title: The changing age distribution of men who have sex with men diagnosed with HIV in Victoria.
abstract: OBJECTIVE
  To describe recent trends among men who have sex with men (MSM) in age at diagnosis of HIV in Victoria.
  
  
  METHODS
  Analysis of Victorian HIV surveillance data from (i) passive surveillance (2000-2009) and (ii) the Victorian Primary Care Network for Sentinel Surveillance (VPCNSS) (2006-2009). Age-trend comparisons were made using syphilis and gonorrhoea enhanced surveillance.
  
  
  METHODS
  HIV diagnoses, HIV testing and behavioural indicators by year and age group among MSM.
  
  
  RESULTS
  Following a period of sustained increase between 2000 and 2007, the median age at HIV diagnosis among MSM declined significantly, from 38.8 years in 2007 to 35.3 years in 2008 (P=0.023), remaining at 35.9 years in 2009. Between 2007 and 2008, the median age of syphilis and gonorrhoea notifications also declined, from 40.6 to 36.0 years and from 32.3 to 29.3 years, respectively. The median age of HIV testing among MSM in the VPCNSS population remained constant between 2006 and 2009, at 33.0 years. Compared with older MSM, those aged less than 35 years were more likely to have never previously been tested for HIV (relative risk [RR], 1.36 [95% CI, 1.30-1.41]); to not know the HIV status of their regular partner (RR, 1.11 [95% CI, 1.01-1.21]); and to report inconsistent condom use with casual partners (RR, 1.07 [95% CI, 1.01-1.14]) and regular partners (RR, 1.07 [95% CI, 1.00-1.14]).
  
  
  CONCLUSIONS
  Younger MSM in Victoria may be at increasing risk of HIV infection. Enhanced methods of monitoring HIV and sexually transmitted infection transmission in younger MSM are needed, as well as prevention messages to target this group, who may not fully understand their HIV risk.
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia. carol@burnet.edu.au
authors.forename: Carol
authors.initials: C
authors.lastname: El-Hayek
authors.forename: Isabel
authors.initials: I
authors.lastname: Bergeri
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Hellard
authors.forename: Alisa E
authors.initials: AE
authors.lastname: Pedrana
authors.forename: Nasra
authors.initials: N
authors.lastname: Higgins
authors.forename: Alan
authors.initials: A
authors.lastname: Breschkin
authors.forename: Mark
authors.initials: M
authors.lastname: Stoové
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D013587:Syphilis / Q000453:epidemiology; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult