title: Young, Online and in the Dark: Scaling Up HIV Testing among MSM in ASEAN.
abstract: BACKGROUND
  Poor HIV testing uptake by MSM may be attributable to unique challenges that are localized in Southeast Asia.
  
  
  OBJECTIVE
  To characterize MSM who never tested for HIV, to identify correlates of never testing, and to elucidate the perceived barriers to HIV testing.
  
  
  METHODS
  The present study used data from the Asian Internet MSM Sex Survey (AIMSS) and restricted the analysis to 4,310 MSM from the ten member countries of the Association of South East Asian Nations (ASEAN).
  
  
  RESULTS
  Among MSM participants from ASEAN in our sample, 1290 (29.9%) reported having never been tested for HIV, 471 (10.9%) tested for HIV more than 2 years ago, and 2186 (50.7%) reported their last test date was between 6 months and two years ago, with only 363 (8.4%) of these men having been tested in the past 6 months. In multivariable logistic regression, younger MSM (age 15-22 years old [AOR: 4.60, 95% CI: 3.04-6.96]), MSM with lower education (secondary school or lower [AOR: 1.37, 95% CI: 1.03-1.83]), MSM who identify as bisexual or heterosexual (compared to gay-identified) (AOR: 1.94, 95% CI: 1.60-2.35), and MSM who had never used a condom with male partners (AOR: 1.61, 95% CI: 1.32-1.97) had higher odds of never been HIV tested. Main reason for not being tested was a low risk perception of HIV exposure (n = 390, 30.2%).
  
  
  CONCLUSIONS
  Current HIV prevention response must not leave MSM "in the dark," but instead meet them where they are by utilizing the Internet creatively through social media and smart phones. As ASEAN Economic Community (AEC) is quickly becoming a reality, so must there be an equally fast and united response to slowing down the HIV epidemics among MSM in ASEAN.
authors.affiliation: Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand; Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Guadamuz
authors.affiliation: Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Doug H
authors.initials: DH
authors.lastname: Cheung
authors.affiliation: Department of Epidemiology and Biostatistics & Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Chongyi
authors.initials: C
authors.lastname: Wei
authors.affiliation: ICM Pharma Pte Ltd, Singapore.
authors.forename: Stuart
authors.initials: S
authors.lastname: Koe
authors.affiliation: Center of Excellence for Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Sin How
authors.initials: SH
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D001210:Asia, Southeastern; D040421:Cell Phone; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008297:Male; D012747:Sexual Partners; D061108:Social Media; D011795:Surveys and Questionnaires; D055815:Young Adult