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Audit of HIV testing frequency and behavioural interventions for men who have sex with men: policy and practice in sexual health clinics in England
  1. Monica Desai1,3,
  2. Sarika Desai1,
  3. Ann Kathleen Sullivan2,
  4. Malika Mohabeer2,
  5. Danielle Mercey3,
  6. Margaret A Kingston4,
  7. Caroline Thng4,
  8. Sheena McCormack5,
  9. O Noel Gill1,
  10. Anthony Nardone1,
  11. On behalf of GUMNet
  1. 1HIV & STI Department, Health Protection Agency, London, UK
  2. 2John Hunter Clinic for Sexual Health, Chelsea & Westminster Hospital NHS Foundation Trust, London, UK
  3. 3Mortimer Market Centre, Central and Northwest London NHS Foundation Trust, London, UK
  4. 4The Manchester Centre for Sexual Health, Manchester Royal Infirmary, Manchester, UK
  5. 5Medical Research Council Clinical Trials Unit, London, UK
  1. Correspondence to Dr Monica Desai, HIV & STI Department, Health Protection Agency, 61 Colindale Ave, London NW9 5HT, UK; desai.monica{at}


Background National guidance recommends targeted behavioural interventions and frequent HIV testing for men who have sex with men (MSM). We reviewed current policy and practice for HIV testing and behavioural interventions (BI) in England to determine adherence to guidance.

Methods 25 sexual health clinics were surveyed using a semistructured audit asking about risk ascertainment for MSM, HIV testing and behavioural intervention policies. Practice was assessed by reviewing the notes of the first 40 HIV-negative MSM aged over 16 who attended from 1 June 2010, in a subset of 15 clinics.

Results 24 clinics completed the survey: 18 (75%) defined risk for MSM and 17 used unprotected anal intercourse (UAI) as an indication of high risk. 21 (88%) offered one or more structured BI. Of 598 notes reviewed, 199 (33%) MSM reported any UAI. BI, including safer sex advice, was offered to and accepted by 251/598 (42%) men. A low proportion of all MSM (52/251: 21%) accepted a structured one-to-one BI as recommended by national guidance and uptake was still low among higher risk MSM (29/107: 27%). 92% (552/598) of men had one or more HIV test over a 1-year period.

Conclusions In 2010, the number of HIV tests performed met the national minimum standard but structured behavioural interventions were being offered to and accepted by only a small proportion of MSM, including those at a higher risk of infection. Reasons for not offering behavioural interventions to higher risk MSM, whether due to patient choice, a lack of staff training or resource shortage, need to be investigated and addressed.

  • HIV
  • Behavioural Interventions
  • Prevention

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