Why do men who have sex with men test for HIV infection? Results from a community-based testing program in Seattle.
BACKGROUND
The Centers for Disease Control and Prevention recommends at least annual HIV testing for men who have sex with men (MSM), but motivations for testing are not well understood.


METHODS
We evaluated data from MSM testing for HIV at a community-based program in King County, Washington. Correlates of regular testing were examined using generalized estimating equation regression models.


RESULTS
Between February 2004 and June 2011, 7176 MSM attended 12,109 HIV testing visits. When asked reasons for testing, 49% reported that it was time for their regular test, 27% reported unprotected sex, 24% were starting relationships, 21% reported sex with someone new, 21% sought sexually transmitted infection/hepatitis screening, 12% reported sex with an HIV-infected partner, 2% suspected primary HIV infection, and 16% reported other reasons. In multivariable analysis, factors associated with regular testing included having a regular health care provider and the following in the previous year: having only male partners, having 10 or more male partners, inhaled nitrite use, not injecting drugs, and not having unprotected anal intercourse with a partner of unknown/discordant status (P ≤ 0.001 for all). Men reporting regular testing reported shorter intertest intervals than men who did not (median of 233 vs. 322 days, respectively; P < 0.001).


CONCLUSIONS
Regular testing, sexual risk, and new partnerships were important drivers of HIV testing among MSM, and regular testing was associated with increased testing frequency. Promoting regular testing may reduce the time that HIV-infected MSM are unaware of their status, particularly among those who have sex with men and women or inject drugs.
Department of Medicine, University of Washington, Seattle, WA, USA. dkatz7@u.washington.edu
David A
DA
Katz
Fred
F
Swanson
Joanne D
JD
Stekler
D000328:Adult; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006679:HIV Seropositivity; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009573:Nitrites; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012306:Risk; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis*; D019966:Substance-Related Disorders; D047568:Unsafe Sex; D014861:Washington; D055815:Young Adult
D009573:Nitrites