HIV testing trends among gay men in Scotland, UK (1996–2005): implications for HIV testing policies and prevention
- 1MRC Social and Public Health Sciences Unit, Glasgow, UK
- 2Division of Psychology, School of Life Sciences, Glasgow Caledonian University, Glasgow, UK
- 3Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London, UK
- Correspondence to Dr L M Williamson, MRC Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow G12 8RZ, UK;
- Accepted 26 December 2009
- Published Online First 9 March 2009
Objective: To examine trends in the HIV testing behaviour of gay men in Scotland over a 10-year period.
Methods: Seven cross-sectional surveys in commercial gay venues in Glasgow and Edinburgh (1996–2005). 9613 men completed anonymous, self-completed questionnaires (70% average response rate).
Results: Among 8305 respondents included in these analyses, HIV testing increased between 1996 and 2005, from 49.7% to 57.8% (p<0.001). The proportion of men who had tested recently (in the calendar year of, or immediately before, the survey) increased from 28.4% in 1996 to 33.2% in 2005, when compared with those who have tested but not recently, and those who have never tested (adjusted odds ratio 1.31, 95% CI 1.13 to 1.52). However, among ever testers, there was no increase in rates of recent testing. Recent testing decreased with age: 31.3% of the under 25, 30.3% of the 25–34, 23.2% of the 35–44 and 21.2% of the over 44 years age groups had tested recently. Among men reporting two or more unprotected anal intercourse partners in the previous year, only 41.4% had tested recently.
Conclusions: HIV testing among gay men in Scotland increased between 1996 and 2005, and corresponds with the Scottish Government policy change to routine, opt-out testing in genitourinary medicine clinics. Testing rates remain low and compare unfavourably with near-universal testing levels elsewhere. The limited change and decline across age groups in recent HIV testing rates suggest few men test repeatedly or regularly. Additional, innovative efforts are required to increase the uptake of regular HIV testing among gay men.
See Editorial, p 487
Funding The UK Medical Research Council funded the 1996, 1999, 2002a and 2005 surveys as part of the Sexual and Reproductive Health Programme (WBS U.1300.00.005) at the Social and Public Health Sciences Unit. Healthy Gay Scotland funded the 2000, 2002b and 2003 surveys.
Competing interests None.
Ethics approval Ethics approval was granted for the 1996, 1999, 2002a and 2005 surveys by the University of Glasgow Ethics Committees for Non-clinical Research Involving Human Subjects, and for the 2000 survey by the Psychology Ethics Committee at Glasgow Caledonian University.
Contributors: PF had the initial idea for the paper and all authors contributed to the interpretation of the data and development of the paper. CK conducted the analyses and LMW wrote the first draft. All authors contributed to subsequent drafts and approved the final version of the manuscript. The 1996 and 1999 surveys were designed and conducted by GJH and PF, the 2002a and 2005 surveys by GJH and LMW and the 2000, 2002b and 2003 surveys by PF.
Provenance and Peer review Not commissioned; externally peer reviewed.