title: HIV testing among men who have sex with men in Tijuana, Mexico: a cross-sectional study.
abstract: OBJECTIVE
  HIV testing is critical to the delivery of comprehensive HIV prevention and care services, yet coverage of sexual minorities by HIV testing programmes remains insufficient in many low- and middle-income countries, including Mexico. The objective of this study was to identify the prevalence and correlates of HIV testing among men who have sex with men (MSM) in Tijuana, Mexico.
  
  
  METHODS
  We conducted a cross-sectional study (2012-2013) among 189 MSM recruited via respondent-driven sampling (RDS). RDS-weighted logistic regression was used to identify correlates of prior HIV testing.
  
  
  RESULTS
  RDS-adjusted prevalence of prior and recent (≤ 12 months) HIV testing was 63.5% (95% CI 51.9% to 73.5%) and 36.8% (95% CI 25.4% to 46.4%), respectively. Prior HIV testing was positively associated with older age (adjusted OR (AOR)=1.09, 95% CI 1.04 to 1.15), being born in Tijuana (AOR=2.68, 95% CI 1.05 to 6.86), higher levels of education (AOR=2.65, 95% CI 1.08 to 6.53), identifying as homosexual or gay (AOR=3.73, 95% CI 1.48 to 9.42), being more 'out' about having sex with men (AOR=1.28, 95% CI:1.02 to 1.62), and a history of sexual abuse (AOR=3.24, 95% CI 1.06 to 9.86). Prior HIV testing was negatively associated with reporting more condomless anal intercourse acts (past 2 months) (AOR=0.95, 95% CI 0.92 to 0.98) and greater internalised homophobia (AOR=0.92, 95% CI 0.86 to 0.99).
  
  
  CONCLUSIONS
  Our findings indicate an urgent need for expanded HIV testing services for MSM in Tijuana. Innovative, non-stigmatising, confidential HIV testing interventions targeted at young, less educated, migrant and non-gay identifying MSM may facilitate HIV testing and timely linkage to HIV care and treatment within this population.
authors: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, California, USA.
authors: Heather A
authors: HA
authors: Pines
authors: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, California, USA.
authors: David
authors: D
authors: Goodman-Meza
authors: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, California, USA.
authors: Eileen V
authors: EV
authors: Pitpitan
authors: Agencia Familiar Binacional, AC, Tijuana, Mexico.
authors: Karla
authors: K
authors: Torres
authors: Department of Psychiatry, University of California, San Diego, La Jolla, USA.
authors: Shirley J
authors: SJ
authors: Semple
authors: Department of Psychiatry, University of California, San Diego, La Jolla, USA.
authors: Thomas L
authors: TL
authors: Patterson
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008800:Mexico; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D055815:Young Adult
keywords: HIV testing; Mexico-US border; men who have sex with men; respondent-driven sampling