Increases in HIV testing among men who have sex with men--National HIV Behavioral Surveillance System, 20 U.S. Metropolitan Statistical Areas, 2008 and 2011

Abstract

In 2011, 62% of estimated new HIV diagnoses in the United States were attributed to male-to-male sexual contact (men who have sex with men, MSM); 39% of these MSM were black or African American. HIV testing, recommended at least annually by CDC for sexually active MSM, is an essential first step in HIV care and treatment for HIV-positive individuals. A variety of HIV testing initiatives, designed to reach populations disproportionately affected by HIV, have been developed at both national and local levels. We assessed changes in HIV testing behavior among MSM participating in the National HIV Behavioral Surveillance System in 2008 and 2011. We compared the percentages tested in the previous 12 months in 2008 and 2011, overall and by race/ethnicity and age group. In unadjusted analyses, recent HIV testing increased from 63% in 2008 to 67% in 2011 overall (P<0.001), from 63% to 71% among black MSM (P<0.001), and from 63% to 75% among MSM of other/multiple races (P<0.001); testing did not increase significantly for white or Hispanic/Latino MSM. Multivariable model results indicated an overall increase in recent HIV testing (adjusted prevalence ratio [aPR] = 1.07, P<0.001). Increases were largest for black MSM (aPR = 1.12, P<0.001) and MSM of other/multiple races (aPR = 1.20, P<0.001). Among MSM aged 18-19 years, recent HIV testing was shown to increase significantly among black MSM (aPR = 1.20, P = 0.007), but not among MSM of other racial/ethnic groups. Increases in recent HIV testing among populations most affected by HIV are encouraging, but despite these increases, improved testing coverage is needed to meet CDC recommendations.

Figure 1. Number of HIV tests in a two-year period among MSM in 2008 and 2011.

During the interview, NHBS participants were asked to report their HIV testing frequency in the two years before interview. Testing twice in a two-year period was used as a proxy for annual testing. The distribution of HIV testing frequency among MSM during the 2 years before interview, shown here, changed from 2008 to 2011 (P<0.001). The percentage of men who tested one time or less in the 2 years before interview (less than annually) decreased from 40% in 2008 to 34% in 2011. The percentage who tested twice in two years (annually) was similar (23% to 22%), while the percentage of men who tested three or more times in two years (more than annually) increased from 37% to 44%.