Sociodemographic and health-related factors associated with having unmet HIV testing need during three periods of the first year of the UK’s pandemic response
| Lookback period (period number) | March–June/July 2020 (P1) | July–November/December 2020 (P2) | December 2020-March/April 2021 (P3) | |||||||||||||||
| Sample composition, col % (n) | (Row) % have unmet HIV testing need (n) | uOR (95% CI) have unmet HIV testing need | P value | aOR (95% CI)* have unmet HIV testing need | P value | Sample composition, col % (n) | (Row) % have unmet HIV testing need (n) | uOR (95% CI) have unmet HIV testing need | P value | aOR (95% CI)* have unmet HIV testing need | P value | Sample composition, col % (n) | (Row) % have unmet HIV testing need (n) | uOR (95% CI) have unmet HIV testing need | P value | aOR (95% CI)* have unmet HIV testing need | P value | |
| All† | 100.0 (1753) | 22.9 (402) | – | – | – | – | 100.0 (1308) | 31.0 (405) | – | – | – | 100.0 (1330) | 25.1 (334) | – | – | – | – | |
| Sociodemographic characteristics | ||||||||||||||||||
| Age (years) | ||||||||||||||||||
| Under 30 | 26.7 (468) | 21.8 (102) | 1 | 0.073 | 1 | 0.156 | 28.9 (378) | 36.8 (139) | 1 | 0.014 | 1 | 0.099 | 25.8 (343) | 24.5 (84) | 1 | 0.280 | 1 | 0.350 |
| 30–44 | 35.5 (623) | 26.0 (162) | 1.26 (0.95–1.67) | 1.24 (0.92–1.65) | 37.7 (493) | 27.8 (137) | 0.66 (0.50–0.88) | 0.74 (0.55–1.00) | 35.1 (466) | 23.0 (107) | 0.92 (0.66–1.27) | 1.02 (0.73–1.43) | ||||||
| 45 and over | 37.8 (662) | 20.9 (138) | 0.94 (0.71–1.26) | 0.97 (0.72–1.30) | 33.4 (437) | 29.5 (129) | 0.72 (0.54–0.97) | 0.76 (0.56–1.04) | 39.1 (520) | 27.3 (142) | 1.16 (0.66–1.27) | 1.23 (0.89–1.69) | ||||||
| Sexual identity | ||||||||||||||||||
| Gay | 85.1 (1492) | 21.5 (321) | 1 | 0.001 | 1 | 0.001 | 82.4 (1078) | 29.0 (313) | 1 | 0.001 | 1 | 0.054 | 83.4 (1109) | 22.6 (251) | 1 | <0.001 | 1 | <0.001 |
| Bisexual‡ | 14.9 (261) | 31.0 (81) | 1.64 (1.23–2.19) | 1.65 (1.23–2.22) | 17.6 (230) | 40.0 (92) | 1.63 (1.21–2.19) | 1.35 (0.99–1.84) | 16.6 (221) | 37.6 (83) | 2.06 (1.51–2.79) | 1.84 (1.34–2.52) | ||||||
| Ethnicity | ||||||||||||||||||
| White§ | 88.5 (1552) | 22.0 (342) | 1 | 0.016 | 1 | 0.033 | 87.2 (1141) | 30.3 (346) | 1 | 0.196 | 1 | 0.116 | 90.0 (1197) | 25.0 (299) | 1 | 0.737 | 1 | 0.670 |
| All other ethnic groups¶ | 11.5 (201) | 30.0 (60) | 1.51 (1.09–2.08) | 1.45 (1.03–2.04) | 12.8 (167) | 35.3 (59) | 1.26 (0.89–1.77) | 1.34 (0.93–1.93) | 10.0 (133) | 26.3 (35) | 1.07 (0.71–1.61) | 1.10 (0.72–1.68) | ||||||
| Country of residence in the UK | ||||||||||||||||||
| England | 85.5 (1499) | 22.0 (330) | 1 | 0.030 | 1 | 0.011 | 83.4 (1091) | 29.6 (323) | 1 | 0.018 | 1 | 0.063 | 83.4 (1109) | 23.8 (264) | 1 | 0.016 | 1 | 0.035 |
| Outside England | 14.5 (254) | 28.4 (72) | 1.40 (1.04–1.89) | 1.48 (1.10–2.01) | 16.6 (217) | 37.8 (82) | 1.44 (1.07–1.96) | 1.35 (0.98–1.85) | 16.6 (221) | 31.7 (70) | 1.48 (1.08–2.03) | 1.41 (1.02–1.95) | ||||||
| Born in the UK | ||||||||||||||||||
| Yes | 78.3 (1373) | 22.1 (304) | 1 | 0.135 | – | n.a. | 76.3 (998) | 32.0 (319) | 1 | 0.157 | – | n.a. | 78.5 (1044) | 24.8 (259) | 1 | 0.626 | – | n.a. |
| No | 21.7 (380) | 25.8 (98) | 1.22 (0.94–1.59) | – | 23.7 (310) | 27.7 (86) | 0.82 (0.62–1.08) | – | 21.5 (286) | 26.2 (75) | 1.08 (0.80–1.45) | – | ||||||
| Highest educational qualification | ||||||||||||||||||
| Degree or higher | 58.9 (1031) | 23.5 (242) | 1 | 0.530 | 1 | 0.883 | 58.8 (769) | 28.7 (221) | 1 | 0.038 | 1 | 0.319 | 56.2 (748) | 24.6 (184) | 1 | 0.624 | 1 | 0.678 |
| Below degree | 41.2 (721) | 22.2 (160) | 0.93 (0.74–1.17) | 0.98 (0.78–1.24) | 41.2 (539) | 34.1 (184) | 1.29 (1.01–1.63) | 1.13 (0.88–1.46) | 43.8 (582) | 25.8 (150) | 1.06 (0.83–1.37) | 0.95 (0.73–1.23) | ||||||
| Employed (inc. furlough**) | ||||||||||||||||||
| Yes | 77.7 (1355) | 23.8 (322) | 1 | 0.106 | – | n.a. | 75.4 (986) | 30.2 (298) | 1 | 0.311 | – | n.a. | 78.0 (1037) | 23.9 (248) | 1 | 0.059 | – | n.a. |
| No | 22.3 (388) | 19.9 (77) | 0.79 (0.60–1.05) | – | 24.6 (322) | 33.2 (107) | 1.15 (0.88–1.50) | – | 22.0 (293) | 29.4 (86) | 1.32 (0.99–1.76) | – | ||||||
| Health-related factors | ||||||||||||||||||
| PrEP use (in the lookback period) | ||||||||||||||||||
| No | 84.9 (1481) | 22.0 (326) | 1 | 0.033 | 1 | 0.031 | 74.2 (970) | 36.4 (353) | 1 | <0.001 | 1 | <0.001 | 76.8 (1022) | 27.8 (284) | 1 | <0.001 | 1 | 0.001 |
| Yes | 15.1 (264) | 28.0 (74) | 1.38 (1.03–1.85) | 1.40 (1.03–1.89) | 25.8 (337) | 15.4 (52) | 0.32 (0.23–0.44) | 0.35 (0.25–0.48) | 23.2 (308) | 16.2 (50) | 0.50 (0.36–0.70) | 0.55 (0.39–0.77) | ||||||
| Life satisfaction level | ||||||||||||||||||
| Medium–very high | 69.0 (1208) | 23.8 (288) | 1 | 0.190 | 1 | 0.128 | 75.5 (988) | 30.6 (302) | 1 | 0.586 | 1 | 0.468 | 75.2 (998) | 23.2 (231) | 1 | 0.006 | 1 | 0.012 |
| Low | 31.0 (543) | 21.0 (114) | 0.85 (0.66–1.08) | 0.82 (0.64–1.06) | 24.5 (320) | 32.2 (103) | 1.08 (0.82–1.41) | 1.11 (0.84–1.47) | 24.8 (329) | 30.7 (101) | 1.47 (1.12–1.94) | 1.44 (1.08–1.91) | ||||||
Unmet HIV testing need, defined as reporting one or more new sex partners and/or multiple CAS partners in the lookback period without testing for HIV during the same period.
*Adjusting for: age; sexual identity; ethnicity; country of residence; education; PrEP use; life satisfaction.
†Cisgender MSM that report a negative or unknown HIV status.
‡Including ‘Bisexual’ (S1: n=210; S2: n=169; S3: n=171); ‘Other’ (S1: n=43; S2: n=47; S3: n=44); ‘Straight’ (S1: n=8; S2: n=14; S3: n=6).
§Including ‘White British’ (S1: n=1288; S2: n=924; S3: n=1000); ‘White Irish’ (S1: n=64; S2: n=50; S3: n=42); ‘White other’ (S1: n=200; S2: n=167; S3: n=155).
¶Including ‘Black’ (S1: n=24; S2: n=38; S3: n=22); ‘Asian’ (S1: n=98; S2: n=61; S3: n=52); ‘Mixed or other’ (S1: n=79; S2: n=68; S3: n=59).
**The UK government paid 80% of the salary of those who were unable to work due to COVID-19 restrictions.15
aOR, adjusted OR; CAS, condomless anal sex; CI, confidence interval; MSM, men who have sex with men; n.a., not applicable; PrEP, pre-exposure prophylaxis; uOR, unadjusted OR.