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Low HIV-testing rates among younger high-risk homosexual men in Amsterdam
  1. Ineke G Stolte1,
  2. John B F de Wit2,
  3. Marion E Kolader3,
  4. Han S A Fennema3,
  5. Roel A Coutinho4,
  6. Nicole H T M Dukers1
  1. 1Department of Research, Cluster of Infectious Diseases, Health Service of Amsterdam, Amsterdam, The Netherlands
  2. 2Department of Social and Organizational Psychology, University of Utrecht, Utrecht, The Netherlands
  3. 3Cluster of Infectious Diseases, STI Outpatient Clinic, Municipal Health Service of Amsterdam, Amsterdam, The Netherlands
  4. 4Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  1. Correspondence to:
 Dr I G Stolte
 Health Service Amsterdam, Cluster of Epidemiology, Documentation and Health Promotion, Nieuwe Achtergracht 100, PO box 2200 1000 CE Amsterdam, The Netherlands;istolte{at}


Objective: To investigate HIV-testing behaviour and HIV prevalence among homosexual visitors of a sexually transmitted infection (STI) outpatient clinic, and to investigate determinants of unknown HIV status, and of HIV testing separately for men with unknown and negative HIV status.

Design: Cross-sectional survey conducted from March 2002 to December 2003 among homosexual men with negative or unknown HIV status visiting the Amsterdam STI clinic.

Methods: A convenience sample of 1201 men with negative or unknown HIV status answered a written questionnaire about history of HIV testing, sexual risk behaviour and behavioural determinants (non-response, 35%). Information was matched to the STI registration system. Associations were determined using logistic regression.

Results: 817 men reported a negative HIV status, and 384 reported an unknown HIV status. The overall HIV prevalence among the 523 men who tested at new STI consultation was 2.8%. The proportion of men with unknown HIV status was relatively high among those diagnosed with infectious syphilis and those reporting unprotected anal intercourse with a casual partner. Their testing rates at new STI clinic visit were lower. Among men with an unknown HIV status, those aged <30 years and reporting risky sexual behaviour tested the least (OR 0.13, 95% CI 0.03 to 0.61).

Conclusion: Although HIV testing rates have increased, they are still lower than in other industrialised countries. Moreover, some men still undertake high-risk sex without knowing their own HIV status, which might pose a risk for ongoing HIV transmission. Therefore, more active testing promotion is needed.

  • CP, casual partner
  • HAART, highly active antiretroviral therapy
  • RG, rectal gonorrhoea
  • SP, sexual partner
  • STI, sexually transmitted infection
  • UAI, unprotected anal intercourse; VDRL, Venereal Disease Research Laboratory

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  • Published Online First 21 February 2007

  • Funding: This research has been funded by grant number 4014 from Aids Fonds Netherlands.

  • Competing interests: None declared.

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