AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #175 - HIV and STDs testing practices in France
Authors: Presenting Author: Ms Elisabete de Carvalho - Sida Info Service
Additional Authors: Ms. Mathilde Coudray,
Aim: With five million tests performed each year, France has one of the highest HIV testing rates in Europe. Despite this, an estimated 50.000 people are unaware they are infected. Little is known about other sexually transmitted diseases (STDs) screening. The objective of this study is to examine HIV and STDs testing practices in France: who gets HIV tested? Why? Where? What about other STDs testing? It will also discuss reasons for not taking an HIV test.
Method / Issue: A total of 1357 people were surveyed using a self-administered questionnaire. It included HIV and STDs testing history and intentions as well as attitudinal and behavioral items. A high level of MSM (Men who have Sex with Men) participation (n=813) was induced in order to focus on this high-risk group.
Results / Comments: Three-quarters of participants reported ever being tested for HIV. This proportion is significantly higher among MSM (82%) than heterosexual respondents (66%). When asked the main reasons why they got the last test, almost half the MSM and three out of ten heterosexual men and women wanted to “check” or to “update” their HIV status. It is consistent with the fact that four MSM out of ten have ever had unprotected sex but did not get HIV tested right after —versus three heterosexuals out of ten. Free and anonymous testing sites are preferred by people reporting unprotected penetration and younger respondents while the others chose a private medical biology analysis laboratory. More than half the MSM participants were screened for another STD —mainly syphilis and hepatitis B. This proportion is lower among heterosexuals (38.6%) and they are the most often tested for hepatitis B and Chlamydia. Qualitative analysis shows that perceived barriers to taking a test are multiple: perception of low-risk for HIV infection, fear of a positive test result, lack of awareness of testing facilities, not feeling sick, testing process perceived as complex, difficulties to face the counselors and to talk about sexuality are the most reported. Rapid testing is not widespread in France but 77.6% of participants that ever heard of it would be interested in this technique. Two-thirds may consider HIV home self-testing if available and reliable.
Discussion: As a 37-year-old man said: “There is still some way to go before testing becomes a commonplace”. The results of this survey point out a large variety of HIV testing behaviours according to sexual orientation or age. Needs, expectations and fears are so diverse that a unique strategy cannot be delivered. There is evidence that the presence of other STDs increases the likelihood of both transmitting and acquiring HIV but STDs screening is not systematically done. HIV and STDs testing have to be provided in a wide range of settings and associated with counselling in order to turn into an effective prevention strategy.
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