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Potential public health benefits of HIV testing occurring at home in Australia

In Australia between 1999 and 2013 the annual number of HIV diagnoses rose by over 70%, from 724 to 1236, and gay and bisexual men (GBM) accounted for 70% of new cases.1 HIV testing is recognised in the Seventh National HIV Strategy as a key public health strategy.2 Increased HIV testing leads to earlier detection of HIV infections, which allows people who are diagnosed to reduce the risk of transmission to others by modifying their sexual practices.3 Being diagnosed with HIV also allows people to decide whether they wish to initiate treatment that suppresses viral replication and thereby reduces infectiousness.4 Mathematical modelling has predicted that substantial increases in HIV testing can reduce HIV incidence in the community.5

Despite GBM having access to laboratory HIV testing through clinical services, HIV testing rates remain less than ideal. Less than a quarter of high-risk GBM undergo testing at the recommended frequency (3–6 monthly).6 Surveys show the proportion of GBM who have never had a test for HIV is 14%–26%,7,8 and in 2013 there were about 3700 people undiagnosed and living with HIV in Australia.1 GBM…