AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #169 - Significant differences in association of HIV testing uptake and risk taking between men having sex with men (MSM) across Europe – Results of the European MSM Internet Survey (EMIS)
Authors: Presenting Author: Dr Ulrich Marcus - Robert Koch-Institute
Additional Authors: Mr. Michele Breveglieri, Mr. Percy Fernández-Dávila, Mrs. Laia Ferrer, Mrs. Cinta Folch, Mr. Ford Hickson, Mr. Harm Hospers, Mr. Massimo Mirandola, Mrs. Johanna Rankin, Mr. David Reid, Mr. Peter Weatherburn, Mr. Axel J Schmidt,
Aim: HIV testing is being promoted as a preventive intervention. Early diagnosis of HIV – if resulting in effective antiretroviral treatment – can decrease infectiousness and prevent disease progression. Appropriate counselling in the context of HIV testing has the potential to decrease risk taking and increase protective behaviour. However, potential benefits of HIV testing would be smaller if testing is not correlated with risk taking.
Method / Issue: From June through August 2010, the European MSM Internet Survey (EMIS) mobilized more than 180,000 respondents from 38 European countries to complete an online questionnaire in one of 25 languages. The questionnaire covered sexual happiness, HIV and STI testing and diagnoses, unmet prevention needs, intervention performance, HIV-related stigma and gay-related discrimination. Recruitment was organized predominantly online, through gay social media and links and banners on more than 100 websites for MSM all over Europe. Based on national datasets comprising more than 1,000 respondents (n=25), we correlated risk taking and 1) ever testing for HIV and 2) recent HIV testing (defined as HIV testing in the past 12 months). Risk taking was defined as reporting unprotected anal intercourse with a partner of unknown or discordant HIV serostatus in the past 12 months. Determinants of ever and recent testing were evaluated in multivariate regression analyses.
Results / Comments: The ratio of respondents who reported risk taking in the recent 12 months and ever testing for HIV, compared to risk takers never having tested, ranged from 0.5 to 3.5. For respondents reporting no risk taking, the ratio of testers to non-testers ranged from 1.6 to 7.8. Higher ratios of at-risk testers were observed in Western European countries, lower proportions in Central and partly also in Eastern Europe (WHO regions). Similar differences were observed regarding recent testing. By multivariate regression analysis the following factors were identified as being independently associated with testing uptake: age, number of sexual partners in the past 12 months, perceived access to free or affordable HIV testing, city size, being out towards friends and colleagues, and having a steady partner.
Discussion: Considerable differences in the association between risk taking and HIV testing uptake are observed among MSM in Europe. Besides age, test accessibility and number of sexual partners, the ability to live openly as a gay man are important determinants for targeted and effective implementation of HIV test promotion. High levels of homophobia may deter MSM with increased risk of HIV infection from taking HIV tests, and thus render HIV test promotion less effective.
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