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Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men

Author

Listed:
  • Sarah J. Marks
  • Roland C. Merchant
  • Melissa A. Clark
  • Tao Liu
  • Joshua G. Rosenberger
  • Jose A. Bauermeister
  • Kenneth H. Mayer

Abstract

HIV incidence among young adult men-who-have-sex-with-men (YMSM) is among the highest in the United States (US), yet YMSM have lower rates of HIV testing than most other MSM. Among 1,835 U.S. Black, Hispanic, and White YMSM who reported condomless anal intercourse (CAI) in the prior year, 30% (95% confidence interval [CI]: [28%, 32%]) had not been tested for HIV in the past year as recommended by national guidelines, and 19% (95% CI: [17%, 21%]) had never been tested. Factors associated with not being tested in the past year included not having a primary care provider (PCP)) (odds ratio [OR]: 2.00, 95% CI: [1.53, 2.60]), discomfort with asking a PCP for an HIV test (OR: 2.66, 95% CI: [2.05, 3.44]), living in a smaller community (OR: 1.71, 95% CI: [1.35, 2.18]), younger age (OR: 2.00, 95% CI: [1.53, 2.60]), and greater self-perception of having an undiagnosed HIV infection (OR: 1.46, 95% CI: [1.07, 1.99]). YMSM who had not been tested in the prior year were less likely to know where to get tested, yet were interested in trying home-based HIV self-testing. This study shows that knowledge, clinician-relationship, geographic, and perceptional barriers must be overcome to improve HIV testing among YMSM. Home-based HIV self-testing may address some of these barriers, particularly for YMSM living in smaller communities.

Suggested Citation

  • Sarah J. Marks & Roland C. Merchant & Melissa A. Clark & Tao Liu & Joshua G. Rosenberger & Jose A. Bauermeister & Kenneth H. Mayer, 2021. "Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men," SAGE Open, , vol. 11(2), pages 21582440211, May.
    • Handle: RePEc:sae:sagope:v:11:y:2021:i:2:p:21582440211016835
    DOI: 10.1177/21582440211016835
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    References listed on IDEAS

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    1. Wilson, P.A. & Moore, T.E., 2009. "Public health responses to the HIV epidemic among black men who have sex with men: A qualitative study of US Health Departments and Communities," American Journal of Public Health, American Public Health Association, vol. 99(6), pages 1013-1022.
    2. Ci Zhang & Xianhong Li & Mary-Lynn Brecht & Deborah Koniak-Griffin, 2017. "Can self-testing increase HIV testing among men who have sex with men: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-19, November.
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    Keywords

    HIV; YMSM; testing; HIV home testing;
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