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Reasons for Not HIV Testing, Testing Intentions, and Potential Use of an Over-the-Counter Rapid HIV Test in an Internet Sample of Men Who Have Sex With Men Who Have Never Tested for HIV

MacKellar, Duncan A. DrPH, MA, MPH*; Hou, Su-I RN, DrPH; Whalen, Christopher C. MD, MS; Samuelsen, Karen PhD; Sanchez, Travis DVM, MPH*; Smith, Amanda MPH*; Denson, Damian MPH§; Lansky, Amy PhD*; Sullivan, Patrick DVM, PhDfor the WHBS Study Group

Sexually Transmitted Diseases: May 2011 - Volume 38 - Issue 5 - p 419-428
doi: 10.1097/OLQ.0b013e31820369dd
Original Study

Background: Correlates of main reasons for not HIV testing, HIV testing intentions, and potential use of an over-the-counter rapid HIV test (OTCRT) among men who have sex with men who have never tested for HIV (NTMSM) are unknown.

Methods: We evaluated these correlates among 946 NTMSM from 6 US cities who participated in an internet-based survey in 2007.

Findings: Main reasons for not testing were low perceived risk (32.2%), structural barriers (25.1%), and fear of testing positive (18.1%). Low perceived risk was associated with having fewer unprotected anal intercourse (UAI) partners and less frequent use of the internet for HIV information; structural barriers were associated with younger age and more UAI partners; fear of testing positive was associated with black and Hispanic race/ethnicity, more UAI partners, and more frequent use of the internet for HIV information. Strong testing intentions were held by 25.9% of all NTMSM and 14.8% of those who did not test because of low perceived risk. Among NTMSM who were somewhat unlikely, somewhat likely, and very likely to test for HIV, 47.4%, 76.5%, and 85.6% would likely use an OTCRT if it was available, respectively.

Conclusions: Among NTMSM who use the internet, main reasons for not testing for HIV vary considerably by age, race/ethnicity, UAI, and use of the internet for HIV information. To facilitate HIV testing of NTMSM, programs should expand interventions and services tailored to address this variation. If approved, OTCRT might be used by many NTMSM who might not otherwise test for HIV.

A study of men who have sex with men who have never tested for human immunodeficiency virus found that few held strong testing intentions but that many would use an over-the-counter rapid human immunodeficiency virus test if available.

From the *Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA; †College of Public Health, University of Georgia, Athens, GA; ‡Department of Educational Psychology and Instructional Technology, University of Georgia, Athens, GA; §University of Illinois, Chicago, IL; and ¶Rollins School of Public Health, Emory University, Atlanta, GA

The authors thank the men who completed this survey and the dedicated men and women who worked on the Web-based HIV Behavioral Surveillance project and contributed to its success. The members of the WHBS Study Group include the following: Colin Flynn and Frangiscos Sifakis, Baltimore, MD; Eric Rubinstein and Gabriella Garcia, Boston, MA; Richard Yeager and Douglas Shehan, Dallas, TX; Trista Bingham and Alexander Carruth, Los Angeles, CA; Christopher Murrill and Sabina Hirshfield, New York, NY; H. Fisher Raymond and Greg Rebchook, San Francisco, CA; Matthew Amsden and Tom Coggia, Reveal Communications; Paul Young and Benjamin Neal, NOVA Research Company.

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Correspondence: Duncan A. MacKellar, MA, MPH, DrPH, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-04, Atlanta, GA 30333. E-mail:

Received for publication July 2, 2010, and accepted October 20, 2010.

© Copyright 2011 American Sexually Transmitted Diseases Association