Covariates for frequent HIV testing among Dutch men who have sex with men.

Abstract

Background: In the Netherlands, late presentation into HIV care among MSM has not declined since 2008. The availability of antiretroviral therapy was expected to increase testing rates, but this has not happened. It is important that MSM know their HIV status, because getting into care when HIV has not progressed allows for a more effective and efficient treatment. Therefore, sexual active MSM are advised to test every 3-6 months. The objective of this study is to gain insight into the covariates for frequent testing among MSM. Methods: The data was collected through a large scale survey among Dutch MSM. The dependent variable was testing frequency, which was divided in two groups: those who test frequently (every 3-6 months) and those who test less frequently. Those who never tested were not included in the analysis. The covariates were related to sexual behaviour and relationship status, social environment, health and wellbeing and HIV prevention beliefs. Bivariate logistic regression is used to calculate odds ratios. Those with a significance level of p<0.10 were included in the model for multivariate analysis. Results: 3321 respondents were included in the analysis, 56.1% of them do not follow the guidelines of testing every 3-6 months. Factors associated with a higher likelihood of testing frequently in multivariate analysis are having a non-Western migration background, engaging in anal sex with casual partners and one night stands, engaging in group sex, ever having used PrEP, ever had an STI before and perceived likelihood of HIV infection. Factors associated with a lower likelihood of testing frequently in multivariate analysis are being in a relationship, living outside of Amsterdam and being notified to test for HIV. Discussion: One possible explanation for these covariates is risk perception: those who perform more risk behaviour and perceive the likelihood of HIV infection to be higher are more likely to test frequently. Another explanation can be the prevention efforts taken in Amsterdam and for people with a non-western migration background, which explains why they are more likely to test frequently than those outside of Amsterdam and from a Dutch origin. The third potential explanation is social norms, in settings where testing for HIV is more normalized, for example in Amsterdam, other people are also more likely to get tested. Sexual health promotion for MSM should be more widespread, focusing on different types of MSM, including those with a low risk and those living outside of Amsterdam.