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REVIEW

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

David J. Templeton A B C H , Phillip Read B D , Rajesh Varma E and Christopher Bourne F G
+ Author Affiliations
- Author Affiliations

A RPA Sexual Health, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.

B The Kirby Institute for Infection and Immunity in Society, The University of New South Wales, Kensington, NSW 2052, Australia.

C Central Clinical School, The University of Sydney, Sydney, NSW 2006, Australia.

D Kirketon Road Centre, PO Box 22, Kings Cross, Sydney, NSW 1340, Australia.

E Western Sydney Sexual Health Centre, Jeffery House, Level 1, 162 Marsden Street, Parramatta, NSW 2150, Australia.

F Sydney Sexual Health Centre, Sydney Hospital, PO Box 1614 Sydney, NSW 2001, Australia.

G School of Public Health and Community Medicine, The University of New South Wales, Kensington, NSW 2052, Australia.

H Corresponding author. Email: dtempleton@kirby.unsw.edu.au

Sexual Health 11(3) 217-229 https://doi.org/10.1071/SH14003
Submitted: 3 January 2014  Accepted: 9 February 2014   Published: 2 April 2014

Abstract

Men who have sex with men (MSM) in Australia and overseas are disproportionately affected by sexually transmissible infections (STIs), including HIV. Many STIs are asymptomatic, so regular testing and management of asymptomatic MSM remains an important component of effective control. We reviewed articles from January 2009–May 2013 to inform the 2014 update of the 2010 Australian testing guidelines for asymptomatic MSM. Key changes include: a recommendation for pharyngeal chlamydia (Chlamydia trachomatis) testing, use of nucleic acid amplification tests alone for gonorrhoea (Neisseria gonorrhoeae) testing (without gonococcal culture), more frequent (up to four times a year) gonorrhoea and chlamydia testing in sexually active HIV-positive MSM, time required since last void for chlamydia first-void urine collection specified at 20 min, urethral meatal swab as an alternative to first-void urine for urethral chlamydia testing, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.

Additional keywords: chlamydia, first-void urine, gonorrhoea, nucleic acid amplification test, reminders, swabs.


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