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Recent HIV Testing Among Young Men Who Have Sex With Men: Correlates, Contexts, and HIV Seroconversion

MacKellar, Duncan A. MA, MPH*; Valleroy, Linda A. PhD*; Anderson, John E. PhD*; Behel, Stephanie MPH*; Secura, Gina M. MPH; Bingham, Trista MPH, MS; Celentano, David D. ScD§; Koblin, Beryl A. PhD; LaLota, Marlene MPH; Shehan, Douglas**; Thiede, Hanne DVM, MPH††; Torian, Lucia V. PhD‡‡; Janssen, Robert S. MD*

Sexually Transmitted Diseases: March 2006 - Volume 33 - Issue 3 - p 183-192
doi: 10.1097/01.olq.0000204507.21902.b3

Objectives: We evaluated the correlates and contexts of HIV testing within the past year, subsequent risk reduction, and HIV seroconversion among young men who have sex with men (MSM).

Methods: Young men aged 23 to 29 years were approached, interviewed, counseled, and tested for HIV at 181 randomly sampled MSM-identified venues in six U.S. cities from 1998 through 2000. Analyses were restricted to 2,797 MSM who reported never testing HIV-positive.

Results: Of the 2,797 MSM, 1,281 (46%) either never previously tested or had not tested in the past year (never/remote testers); 1,516 (54%) had tested in the past year (recent testers); and 271 (10%) tested HIV-positive as part of the study. Of 1,885 recent sex partners reported by HIV-infected participants, 68% were partners of never/remote testers. Of recent testers, 50% tested anonymously, 51% tested because of specific risks, 59% were counseled, 47% reported reducing their risks after testing, and 8% tested HIV-positive (percent HIV-infected by race: blacks, 24%; Hispanics, 6%; whites, 4%; Asians, 1%).

Conclusion: Nearly half of young MSM participants had not tested in the past year and HIV-infected never/remote testers accounted for approximately two thirds of recent partners potentially exposed to HIV. Of those who had tested recently, many MSM, especially those who are black, had already acquired HIV. To reduce HIV transmission and facilitate early diagnosis and entry into care, increased HIV testing among young at-risk MSM in the United States, especially those who are black, is needed.

This study found that men who have sex with men (MSM) who had not recently tested for HIV accounted for nearly two thirds of partners potentially exposed to HIV, underscoring the urgency for more testing of MSM.

From the *Division of HIV/AIDS Prevention–Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; † St. Louis University School of Public Health, St. Louis, Missouri; ‡ Los Angeles County Department of Health Services, Los Angeles, California; § Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; ∥ The New York Blood Center, New York City, New York; ¶ Florida Department of Health, Tallahassee, Florida; ** University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; †† Public Health–Seattle & King County, Seattle, Washington; and the ‡‡ New York City Department of Health, New York, NY

The authors thank the young men who volunteered for this research project and the dedicated staff who contributed to its success. The authors also thank the YMS Phase II coordinators: John Hylton and Karen Yen (Baltimore), Santiago Pedraza (Dallas), Denise Fearman-Johnson and Bobby Gatson (Los Angeles), David Forest and Henry Artiguez (Miami), Vincent Guilin (New York City), and Tom Perdue (Seattle); and the laboratory and data management staff in all cities.

Correspondence: Duncan A. MacKellar, MA, MPH, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-46, Atlanta, GA 30333. E-mail:

Reprints: Reprint Services, Office of Communications, NCHSTP, Mailstop E-06, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333.

Received for publication May 6, 2005, and accepted July 27, 2005.

© Copyright 2006 American Sexually Transmitted Diseases Association