title: The Impact of a Social Marketing Campaign on HIV and Sexually Transmissible Infection Testing Among Men Who Have Sex With Men in Australia.
abstract: BACKGROUND
  In response to increasing HIV and other sexually transmissible infection (HIV/STI) notifications in Australia, a social marketing campaign Drama Downunder (DDU) was launched in 2008 to promote HIV/STI testing among men who have sex with men (MSM). We analyzed prospective data from (1) an online cohort of MSM and (2) clinic-level HIV/STI testing to evaluate the impact of DDU on HIV, syphilis, gonorrhea, and chlamydia testing.
  
  
  METHODS
  (1) Cohort participants who completed 3 surveys (2010-2014) contributed to a Poisson regression model examining predictors of recent HIV testing.(2) HIV, syphilis, gonorrhea, and chlamydia tests among MSM attending high caseload primary care clinics (2007-2013) were included in an interrupted time series analysis.
  
  
  RESULTS
  (1) Although campaign awareness was high among 242 MSM completing 726 prospective surveys, campaign recall was not associated with self-reported HIV testing. Reporting previous regular HIV testing (adjusted incidence rate ratio, 2.4; 95% confidence interval, 1.3-4.4) and more than 10 partners in the previous 6 months (adjusted incidence rate ratio, 1.2; 95% confidence interval, 1.1-1.4) was associated with recent HIV testing. (2) Analysis of 257,023 tests showed increasing monthly HIV, syphilis, gonorrhea, and chlamydia tests pre-DDU. Post-DDU, gonorrhea test rates increased significantly among HIV-negative MSM, with modest and nonsignificant increasing rates of HIV, syphilis, and chlamydia testing. Among HIV-positive MSM, no change in gonorrhea or chlamydia testing occurred and syphilis testing declined significantly.
  
  
  CONCLUSIONS
  Increasing HIV/STI testing trends among MSM occurred pre- and post-DDU, coinciding with other plausible drivers of testing. Modest changes in HIV testing post-DDU suggest that structural changes to improve testing access may need to occur alongside health promotion to increase testing frequency.
authors.affiliation: From the *Centre for Population Health, Burnet Institute, Melbourne, Australia; †School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia; ‡Department Nutrition, Harvard School of Public Health, Boston, MA; §Victorian AIDS Council/Gay Men's Health Service, South Yarra, Australia; ¶Alfred Health, Melbourne Sexual Health Centre, Melbourne, Australia; ∥Central Clinical School Monash University, Alfred Hospital, Melbourne, Australia; and **Alfred Health, Infectious Disease Department, Alfred Hospital, Australia.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Wilkinson
authors.forename: Alisa E
authors.initials: AE
authors.lastname: Pedrana
authors.forename: Carol
authors.initials: C
authors.lastname: El-Hayek
authors.forename: Alyce M
authors.initials: AM
authors.lastname: Vella
authors.forename: Jason
authors.initials: J
authors.lastname: Asselin
authors.forename: Colin
authors.initials: C
authors.lastname: Batrouney
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
authors.forename: Tim R H
authors.initials: TR
authors.lastname: Read
authors.forename: Margaret
authors.initials: M
authors.lastname: Hellard
authors.forename: Mark
authors.initials: M
authors.lastname: Stoové
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D006293:Health Promotion; D018451:Homosexuality, Male; D006801:Humans; D065186:Interrupted Time Series Analysis; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D040241:Social Marketing; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*