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Men who take more risks avoid HIV testing due to structural barriers

Men who take more risks avoid HIV testing due to structural barriers

Regular HIV testing is recommended in men who take sexual risks. We assessed the relationship between perceived barriers to HIV testing, and frequency of testing among men who engaged in unprotected anal intercourse with casual partners (UAIC), to inform HIV testing strategies.

Methods: TAXI-KAB was a national online survey of Australian gay men recruited during late 2012. Men were asked about sexual behavior, last HIV test and barriers to testing in the past 12 months. We focused on men who reported UAIC, and used chi-squared tests to see if barriers varied according to whether men had tested more than or less than 2 years ago (“distant testers” and “recent testers” respectively).

Results: Of 771 men recruited, 269 (34.9%) reported UAIC in the past 6 months. Among men reporting UAIC testing barriers were often higher among distant testers: ‘the process of getting tested is too much hassle’ (50% in distant testers vs 23% in recent testers, p=0.012), ‘I haven’t had any symptoms or illness that made me worry’ (48% vs 17%, p=0.003) and ‘I don’t want to have to discuss my sex life’ (41% vs 11%, p<0.001). Distant testers indicated they did not appreciate ‘having to return for a result’ (47% in distant testers vs 27% in recent testers, p=0.08). Length of time since being tested was not associated with: ‘I haven’t done anything risky’ (22% vs 15%, p=0.393) nor ‘I don’t want to know the result’ (25% vs 22%, p=0.816).

Conclusion: Structural and other barriers to HIV testing are important for men who engage in UAIC and appear more influential in distant testers. These results highlight the importance of convenient ways to access testing. Empowering men to assess their own risks and need for testing without detailed pre-test discussions may encourage testing for some men.

Speakers: Phillip Keen
Conference: ASHM 2013
Areas of Interest / Categories: AIDS 2013, Health Promotion, HIV, Homosexuality, Sexual Behaviour

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