{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:24:16Z","timestamp":1770978256308,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,8,4]],"date-time":"2019-08-04T00:00:00Z","timestamp":1564876800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Achieving the virtual elimination of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> requires equitable access to <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevention tools for all priority populations. Restricted access to healthcare means migrants face particular barriers to <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevention services. In February 2016, a peer\u2010led rapid <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing service for gay, bisexual and other men who have sex with men (gay and bisexual men, <jats:styled-content style=\"fixed-case\">GBM<\/jats:styled-content>) in Melbourne, Australia, introduced free sexually transmissible infection (<jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content>) testing funded through Medicare (Australia's universal healthcare system). Medicare ineligible migrant clients were required to pay up to $158<jats:styled-content style=\"fixed-case\">AUD<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> tests. We determined the uptake of <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> testing and assessed the impact on repeat <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing among Medicare eligible and ineligible clients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> tests conducted between August 2014 and March 2018 were included. We describe client characteristics, <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> testing uptake and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> positivity among Medicare eligible and ineligible clients. Repeat <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing, assessed as the percentage of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> tests with a return test within six months, was compared pre\u2010integration (August 2014\u2010June 2016) and post\u2010integration(July 2016\u2010March 2018) of <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> testing using segmented linear regression of monthly aggregate data for Medicare eligible and ineligible clients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Analyses included 9134 <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> tests among 4753 individuals. Medicare ineligible clients were younger (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01), and fewer reported previously testing for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) and high <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> risk sexual behaviours. There was no difference in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> positivity between the two groups (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.09). <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> testing uptake was significantly lower among Medicare ineligible clients (7.6%, 85.3%; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). Following <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> testing introduction there was an immediate increase in six\u2010month return <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing (6.4%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02) and a significantly increasing rate of return <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing between July 2016 and March 2018 (0.5% per month; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) among Medicare eligible clients but no immediate change in return testing (\u22120.9%; <jats:italic>p<\/jats:italic> =\u00a00.7) or the rate of change in return testing between July 2016 and March 2018 (0.1% per month; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.3) among Medicare ineligible clients. In March 2018, six\u2010month return <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing was 52.3% and 13.2% among Medicare eligible and ineligible clients respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Improvements in return <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing observed among Medicare eligible clients did not extend to Medicare ineligible clients highlighting the impact of inequitable access to comprehensive sexual healthcare on test\u2010and\u2010treat approaches to <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevention.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25353","type":"journal-article","created":{"date-parts":[[2019,8,5]],"date-time":"2019-08-05T06:53:36Z","timestamp":1564988016000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Assessment of service refinement and its impact on repeat <scp>HIV<\/scp> testing by client's access to Australia's universal healthcare system: a retrospective cohort study"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5892-4482","authenticated-orcid":false,"given":"Kathleen E","family":"Ryan","sequence":"first","affiliation":[{"name":"Burnet Institute Melbourne Vic. Australia"},{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Vic. Australia"},{"name":"Department of Infectious Diseases Alfred Health Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna L","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Burnet Institute Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Asselin","sequence":"additional","affiliation":[{"name":"Burnet Institute Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David P","family":"Leitinger","sequence":"additional","affiliation":[{"name":"PRONTO! Thorne Harbour Health Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Locke","sequence":"additional","affiliation":[{"name":"PRONTO! Thorne Harbour Health Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alisa","family":"Pedrana","sequence":"additional","affiliation":[{"name":"Burnet Institute Melbourne Vic. Australia"},{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Hellard","sequence":"additional","affiliation":[{"name":"Burnet Institute Melbourne Vic. Australia"},{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Vic. Australia"},{"name":"Department of Infectious Diseases Monash University and Alfred Health Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Stoov\u00e9","sequence":"additional","affiliation":[{"name":"Burnet Institute Melbourne Vic. Australia"},{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,4]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"UNAIDS.90\u201090\u201090 An ambitious treatment target to help end the AIDS epidemic.2014;:40 [cited 2017 Jul 25]. Available from:http:\/\/www.unaids.org\/en\/resources\/documents\/2014\/90-90-90"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000717"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181c3f2d0"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(18)30009-2"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-2571-y"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/cks130"},{"key":"e_1_2_9_8_1","unstructured":"AsselinJ WilkinsonA HigginsN Stoov\u00e9M HellardME El\u2010HayekC.HIV testing and diagnosis among young Asian\u2010born men who have sex with men in Victoria Australia: understanding needs & vulnerability. In: International AIDS Conference. Melbourne Australia;2014."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3325-0"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH12033"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.18.1.20221"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1888-1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2635-z"},{"key":"e_1_2_9_14_1","unstructured":"Australian Government Department of Human Services.RHCA \u2010 Medical care for visitors to Australia.2017[cited 2018 Feb 5]. Available from:https:\/\/www.humanservices.gov.au\/individuals\/enablers\/rhca-medical-care-visitors-australia"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH16027"},{"key":"e_1_2_9_16_1","unstructured":"Trinity biotech.Trinity biotech Uni\u2010Gold Recombigen HIV test package insert.2014; 1\u201318 [cited 2016 Jun 1]. Available from:http:\/\/www.trinitybiotech.com\/ProductDocuments\/1206506-29EN.pdf"},{"key":"e_1_2_9_17_1","unstructured":"STIGMA Group.Australian sexually transmitted infection & HIV testing guidelines 2014 for asymptomatic men who have sex with men.2014. [cited 2016 Feb 1]. Available from:http:\/\/stipu.nsw.gov.au\/wp-content\/uploads\/STIGMA_Testing_Guidelines_Final_v5.pdf"},{"key":"e_1_2_9_18_1","first-page":"1","article-title":"A Systematic mechanism for the collection and interpretation of display format pathology test results from Australian primary care records","volume":"6","author":"Boyle D","year":"2011","journal-title":"Electron J Heal Informatics"},{"key":"e_1_2_9_19_1","first-page":"1","article-title":"Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS): a protocol for monitoring the control of sexually transmissible infections and blood borne viruses (Preprint)","volume":"35","author":"Callander D","year":"2018","journal-title":"JMIR Res Protoc"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2055-6640(20)30338-1"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2018.00151"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052421"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25104"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjia2.25353","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25353","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.25353","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25353","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T22:56:07Z","timestamp":1694213767000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.25353"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1002\/jia2.25353"],"URL":"https:\/\/doi.org\/10.1002\/jia2.25353","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]},"assertion":[{"value":"2018-12-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e25353"}}