign nationality and for geographic areas hosting big cities.Journal of the International AIDS Society · 2019Article
- Undiagnosed HIV infections among gay and bisexual men increasingly contribute to new infections in Australia.Journal of the International AIDS Society · 2018Article
- Modelling the dynamics of population viral load measures under HIV treatment as prevention.Infectious Disease Modelling · 2018Article
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Authors and funding
9 authors.
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Abstract
introductionWe determined the contribution of undiagnosed HIV to new infections among gay and bisexual men (GBM) over a 12-year period in Australia where there has been increasing focus on improving testing and HIV treatment coverage.
methodsWe generated annual estimates for each step of the HIV cascade and the number of new HIV infections for GBM in Australia over 2004 to 2015 using relevant national data. Using Bayesian melding we then fitted a quantitative model to the cascade and incidence estimates to infer relative transmission coefficients associated with being undiagnosed, diagnosed and not on ART, on ART with unsuppressed virus, or on ART with suppressed virus.
resultsBetween 2004 and 2015, we estimated the percentage of GBM with HIV in Australia who were unaware of their status to have decreased from 14.5% to 7.5%. During the same period, there was a substantial increase in the number and proportion of GBM living with HIV on treatment and with suppressed virus, with the number of virally suppressed GBM increasing from around 3900 (30.2% of all GBM living with HIV) in 2004 to around 14,000 (73.7% of all GBM living with HIV) in 2015. Despite the increase in viral suppression, the annual number of new infections rose from around 660 to around 760 over this period. Our results have a wide range due to the uncertainty in the cascade estimates and transmission coefficients. Nevertheless, undiagnosed GBM increasingly appear to contribute to new infections. The proportion of new infections attributable to undiagnosed GBM almost doubled from 33% in 2004 to 59% in 2015. Only a small proportion (<7%) originated from GBM with suppressed virus. DISCUSSION: Our study suggests that an increase in HIV treatment coverage in Australia has reduced the overall risk of HIV transmission from people living with HIV. However, the proportion of infections and the rate of transmission from undiagnosed GBM has increased substantially. These findings highlight the importance of HIV testing and intensified prevention for Australian GBM at high risk of HIV.
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