Abstract

Offering of HIV testing to men who have sex with men (MSM) by US healthcare providers: the role of disclosure of male-male sex risk

K. Wall, P. Sullivan

Emory University/Rollins School of Public Health, Epidemiology, Atlanta, United States

Background: CDC recommends offering HIV testing annually to all persons aged 13-64, and at least annually to MSM. Few studies have evaluated implementation of these guidelines. We describe the extent to which medical providers offered HIV testing to MSM in the United States, and factors associated with being offered testing.
Methods: Data were collected March-April 2009 using an online survey of MSM recruited on MySpace. Eligible participants were HIV negative men ≥ 18 years old living in the United States who had visited a healthcare provider in the 12 months before the survey. We used multivariable logistic regression to estimate the odds of being offered testing for demographic factors and for having disclosed male-male sex behavior to the healthcare provider.
Results: We screened 16,597 men; 11,681 (70%) were eligible, and 9,006 (77%) consented. Of those, 4,620 MSM (51%) had visited a healthcare provider in the past year, of whom 1,385 (30%) were offered HIV testing by their provider. Being offered testing was associated with disclosing male-male sex to the provider by age (age 20: adjusted odds ratio (aOR) 19.3, 95% confidence interval (CI): 15.8, 23.5; age 30: aOR 14.3, CI: 11.3, 18.0; age 40: aOR 10.6, CI: 6.9, 16.3; age 50: aOR 7.9, CI: 4.1, 15.2); ever being tested for HIV (aOR 1.1, CI: 1.0, 1.3); black race (aOR 1.9, CI: 1.5, 2.4) and Hispanic ethnicity (aOR 1.9, CI: 1.6, 2.3; both versus white non-Hispanic); and a higher number of male sex partners in the past year (aOR 1.01, CI: 1.00, 1.06 per 5 partners).
Conclusions: Less than one-third of participants reported being offered HIV testing, suggesting limited adoption of CDC recommendations among this high risk group. MSM should disclose male-male sex risk, and healthcare providers should actively assess such risk, because this may improve offering of recommended health screenings.
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