Repeat HIV testing, risk behaviors, and HIV seroconversion among young men who have sex with men: a call to monitor and improve the practice of prevention.
OBJECTIVE
We compared recent risk behaviors and HIV seroconversion among young men who have sex with men (MSM) who were first-time, infrequent, and repeat HIV testers.


METHODS
Male adolescents and young men aged 15 to 22 years were randomly sampled, interviewed, counseled, and tested for HIV at 194 gay-identified venues in seven U.S. cities from 1994 through 1998. Analyses were restricted to MSM who reported having never tested or last tested HIV-negative.


RESULTS
Of 3430 participants, 36% tested for the first time, 39% had tested infrequently (one or two times), and 26% had tested repeatedly (> or = three times). Compared with first-time testers, repeat testers were more likely to report recent risk behaviors and to acquire HIV (7% versus 4%). Over 75% of repeat testers who seroconverted acquired HIV within 1 year of their last test. Compared with repeat testers, first-time testers reported similar use of health care but delayed testing for nearly 2 additional years after initiating risk.


CONCLUSIONS
Many young MSM soon acquire HIV after repeated use of HIV counseling and testing services. Providers must strengthen practices to identify, counsel, and test young MSM and provide enhanced behavioral interventions for those with persistent risks.
MacKellar
Duncan A
DA
Division of HIV/AIDS Prevention-Surveillance and Epidemiology, National Center for HIV, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. dym4@cdc.gov
Valleroy
Linda A
LA
Secura
Gina M
GM
Bartholow
Brad N
BN
McFarland
William
W
Shehan
Douglas
D
Ford
Wesley
W
LaLota
Marlene
M
Celentano
David D
DD
Koblin
Beryl A
BA
Torian
Lucia V
LV
Perdue
Thomas E
TE
Janssen
Robert S
RS
D000293:Adolescent; D000328:Adult; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control*; D006679:HIV Seropositivity / Q000175:diagnosis*; D006306:Health Surveys; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D011897:Random Allocation; D012309:Risk-Taking; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population