title: Repeated STI and HIV testing among HIV-negative men who have sex with men attending a large STI clinic in Amsterdam: a longitudinal study.
abstract: OBJECTIVE
  In the Netherlands, men who have sex with men (MSM) are advised via informal guidelines to test for STI at least annually. We estimated the proportion of HIV-negative MSM testing repeatedly at 12-month or smaller intervals at a large STI clinic in the Netherlands. In addition, we explored whether repeated testing is related to risk behaviour.
  
  
  METHODS
  Longitudinal data of HIV-negative MSM visiting the Amsterdam STI clinic between 2009 and 2012 were analysed. To estimate the timing of repeated testing, Kaplan-Meier methods were used. Determinants for repeated testing (distinguishing testing at 12-month or smaller intervals and less than 12-monthly testing, with single testers as reference group) were identified using multivariate multinomial logistic regression analyses.
  
  
  RESULTS
  In total, 19,479 consultations of 9174 HIV-negative MSM were identified. Of these MSM, 35% (95% CI 33% to 36%) were estimated to return to the STI clinic within 1 year following baseline consultation. Among 1767 men with at least two consultations and at least 2 years between baseline and last consultation, 43% tested repeatedly at 12-month or smaller intervals in those first 2 years. Repeated testers reported higher sexual risk behaviour (ie, only casual or both casual and steady sex partners, higher numbers of sex partners) at baseline compared with single testers. This effect tended to be slightly stronger for men testing repeatedly at 12-month or smaller intervals.
  
  
  CONCLUSIONS
  The proportion of MSM testing for STI annually is low. MSM testing repeatedly had higher baseline levels of risk behaviour. Strategies to motivate MSM to test annually should be explored.
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, The Netherlands Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Henrike J
authors.initials: HJ
authors.lastname: Vriend
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, The Netherlands Research Department, Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Ineke G
authors.initials: IG
authors.lastname: Stolte
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, The Netherlands.
authors.forename: Janneke C M
authors.initials: JC
authors.lastname: Heijne
authors.affiliation: Research Department, Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands STI Outpatient Clinic, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Titia
authors.initials: T
authors.lastname: Heijman
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, The Netherlands STI Outpatient Clinic, Public Health Service of Amsterdam, Amsterdam, The Netherlands Department of Dermatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Henry J C
authors.initials: HJ
authors.lastname: De Vries
authors.affiliation: Research Department, Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Geskus
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, The Netherlands Julius Center, University Medical Center, Utrecht, The Netherlands.
authors.forename: Marianne A B
authors.initials: MA
authors.lastname: Van der Sande
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, The Netherlands Research Department, Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Maria
authors.initials: M
authors.lastname: Prins
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000328:Adult; D000554:Ambulatory Care Facilities; D017408:Guidelines as Topic; D015438:Health Behavior; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000517:prevention & control* / Q000523:psychology
keywords: GUIDELINE DEVELOPMENT; HOMOSEXUALITY; TESTING