Introduction The proportion of MSM unaware of their HIV infection is 31% in the Netherlands. People who are unaware of HIV are more likely to transmit HIV to others and are unable to benefit from (early) treatment. To improve HIV testing, it is crucial to identify characteristics of MSM who were never tested.

Methods We analysed HIV testing behaviour in the Dutch sample (n = 3,787) of the European MSM Internet Survey (EMIS) in relation to socio-demographic and behavioural factors by logistic regression.

Results Of the MSM, 20.5% reported to be ‘never tested for HIV’. The adjusted model showed that MSM of younger age (<25 yrs aOR 4.6 CI 3.7–5.8 vs >40 yrs), with lower education (2.1 CI 1.8–2.4 vs high), with lower HIV knowledge (5.5 CI 3.8–8.0 vs higher) had higher odds on ‘never tested for HIV’. Further, MSM with lower sexual risks were more likely to be never tested for HIV; MSM with no UAI <12 months (3.8 CI 3.1–4.8 vs yes), never visiting gay venues (3.9 CI 3.3–4.7 vs ever), with no STIs < 12 months (11.3 CI 6.6–19.3 vs yes), no sex/party drugs (2.7 CI 2.0–3.7 vs yes), outness (3.4 CI 2.9–4.0 vs other), and having more gay friends (few 6.0 CI 4.6–7.9 vs most are gay). Additionally, of all MSM who were never tested for HIV 70.3% had anal intercourse with ≥1 casual partner (s) <12 months and 47% had unprotected intercourse.

Conclusion MSM with lower sexual risks were more likely to be never tested for HIV, suggesting that MSM make risk assessments to inform their choices about HIV testing. Nevertheless, MSM who never tested for HIV also showed sexual behaviour that put them at HIV risk, and are therefore important to target for HIV interventions.

Disclosure of interest statement The study is funded by the RIVM. No pharmaceutical grants were received in the development of this study.