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HIV Testing Among Men Who Have Sex With Men: How Often Should One Test?

Roark, Randall A. JD, MPH; Webster, Robert D. MPH; Darrow, William W. PhD; Stempel, Robert R. DrPH†

Journal of Public Health Management & Practice: January/February 2005 - Volume 11 - Issue 1 - p 18–24
Article

HIV counseling and testing has been a cornerstone of AIDS prevention strategies, with men who have sex with men being specifically targeted for the counseling and testing. Unfortunately, it appears that exposure to HIV counseling and testing has little effect on the behaviors of those who test negative. The Centers for Disease Control and Prevention recently altered its recommendations on when and how often men who have sex with men should undergo testing for HIV and other sexually transmitted diseases, now recommending annual testing for sexually active men who have sex with men, with even more frequent testing for men who have sex with men who engage in highest risk behaviors. Using data from our study, we evaluated the new recommendations with respect to HIV testing. Overall, 81% of the men who have sex with men in our sample reported never having tested positive for HIV. Among these men who have sex with men in South Beach nearly 8% tested positive on their current test. Slightly more than half of the men who tested positive on their current test had not been tested in the past 12 months; slightly fewer than half reported they had tested negative within the prior 9 months. Reporting multiple (4 or more) anal sexual partners during the past 12 months was significantly associated with a positive test result. Our results support the new CDC guidelines regarding more frequent testing for sexually active men who have sex with men, with having a high number of anal partners being a significant indicator of need for testing more often than annually in our population.

Detailed within this article, the authors' conducted a study to evaluate CDC's recently altered recommendation for annual HIV testing.

Consultant, Center for AIDS Prevention Studies, AIDS Research Institute, University of California, San Francisco (Roark).

graduate student, Harris Graduate School of Public Policy Studies, University of Chicago, Illinois (Webster).

Professor, School of Public Health, Florida International University, Miami (Darrow).

Professor, School of Public Health, Florida International University, Miami (Stempel).

Corresponding author: Randall A. Roark, JD, MPH, 1580 5th Ave, #201, San Francisco, CA 94122 (e-mail: randallroark@hotmail.com).

†Deceased.

The study described in this article was supported by gifts and grants from the Dean's Fund, College of Health, Florida International University (FIU); FIU Foundation; Miami-Dade County HIV Prevention Community Planning Group, Health Council of South Florida, Department of Health, State of Florida; and the Center for AIDS Prevention Studies, AIDS Research Institute, University of California, San Francisco. Specimens were collected under the supervision of Dr. Robert Dollinger, stored with the assistance of Dr. Beverly Warden, and tested under the direction of Berry Bennett at the State of Florida Department of Health Laboratory in Jacksonville, Florida. Jay Paul, PhD, provided helpful suggestions regarding the development of this report, and Mike Acre, PhD, George Rutherford, MD, and William Woods, PhD, critically reviewed earlier drafts of our manuscript. FIU staff and students who contributed extraordinary efforts to completion of this project included Abraham Buckley, Miguel Cruz, Irma Fernandez, Marie Florent, Elizabeth Joseph, Steven Kurtz, Andrew Mueller, Kesuri Patel, Lynette Phillips, and Richard Taylor. Special thanks go to Jose Prendez for assistance with data entry and management, computer programming, and statistical analyses. This article is dedicated to the memory of Bob Stempel.

© 2005 Lippincott Williams & Wilkins, Inc.