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Original article
Repeated STI and HIV testing among HIV-negative men who have sex with men attending a large STI clinic in Amsterdam: a longitudinal study
  1. Henrike J Vriend1,2,
  2. Ineke G Stolte2,3,
  3. Janneke C M Heijne1,
  4. Titia Heijman3,4,
  5. Henry J C De Vries1,4,5,
  6. Ronald B Geskus3,6,
  7. Marianne A B Van der Sande1,7,
  8. Maria Prins2,3
  1. 1National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, The Netherlands
  2. 2Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, The Netherlands
  3. 3Research Department, Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
  4. 4STI Outpatient Clinic, Public Health Service of Amsterdam, Amsterdam, The Netherlands
  5. 5Department of Dermatology, Academic Medical Center, Amsterdam, The Netherlands
  6. 6Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands
  7. 7Julius Center, University Medical Center, Utrecht, The Netherlands
  1. Correspondence to Rianne Vriend, National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control. P.O. Box 1, Bilthoven 3720 BA, The Netherlands; rianne.vriend{at}rivm.nl

Abstract

Objective In the Netherlands, men who have sex with men (MSM) are advised via informal guidelines to test for STI at least annually. We estimated the proportion of HIV-negative MSM testing repeatedly at 12-month or smaller intervals at a large STI clinic in the Netherlands. In addition, we explored whether repeated testing is related to risk behaviour.

Design and methods Longitudinal data of HIV-negative MSM visiting the Amsterdam STI clinic between 2009 and 2012 were analysed. To estimate the timing of repeated testing, Kaplan–Meier methods were used. Determinants for repeated testing (distinguishing testing at 12-month or smaller intervals and less than 12-monthly testing, with single testers as reference group) were identified using multivariate multinomial logistic regression analyses.

Results In total, 19 479 consultations of 9174 HIV-negative MSM were identified. Of these MSM, 35% (95% CI 33% to 36%) were estimated to return to the STI clinic within 1 year following baseline consultation. Among 1767 men with at least two consultations and at least 2 years between baseline and last consultation, 43% tested repeatedly at 12-month or smaller intervals in those first 2 years. Repeated testers reported higher sexual risk behaviour (ie, only casual or both casual and steady sex partners, higher numbers of sex partners) at baseline compared with single testers. This effect tended to be slightly stronger for men testing repeatedly at 12-month or smaller intervals.

Conclusions The proportion of MSM testing for STI annually is low. MSM testing repeatedly had higher baseline levels of risk behaviour. Strategies to motivate MSM to test annually should be explored.

  • TESTING
  • HOMOSEXUALITY
  • GUIDELINE DEVELOPMENT

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