Measures of risk do not discriminate between MSM tested for HIV within the previous 6 months and MSM tested 6 to 12 months previously: Data from Glasgow, Scotland, in 2010.

Christina Knussen , Dr. ,

Other Contributors:

June 14, 2013

UK and USA guidelines recommend at least annual HIV testing for men who have sex with men (MSM), with more frequent testing for those at risk. Although measures of risk and regularity of HIV testing are essential for evaluating interventions, these are not yet standardised across the UK.1 Risk criteria could include recent unprotected anal intercourse (UAI), a high number of partners, unknown partners, and recent STI.2 From self- report data collected in Glasgow with a bar-based sample (excluding non- Scottish and HIV positive men, n = 683), we compared two groups on these risk criteria, in addition to demographic variables and psychosocial testing barriers. The groups were those reporting an HIV test within the previous 6 months (recent testers) and those reporting a test 6-12 months previously.

Recent testers (39.7%, n = 271) and those tested 6-12 months previously (17.6%, n = 120) differed significantly on the number of sexual partners reported in the previous year; those tested 6-12 months previously were more likely to report only 0-1 sexual partner, while recent testers were more likely to report 2-10 partners: ??2 (2) = 6.33, p = .042. However, the proportions of those reporting ?11 partners were almost identical: 22.5% and 22.9% respectively. The groups did not differ significantly on the numbers of UAI partners in the previous year. Among those with at least one UAI partner, the groups did not differ on status of partners (casual or regular), knowledge of the partners' HIV status, or whether those partners were HIV positive. There was a non- significant trend (p = .094) for recent testers to report STI in the previous year. The groups did not differ on demographic characteristics (age, employment, education, use of the gay scene) or barriers to HIV testing (benefits, fear, clinic barriers, attitudes to sex with HIV positive partners, testing norm).

Most measures of risk did not differentiate between the two groups of testers, suggesting further research on the measurement of risk and frequency or regularity of testing is warranted. We are exploring the utility of including measures of regularity and frequency of HIV testing in our surveys: one of the limitations of the analysis reported here (in addition to reliance on self-reported and cross-sectional data from a bar- based sample) was the use of a retrospective measure of the most recent HIV test.

ACKNOWLEDGEMENTS The survey was funded by NHS Greater Glasgow & Clyde, Ayrshire & Arran and Lanarkshire. The MRC funds Dr Lisa McDaid.

ETHICS APPROVAL Granted by the Psychology Ethics Subcommittee at Glasgow Caledonian University.

REFERENCES

1. Desai M, Desai S, Sullivan AK, et al. Audit of HIV testing frequency and behavioural interventions for men who have sex with men: policy and practice in sexual health clinics in England. Sex Transm Infect. Published Online First: January 7, 2013. doi:10.1136/sextrans- 2012- 050679.

2. Katz DA, Dombrowski JC, Swanson F, et al. HIV intertest interval among MSM in King County, Washington. Sex Transm Infect 2013;89:32-37. doi:10.1136/sextrans-2011-050470.

Conflict of Interest:

None declared

Conflict of Interest

None declared