title: HIV testing frequency among men who have sex with men attending sexually transmitted disease clinics: implications for HIV prevention and surveillance.
abstract: OBJECTIVE
  To describe trends in the occurrence and frequency of HIV testing among men who have sex with men (MSM) receiving care in 4 US sexually transmitted disease (STD) clinics and to define factors associated with HIV testing frequency and positivity.
  
  
  METHODS
  Routine clinical encounters during 57,131 visits by MSM to STD clinics in 4 cities (Seattle-King County, San Francisco, Denver, and District of columbia), 2002-2006, were examined.
  
  
  RESULTS
  From 2002 to 2006, a city-specific median of 69.1% of presumptive HIV-uninfected MSM were tested for HIV, of which, a median of 86.7% had previously tested (4.5% unknown) and a median of 3.9% were newly diagnosed with HIV. Between 2002 and 2006, the median percentage of tested MSM who reported no previous HIV testing decreased from 9.4% to 5.4% (P = 0.01) and the city-specific median intertest interval decreased from 302 to 243 days (P = 0.03). Among MSM with newly diagnosed HIV, the median intertest interval decreased from 531 days in 2002 to 287 days in 2006 (P = 0.001). Predictors of newly diagnosed HIV infection included the following: younger age, longer intertest interval, black or Hispanic race/ethnicity, clinic in San Francisco, and concurrent diagnosis with a bacterial STD.
  
  
  CONCLUSIONS
  In MSM seen at 4 STD clinics, the percentage of never previously HIV tested is decreasing and MSM are testing more frequently.
authors.affiliation: Division of Sexually Transmitted Diseases Prevention, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA. dehelms@cdc.gov
authors.forename: Donna J
authors.initials: DJ
authors.lastname: Helms
authors.forename: Hillard S
authors.initials: HS
authors.lastname: Weinstock
authors.forename: Kristen C
authors.initials: KC
authors.lastname: Mahle
authors.forename: Kyle T
authors.initials: KT
authors.lastname: Bernstein
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Furness
authors.forename: Charlotte K
authors.initials: CK
authors.lastname: Kent
authors.forename: Cornelis A
authors.initials: CA
authors.lastname: Rietmeijer
authors.forename: Akbar M
authors.initials: AM
authors.lastname: Shahkolahi
authors.forename: James P
authors.initials: JP
authors.lastname: Hughes
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Golden
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003219:Confidentiality; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology