Objectives Despite a recent fall in the incidence of HIV within the UK, men who have sex with men (MSM) continue to be disproportionately affected. As biomedical prevention technologies including pre-exposure prophylaxis are increasingly taken up to reduce transmission, the role of HIV testing has become central to the management of risk. Against a background of lower testing rates among older MSM, this study aimed to identify age-related factors influencing recent (≤12 months) HIV testing.
Methods Cross-sectional subpopulation data from an online survey of sexually active MSM in the Celtic nations—Scotland, Wales, Northern Ireland and Ireland (n=2436)—were analysed to compare demographic, behavioural and sociocultural factors influencing HIV testing between MSM aged 16–25 (n=447), 26–45 (n=1092) and ≥46 (n=897).
Results Multivariate logistic regression demonstrated that for men aged ≥46, not identifying as gay (OR 0.62, CI 0.41 to 0.95), location (Wales) (OR 0.49, CI 0.32 to 0.76) and scoring higher on the personalised Stigma Scale (OR 0.97, CI 0.94 to 1.00) significantly reduced the odds for HIV testing in the preceding year. Men aged 26–45 who did not identify as gay (OR 0.61, CI 0.41 to 0.92) were also significantly less likely to have recently tested for HIV. For men aged 16–25, not having a degree (OR 0.48, CI 0.29 to 0.79), location (Republic of Ireland) (OR 0.55, CI 0.30 to 1.00) and scoring higher on emotional competence (OR 0.57, CI 0.42 to 0.77) were also significantly associated with not having recently tested for HIV.
Conclusion Key differences in age-related factors influencing HIV testing suggest health improvement interventions should accommodate the wide diversities among MSM populations across the life course. Future research should seek to identify barriers and enablers to HIV testing among the oldest and youngest MSM, with specific focus on education and stigma.
- hiv testing
- men who have sex with men
- sexual health
- risk reduction
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Handling editor Henry John Christiaan de Vries
Presented at This paper was given as an oral presentation at the British Sociological Association’s Medical Sociology Conference at Glasgow Caledonian University, September 2018.
Contributors JD undertook the secondary data analysis of the SMMASH2 data set, and designed and drafted the paper. KM undertook the secondary data analysis of the SMMASH2 data set, mentored JD in statistical analysis and contributed to redrafts of the paper. PF designed and authored the original SMASHH2 report and contributed to redrafts of the paper. LMM designed and authored the original SMASHH2 report and contributed to redrafts of the paper. JSF is the principal investigator on the SMMASH2 study. He led the development, designed the data collection and preliminary analysis of these data, authored the original SMMASH2 report, undertook secondary data analysis of the SMMASH2 data set, mentored JD in statistical analysis and contributed to redrafts of the paper.
Funding Funding for the original SMMASH2 report was provided by NHS Greater Glasgow and Clyde and NHS Lothian. JD is undertaking a clinical academic nurse research fellowship, funded by NHS Greater Glasgow and Clyde and Glasgow Caledonian University. LMM (MC_UU_12017/11, SPHSU11) and PF (MC_UU_12017/12) (SPHSU12) are funded by the UK Medical Research Council (MRC) and the Scottish Government Chief Scientist Office (CSO) at the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. JSF and KM are funded by the School of Health and Life Sciences, Glasgow Caledonian University.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval SMMASH2 received ethical approval from the Nursing and Community Health Sciences Ethics Committee, Glasgow Caledonian University: HLS/NCH/15/26.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.