HIV testing behaviour and use of risk reduction strategies by HIV risk category among MSM in Vancouver.
We carried out an analysis of a serobehavioural study of men who have sex with men >19 years of age in Vancouver, Canada to examine HIV testing behaviour and use of risk reduction strategies by HIV risk category, as defined by routinely gathered clinical data. We restricted our analysis to those who self-identified as HIV-negative, completed a questionnaire, and provided a dried blood spot sample. Of 842 participants, 365 (43.3%) were categorised as lower-risk, 245 (29.1%) as medium-risk and 232 (27.6%) as higher-risk. The prevalence of undiagnosed HIV infection was low (lower 0.8%, medium 3.3%, higher 3.9%; p = 0.032). Participants differed by risk category in terms of having had an HIV test in the previous year (lower 46.5%, medium 54.6%, higher 67.0%; p < 0.001) and in their use of serosorting (lower 23.3%, medium 48.3%, higher 43.1%; p < 0.001) and only having sex with HIV-positive men if those men had low viral loads or were taking HIV medication (lower 5.1%, medium 4.8%, higher 10.9%; p = 0.021) as risk reduction strategies. These findings speak to the need to consider segmented health promotion services for men who have sex with men with differing risk profiles. Risk stratification could be used to determine who might benefit from tailored multiple health promotion interventions, including HIV pre-exposure prophylaxis.
Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK paul.bogowicz@ncl.ac.uk.
Paul
P
Bogowicz
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
David
D
Moore
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Steve
S
Kanters
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Warren
W
Michelow
Health Initiative for Men, Vancouver, BC, Canada.
Wayne
W
Robert
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
Robert
R
Hogg
Vancouver Coastal Health, Vancouver, BC, Canada.
Réka
R
Gustafson
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada British Columbia Centre for Disease Control, Vancouver, BC, Canada.
Mark
M
Gilbert
D000328:Adult; D002170:Canada / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015995:Prevalence; D012306:Risk; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data
AIDS; HIV; MSM; epidemiology; men who have sex with men; pre-exposure prophylaxis; serobehavioural study; serosorting; sexual risk behaviour; sexually transmitted infection; stratified prevention