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. 2013 Sep;40(9):724-8.
doi: 10.1097/01.olq.0000431068.61471.af.

Why do men who have sex with men test for HIV infection? Results from a community-based testing program in Seattle

David A Katz  1 , Fred Swanson, Joanne D Stekler
Affiliations

Why do men who have sex with men test for HIV infection? Results from a community-based testing program in Seattle

David A Katz et al. Sex Transm Dis. 2013 Sep.

Abstract

Background: The Centers for Disease Control and Prevention recommends at least annual HIV testing for men who have sex with men (MSM), but motivations for testing are not well understood.

Methods: We evaluated data from MSM testing for HIV at a community-based program in King County, Washington. Correlates of regular testing were examined using generalized estimating equation regression models.

Results: Between February 2004 and June 2011, 7176 MSM attended 12,109 HIV testing visits. When asked reasons for testing, 49% reported that it was time for their regular test, 27% reported unprotected sex, 24% were starting relationships, 21% reported sex with someone new, 21% sought sexually transmitted infection/hepatitis screening, 12% reported sex with an HIV-infected partner, 2% suspected primary HIV infection, and 16% reported other reasons. In multivariable analysis, factors associated with regular testing included having a regular health care provider and the following in the previous year: having only male partners, having 10 or more male partners, inhaled nitrite use, not injecting drugs, and not having unprotected anal intercourse with a partner of unknown/discordant status (P ≤ 0.001 for all). Men reporting regular testing reported shorter intertest intervals than men who did not (median of 233 vs. 322 days, respectively; P < 0.001).

Conclusions: Regular testing, sexual risk, and new partnerships were important drivers of HIV testing among MSM, and regular testing was associated with increased testing frequency. Promoting regular testing may reduce the time that HIV-infected MSM are unaware of their status, particularly among those who have sex with men and women or inject drugs.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. Reasons men who have sex with men reported for seeking HIV testing at Gay City Health Project, 2004 to 2011
N = 7176 unique MSM. Clients could mark more than one reason. Less than 1% of MSM reported the following reasons for seeking testing: “I shared a needle, cooker, cotton, or rinse water”, “Someone from the health department advised me to test”, “An outreach worker offered me a test”, and “I have to test for a court order”. Starting in 2008, “I suspect I may have primary HIV infection” was added to the list of options, and “I am getting tested for hepatitis” and “Someone from the health department advised me to test” were no longer included.
Figure 2
Figure 2. HIV intertest intervals among men who have sex with men seeking HIV testing at Gay City Health Project, by reporting seeking a regular test
N = 12106 HIV testing visits. Men seeking a regular test at GCHP reported shorter intervals since their last HIV test than men who did not (median of 233 vs. 322 days, respectively; p<0.001). Among those seeking a regular test, MSM who tested positive for HIV infection had similar ITIs to those testing negative (p=0.16). Among those who did not report regular testing, however, MSM testing positive had longer ITIs than those testing negative (p=0.004).
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References

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