title: Expanding access to non-medicalized community-based rapid testing to men who have sex with men: an urgent HIV prevention intervention (the ANRS-DRAG study).
abstract: BACKGROUND
  Little is known about the public health benefits of community-based, non-medicalized rapid HIV testing offers (CBOffer) specifically targeting men who have sex with men (MSM), compared with the standard medicalized HIV testing offer (SMOffer) in France. This study aimed to verify whether such a CBOffer, implemented in voluntary counselling and testing centres, could improve access to less recently HIV-tested MSM who present a risk behaviour profile similar to or higher than MSM tested with the SMOffer.
  
  
  METHODS
  This multisite study enrolled MSM attending voluntary counselling and testing centres' during opening hours in the SMOffer. CBOffer enrolees voluntarily came to the centres outside of opening hours, following a communication campaign in gay venues. A self-administered questionnaire was used to investigate HIV testing history and sexual behaviours including inconsistent condom use and risk reduction behaviours (in particular, a score of "intentional avoidance" for various at-risk situations was calculated). A mixed logistic regression identified factors associated with access to the CBOffer.
  
  
  RESULTS
  Among the 330 participants, 64% attended the CBOffer. Percentages of inconsistent condom use in both offers were similar (51% CBOffer, 50% SMOffer). In multivariate analyses, those attending the CBOffer had only one or no test in the previous two years, had a lower intentional avoidance score, and met more casual partners in saunas and backrooms than SMOffer enrolees.
  
  
  CONCLUSIONS
  This specific rapid CBOffer attracted MSM less recently HIV-tested, who presented similar inconsistent condom use rates to SMOffer enrolees but who exposed themselves more to HIV-associated risks. Increasing entry points for HIV testing using community and non-medicalized tests is a priority to reach MSM who are still excluded.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale U912 (SESSTIM), Marseille, France. nicolas.lorente@inserm.com
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lorente
authors.forename: Marie
authors.initials: M
authors.lastname: Preau
authors.forename: Chantal
authors.initials: C
authors.lastname: Vernay-Vaisse
authors.forename: Marion
authors.initials: M
authors.lastname: Mora
authors.forename: Jerome
authors.initials: J
authors.lastname: Blanche
authors.forename: Joanne
authors.initials: J
authors.lastname: Otis
authors.forename: Alain
authors.initials: A
authors.lastname: Passeron
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Le Gall
authors.forename: Philippe
authors.initials: P
authors.lastname: Dhotte
authors.forename: Maria Patrizia
authors.initials: MP
authors.lastname: Carrieri
authors.forename: Marie
authors.initials: M
authors.lastname: Suzan-Monti
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
mesh_terms: D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012725:Sexual Behavior / Q000502:physiology*