First-Time HIV Testing Low Among Men Who Have Sex With Men

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The prevalence of first-time testing was highest among HIV tests with MSM younger than 25 years, further emphasizing the need to increase HIV testing among this group.
The prevalence of first-time testing was highest among HIV tests with MSM younger than 25 years, further emphasizing the need to increase HIV testing among this group.

Men who has sex with men comprise approximately 8% of first-time HIV screening tests, according to a study published in AIDS and Behavior. The MSM Testing Initiative has not been effective at drawing first-time testers compared to national estimates, although it has had some success with reaching MSM receiving their first screening for HIV who subsequently tested positive for the infection.

This study included 68,826 HIV tests of MSM performed by MSM Testing Initiative staff, of which 68,185 included information on prior HIV tests. Of these tests, 8.0% were of first-time testers, and 70.7% of these first-time testers belonged to ethnic or racial minorities (29.8% African American; 34.0% Hispanic; 6.9% other).

MSM age ≤30 years comprised 66.5% of first-time HIV tests. Venue-based testing was responsible for recruiting the majority of first-time testers (90.1%), and 92.6%  reported no sex within the past year with partners who shared needles, injected drugs, or had known HIV diagnosis. Not using a condom during sex in the past year was reported by 75.7% of individuals who had not previously received screening for HIV.

The majority of these individuals reported sex only with men in the past year (76.6%), while 14.7% reported male and female partners, 3.4% reported no sexual activity, 2.3% reported sex with transgender partners, and 3.0% reported sex with only female partners. A confirmed HIV-positive diagnosis was found among 3.9% of individuals who were first-time testers.

Data on HIV tests were collected using a standardized form, which included self-reported answers on sex at birth, current gender identity, race/ethnicity, prior HIV testing, sexual risk behaviors, and which methods had been used for previous testing and recruitment. Individuals who reported male sex at birth and either “male” or “missing” for current gender were included in the study. Row percentages were calculated for investigated characteristics among first-time testers.

The study researchers concluded that “8% of HIV tests occurred with MSM who had never previously tested for HIV. Based on national estimates of never testing among MSM (approximately 30%), [MSM Testing Initiative] was not highly effective at reaching first-time testers. …[At]-home testing and interventions designed to reach MSM who are young or also have sex with women may provide effective methods for HIV prevention and other health care professionals to access groups of MSM who have never previously tested.”

Reference

Clark HA, Oraka E, DiNenno EA, et al. Men who have sex with men (MSM) who have not previously tested for HIV: results from the MSM testing initiative, United States (2012-2015) [published online September 1, 2018] AIDS Behav. doi: 10.1007/s10461-018-2266-3

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