HIV testing, gay community involvement and internet use: social and behavioural correlates of HIV testing among Australian men who have sex with men.

National Centre in HIV Social Research, The University of New South Wales, Sydney, Australia.
AIDS and Behavior (Impact Factor: 3.49). 01/2011; 16(1):13-22. DOI: 10.1007/s10461-010-9872-z
Source: PubMed

ABSTRACT A significant minority of Australian men who have sex with men (MSM) have never been tested for HIV and many men do not test as often as recommended. Using data from 1770 HIV-negative and untested MSM collected in a national, online survey, we compared men who had never tested for HIV with those who had tested over 12 months ago and men who had tested over 12 months ago with those that had tested in the past year. Two multivariate logistic regression models were constructed. Compared with men tested over 12 months ago, untested men were younger, less educated, less likely to have unprotected anal intercourse with a regular male partner, less likely to have sought advice from a doctor, nurse or community organisation, more likely to expect HIV-negative disclosure, had fewer gay friends and spent more time using social networking websites. Compared with men who had tested over 12 months ago, men who had tested within the last year were younger, more likely to expect HIV-negative disclosure and disclose to casual partners, more likely to have sought advice from a doctor or nurse, had attended gay pools, gyms or beaches and had more gay friends and more male sex partners. Our findings suggest that the Internet and sex education in schools are important ways to promote HIV testing to untested MSM. Testing reinforcement messages delivered through gay community outreach and primary care will reach previously tested MSM.

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    ABSTRACT: Background: Behavioural surveillance and research among gay and other men who have sex with men (GMSM) commonly relies on non-random recruitment approaches. Methodological challenges limit their ability to accurately represent the population of adult GMSM. We compared the social and behavioural profiles of GMSM recruited via venue-based, online, and respondent-driven sampling (RDS) and discussed their utility for behavioural surveillance. Methods: Data from four studies were selected to reflect each recruitment method. We compared demographic characteristics and the prevalence of key indicators including sexual and HIV testing practices obtained from samples recruited through different methods, and population estimates from respondent-driven sampling partition analysis. Results: Overall, the socio-demographic profile of GMSM was similar across samples, with some differences observed in age and sexual identification. Men recruited through time-location sampling appeared more connected to the gay community, reported a greater number of sexual partners, but engaged in less unprotected anal intercourse with regular (UAIR) or casual partners (UAIC). The RDS sample overestimated the proportion of HIV-positive men and appeared to recruit men with an overall higher number of sexual partners. A single-website survey recruited a sample with characteristics which differed considerably from the population estimates with regards to age, ethnically diversity and behaviour. Data acquired through time-location sampling underestimated the rates of UAIR and UAIC, while RDS and online sampling both generated samples that underestimated UAIR. Simulated composite samples combining recruits from time-location and multi-website online sampling may produce characteristics more consistent with the population estimates, particularly with regards to sexual practices. Conclusion: Respondent-driven sampling produced the sample that was most consistent to population estimates, but this methodology is complex and logistically demanding. Time-location and online recruitment are more cost-effective and easier to implement; using these approaches in combination may offer the potential to recruit a more representative sample of GMSM.
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    ABSTRACT: A cross sectional survey was administered to 670 men who have sex with men (MSM) and transgender women (TW) in San Salvador through respondent driven sampling to identify determinants of ever testing for HIV using a minority stress framework. A positive association was found between ever testing and older age [adjusted odds ratio (aOR) 2.10], past experience of sexual assault (aOR 2.92), perceiving that most social acquaintances had tested (aOR 1.81), and knowing a PLHIV (aOR 1.94). A negative association was found between homelessness and ever testing (aOR 0.43). Among the MSM sub-sample (n = 506), similar results were found for older age (aOR 2.63), and past experience of sexual assault (aOR 2.56). Internalized homonegativity was negatively associated with ever testing for HIV among MSM (aOR 0.46), and HIV testing stigma and experienced provider discrimination further strengthened this relationship. It is important to mitigate sexual minority stigma in order to increase HIV testing among MSM. Future research should explore this construct among TW.
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    ABSTRACT: This study used mixed methods to examine characteristics related to HIV testing among men who have sex with men (MSM) in Bogotá, Colombia. A sample of 890 MSM responded to a computerized quantitative survey. Follow-up qualitative data included 20 in-depth interviews with MSM and 12 key informant interviews. Hierarchical logistic set regression indicated that sequential sets of variables reflecting demographic characteristics, insurance coverage, risk appraisal, and social context each added to the explanation of HIV testing. Follow-up logistic regression showed that individuals who were older, had higher income, paid for their own insurance, had had a sexually transmitted infection, knew more people living with HIV, and had greater social support were more likely to have been tested for HIV at least once. Qualitative findings provided details of personal and structural barriers to testing, as well as inter-relationships among these factors. Recommendations to increase HIV testing among Colombian MSM are offered.
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Jun 2, 2014