Abstract

Objectives: To determine what proportion of men who have sex with men attending GUM clinics are offered and accept an HIV test, and to examine clinic and patient characteristics associated with offer and uptake.

Methods: A cross sectional study of all GUM clinics in the UK, involving case note review of up to 30 patient records per clinic and the completion of a clinic policy form.

Results: Overall, 86% of MSM were offered a test, and of those, 82% accepted a test. Attending with symptoms of an STI, fewer numbers of partners in the last 3 months, and having tested previously were all independently associated with decreased likelihood of being offered a test. Attending with symptoms of an STI, increasing age, never having had a risk from unprotected anal intercourse or a previous HIV test, and increasing time to wait for results were all independently associated with decreased likelihood of a patient accepting a test. Only a quarter of clinics reported a written policy for HIV testing intervals among MSM, however all clinics reported offering testing to all new MSM patients at first screen. Testing policy for re-attending patients was less clear.

Conclusions: Testing must reach those at most risk and those less likely to test in order to further reduce the proportion of undiagnosed HIV infection. This study suggests that opportunities to detect infection may be being missed, and a move towards universal testing of all MSM attending with a new episode, as well as testing within the window period, is recommended.