title: 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.
abstract: 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.
authors.affiliation: 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
authors.forename: Duncan A
authors.initials: DA
authors.lastname: MacKellar
authors.forename: Linda A
authors.initials: LA
authors.lastname: Valleroy
authors.forename: Gina M
authors.initials: GM
authors.lastname: Secura
authors.forename: Brad N
authors.initials: BN
authors.lastname: Bartholow
authors.forename: William
authors.initials: W
authors.lastname: McFarland
authors.forename: Douglas
authors.initials: D
authors.lastname: Shehan
authors.forename: Wesley
authors.initials: W
authors.lastname: Ford
authors.forename: Marlene
authors.initials: M
authors.lastname: LaLota
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
authors.forename: Beryl A
authors.initials: BA
authors.lastname: Koblin
authors.forename: Lucia V
authors.initials: LV
authors.lastname: Torian
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Perdue
authors.forename: Robert S
authors.initials: RS
authors.lastname: Janssen
mesh_terms: 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