title: Low HIV-testing rates among younger high-risk homosexual men in Amsterdam.
abstract: OBJECTIVE
  To investigate HIV-testing behaviour and HIV prevalence among homosexual visitors of a sexually transmitted infection (STI) outpatient clinic, and to investigate determinants of unknown HIV status, and of HIV testing separately for men with unknown and negative HIV status.
  
  
  METHODS
  Cross-sectional survey conducted from March 2002 to December 2003 among homosexual men with negative or unknown HIV status visiting the Amsterdam STI clinic.
  
  
  METHODS
  A convenience sample of 1201 men with negative or unknown HIV status answered a written questionnaire about history of HIV testing, sexual risk behaviour and behavioural determinants (non-response, 35%). Information was matched to the STI registration system. Associations were determined using logistic regression.
  
  
  RESULTS
  817 men reported a negative HIV status, and 384 reported an unknown HIV status. The overall HIV prevalence among the 523 men who tested at new STI consultation was 2.8%. The proportion of men with unknown HIV status was relatively high among those diagnosed with infectious syphilis and those reporting unprotected anal intercourse with a casual partner. Their testing rates at new STI clinic visit were lower. Among men with an unknown HIV status, those aged <30 years and reporting risky sexual behaviour tested the least (OR 0.13, 95% CI 0.03 to 0.61).
  
  
  CONCLUSIONS
  Although HIV testing rates have increased, they are still lower than in other industrialised countries. Moreover, some men still undertake high-risk sex without knowing their own HIV status, which might pose a risk for ongoing HIV transmission. Therefore, more active testing promotion is needed.
authors.affiliation: Health Service Amsterdam, Cluster of Epidemiology, Documentation and Health Promotion, Nieuwe Achtergracht 100, Amsterdam, The Netherlands. istolte@ggd.amsterdam.nl
authors.forename: Ineke G
authors.initials: IG
authors.lastname: Stolte
authors.forename: John B F
authors.initials: JB
authors.lastname: de Wit
authors.forename: Marion E
authors.initials: ME
authors.lastname: Kolader
authors.forename: Han S A
authors.initials: HS
authors.lastname: Fennema
authors.forename: Roel A
authors.initials: RA
authors.lastname: Coutinho
authors.forename: Nicole H T M
authors.initials: NH
authors.lastname: Dukers
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D023241:Antiretroviral Therapy, Highly Active; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy; D006679:HIV Seropositivity; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D012747:Sexual Partners; D047568:Unsafe Sex / Q000706:statistics & numerical data*