Why do men who have sex with men test for HIV infection? Results from a community-based testing program in Seattle.

The Centers for Disease Control and Prevention recommends at least annual HIV testing for men who have sex with men (MSM), but motivations for testing are not well understood. We evaluated data from MSM testing for HIV at a community-based program in King County, Washington. Correlates of regular testing were examined using GEE regression models. Between February 2004 and June 2011, 7176 MSM attended 12,109 HIV testing visits. When asked reasons for testing, 49% reported it was time for their regular test, 27% reported unprotected sex, 24% were starting relationships, 21% reported sex with someone new, 21% sought STI/hepatitis screening, 12% reported sex with an HIV-infected partner, 2% suspected primary HIV infection, and 16% reported other reasons. In multivariable analysis, factors associated with regular testing included having a regular healthcare provider and the following in the previous year: having only male partners, having ≥10 male partners, inhaled nitrite use, not injecting drugs, and not having unprotected anal intercourse with a partner of unknown/discordant status (p≤0.001 for all). Men reporting regular testing reported shorter intertest intervals than men who did not (median of 233 vs. 322 days, respectively; p<0.001). Regular testing, sexual risk, and new partnerships were important drivers of HIV testing among MSM, and regular testing was associated with increased testing frequency. Promoting regular testing may reduce the time that HIV-infected MSM are unaware of their status, particularly among those who have sex with men and women or inject drugs.

美国疾病控制与预防中心建议男男性行为者（MSM）至少每年进行一次艾滋病病毒（HIV）检测，但检测的动机尚未得到充分了解。 我们评估了来自华盛顿金县一个社区项目中男男性行为者HIV检测的数据。使用广义估计方程（GEE）回归模型检验了定期检测的相关因素。 在2004年2月至2011年6月期间，7176名男男性行为者参加了12109次HIV检测。当被问及检测原因时，49%的人表示是到了常规检测的时间，27%的人报告有过无保护性行为，24%的人开始新恋情，21%的人报告与新伴侣发生过性行为，21%的人寻求性传播感染/肝炎筛查，12%的人报告与HIV感染者有过性行为，2%的人怀疑初次感染HIV，16%的人报告了其他原因。在多变量分析中，与定期检测相关的因素包括有固定的医疗服务提供者以及在过去一年中：只有男性性伴侣、有10个及以上男性性伴侣、使用吸入性亚硝酸盐、不注射毒品以及未与感染状况不明/不一致的伴侣进行无保护的肛交（所有因素p≤0.001）。报告定期检测的男性比不报告的男性检测间隔时间更短（中位数分别为233天和322天；p<0.001）。 定期检测、性风险和新的伴侣关系是男男性行为者进行HIV检测的重要驱动因素，并且定期检测与检测频率增加有关。促进定期检测可能会减少感染HIV的男男性行为者对自身感染状况不知情的时间，特别是在那些与男性和女性都有性行为或注射毒品的人群中。