Men who have sex with men (MSM) continue to be at especially high risk for HIV in the United States. Recent estimates suggest that approximately 20 percent of MSM who have HIV are unaware of their status, and modeling studies show that approximately 50 percent of new infections stem from these individuals. Testing is a cornerstone of HIV prevention efforts, since it can facilitate early diagnosis and treatment (i.e., “test and treat”) and may ultimately reduce HIV incidence through “treatment as prevention.” For this reason, current Centers for Disease Control and Prevention (CDC) guidelines suggest that MSM should be tested for HIV at least annually, but ideally every three to six months if they have had a new sex partner since their last test. Past research has identified a number of demographic and behavioral factors that are associated with HIV testing among MSM in the US, and has identified at-risk subgroups that test less frequently than recommended.
[Photo: Dr. Tyler B. Wray]
This study, headed by Dr. Tyler B. Wray, assistant professor of behavioral and social sciences at Brown University School of Public Health, examined rates and predictors of having tested for HIV within CDC-recommended intervals among MSM in the northeastern U.S. who were recruited from several online sources. Researchers explored whether certain demographic and behavioral factors were associated with having tested within at least the minimum recommended interval of 12 months, as well as those that were associated with having tested at the more optimal recommended interval of every next months.
In this sample of MSM who were recruited online in the northeastern U.S., findings suggest that over half reported testing at least once in the last six months, in line with the CDC’s most stringent current recommendations on the frequency of HIV testing for MSM. However, roughly 31 percent reported not having tested within the last year, exceeding the recommendation that all MSM test at least annually. This is approximately consistent with recent data suggesting that approximately one in four MSM who are infected with HIV are unaware of their infection, and affirms calls to increase testing in this particularly affected population.
Results also suggest that MSM who engaged in more recent HIV-risk behavior and who reported sex with partners they met online, may be more likely to test at CDC-recommended intervals, compared with those at lower risk or who met partners in other ways. The odds of testing within these intervals were higher among minority MSM and those with a college education, compared with White MSM and those without a college degree. Finally, the odds of having tested for HIV recently were lower among those who were heavier drinkers. Further research should explore ways of expanding HIV testing among heavy-drinking MSM who do not necessarily experience or acknowledge alcohol-related problems, such as in-person or virtual outreach efforts focusing on gay-oriented bars and drinking venues.
The article was published in AIDS and Behavior, in November.