It is possible that the lower reported risk factors are in part due to increased internalised sexual identity and HIV-related stigma, as studies indicate both are prevalent in various countries in Asia. ĭespite the rising rates of HIV among newly-arrived Asian born gbMSM in Australia, this group has reported fewer numbers of casual sex partners and less condomless anal sex with casual partners than their Australian counterparts. This study also suggested however, that the difference in the proportion of PrEP use between Asian-born and Australian-born gbMSM was unlikely great enough to account for the four-fold difference in HIV diagnoses between these two groups, and that other factors may contribute to this disparity, such as restricted access to HIV testing and treatment. Additionally, a study of HIV testing among gbMSM in Melbourne in 2017 showed newly-arrived Asian-born gbMSM were less likely to take PrEP than Australian-born gbMSM (6.8% vs 11.1%). A study of Asian-born gbMSM newly-arrived (within four years) diagnosed with HIV between 20 in Australia found that most (88%) did not have access to Medicare. Differential access to government-subsidized healthcare (Medicare)–which greatly reduces the cost of PrEP–may contribute to the increase in the proportion of Asian-born gbMSM diagnosed with HIV. However, among Asian-born gbMSM living in Australia, HIV diagnosis rates have more than doubled from 2008 to 2017, with men in this group making up 23% of new diagnoses in Australia in 2017 (up from 9% in 2008). HIV diagnosis rates for Australian-born gay, bisexual and other men who have sex with men (gbMSM) are declining since widespread implementation of pre-exposure prophylaxis (PrEP) in 2016. Increased connections with sexual health services and LGBTQI communities may facilitate more effective HIV prevention strategies. ConclusionsĪsian-born gbMSM newly-arrived to Australia may have limited knowledge of HIV prevention strategies aside from condom use. Sexual health counselling and connections with LGBTQI community groups appeared to facilitate PrEP and consistent condom use. Many indicated interest in PrEP but described it as too expensive given they do not have access to government-subsidized healthcare. Seven men were on pre-exposure prophylaxis (PrEP) all but one started PrEP after coming to Australia. Most relied on condoms to stay HIV negative however their consistency of use varied. Although participants reported basic knowledge of HIV transmission and treatment, exposure to sexual identity and HIV-related stigma in their countries of birth meant they imagined a HIV diagnosis would be devastating. Men reported little knowledge of HIV prevention strategies outside of condom use prior to coming to Australia.
Interviews were recorded, transcribed verbatim and analysed thematically. Men were excluded if they were living with HIV. Twenty-four gbMSM aged 20–30 years attending Melbourne Sexual Health Centre who were born in Asia and arrived in Australia in the preceding four years, participated in semi-structured face-to-face interviews from 8th May 2019 and 23rd December 2019. Our aim was to explore experiences of Asian-born gbMSM newly arrived in Australia and attending a sexual health centre with regards to their knowledge of and preference for HIV prevention strategies. Asian-born gay, bisexual and other men who have sex with men (gbMSM) newly arrived in Australia are more than four times as likely than their Australian-born counterparts to be diagnosed with incident HIV.