title: Internet-based cohort study of HIV testing over 1 year among men who have sex with men living in England and exposed to a social marketing intervention promoting testing.
abstract: OBJECTIVE
  Increasing HIV testing among men who have sex with men (MSM) is a major policy goal in the UK. Social marketing is a common intervention to increase testing uptake. We used an online panel of MSM to examine rates of HIV testing behaviour and the impact of a social marketing intervention on them.
  
  
  METHODS
  MSM in England were recruited to a longitudinal internet panel through community websites and a previous survey. Following an enrolment survey, respondents were invited to self-complete 13 surveys at monthly intervals throughout 2011. A unique alphanumeric code linked surveys for individuals. Rates of HIV testing were compared relative to prompted recognition of a multi-part media campaign aiming to normalise HIV testing.
  
  
  RESULTS
  Of 3386 unique enrolments, 2047 respondents were included in the analysis, between them submitting 15,353 monthly surveys (equivalent to 1279 years of follow-up), and recording 1517 HIV tests taken, giving an annual rate of tests per participant of 1.19 (95% CI 1.13 to 1.25). Tests were highly clustered in individuals (61% reported no test during the study). Testing rates were higher in London, single men and those aged 25-34 years. Only 7.6% recognised the intervention when prompted. After controlling for sociodemographic characteristics and exposure to other health promotion campaigns, intervention recognition was not associated with increased likelihood of testing. Higher rates of testing were strongly associated with higher number of casual sexual partners and how recently men had HIV tested before study enrolment.
  
  
  CONCLUSIONS
  This social marketing intervention was not associated with increased rates of HIV testing. More effective promotion of HIV testing is needed among MSM in England to reduce the average duration of undiagnosed infection.
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Ford
authors.initials: F
authors.lastname: Hickson
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Tomlin
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: James
authors.initials: J
authors.lastname: Hargreaves
authors.affiliation: Institute of Education, London, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Bonell
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Reid
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Weatherburn
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003625:Data Collection / Q000379:methods; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D004739:England; D015658:HIV Infections / Q000175:diagnosis*; D006302:Health Services Research; D018451:Homosexuality, Male; D006801:Humans; D020407:Internet; D008297:Male; D010342:Patient Acceptance of Health Care; D040241:Social Marketing
keywords: EDUCATION; HIV TESTING; HOMOSEXUALITY; MEN; SERVICE DELIVERY