Identifying Barriers to HIV Testing Among Men who have Sex with Men

Abstract

HIV incidence rates have remained relatively stable throughout the past five years; however, among men who have sex with men (MSM), particularly young MSM, incidence has increased. According to national surveillance data, MSM accounted for 61% of HIV cases diagnosed in 2010. A low viral load reduces the risk of HIV transmission and slows the progression of HIV to AIDS. Treatment as prevention (TasP) has been identified as a major part of the solution to ending the HIV epidemic. This research focuses specifically on reasons for not taking an HIV-test among MSM. For TasP to be effective, widespread testing in order to identify HIV-positive people is needed. For the purpose of the present study, a survey was distributed at gay pride events in Rochester and Buffalo, NY during June and July 2012. Barriers to HIV testing and HIV risk were evaluated using a four-point Likert scale adapted from an instrument developed by Mikolajczak (2006). It was hypothesized that months since last HIV test would be positively correlated with barriers to testing. Months since last HIV test was positively skewed, ranging from 0 to 348 months. Therefore, Spearman rank-order correlations were used. Three items measuring barriers to testing were significantly correlated with months since last HIV test. These were perceived peer support, knowledge of HIV testing sites, and partnered relationship status. Interestingly, previous research suggested that fear of a positive result and low perceived risk were barriers to testing. These findings were not replicated in this sample. Nearly 40% of subjects had not been tested within the last year. TasP would not effectively prevent transmission among an untested group such as this. For TasP to be effective, interventions must be designed to encourage more frequent HIV testing and safer sex among those who have not been recently tested.