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Why Do Men Who Have Sex With Men Test for HIV Infection? Results From a Community-Based Testing Program in Seattle

Katz, David A. PhD, MPH*†; Swanson, Fred MA; Stekler, Joanne D. MD, MPH*†§

doi: 10.1097/
Original Study

Background The Centers for Disease Control and Prevention recommends at least annual HIV testing for men who have sex with men (MSM), but motivations for testing are not well understood.

Methods We evaluated data from MSM testing for HIV at a community-based program in King County, Washington. Correlates of regular testing were examined using generalized estimating equation regression models.

Results Between February 2004 and June 2011, 7176 MSM attended 12,109 HIV testing visits. When asked reasons for testing, 49% reported that it was time for their regular test, 27% reported unprotected sex, 24% were starting relationships, 21% reported sex with someone new, 21% sought sexually transmitted infection/hepatitis screening, 12% reported sex with an HIV-infected partner, 2% suspected primary HIV infection, and 16% reported other reasons. In multivariable analysis, factors associated with regular testing included having a regular health care provider and the following in the previous year: having only male partners, having 10 or more male partners, inhaled nitrite use, not injecting drugs, and not having unprotected anal intercourse with a partner of unknown/discordant status (P ≤ 0.001 for all). Men reporting regular testing reported shorter intertest intervals than men who did not (median of 233 vs. 322 days, respectively; P < 0.001).

Conclusions Regular testing, sexual risk, and new partnerships were important drivers of HIV testing among MSM, and regular testing was associated with increased testing frequency. Promoting regular testing may reduce the time that HIV-infected MSM are unaware of their status, particularly among those who have sex with men and women or inject drugs.

A study of men who have sex with men at a Seattle community-based program found that regular testing, sexual risk, and new partnerships were important motivations for seeking HIV testing.

From the *Department of Medicine, University of Washington, Seattle, WA; †HIV/STD Program, Public Health–Seattle & King County, Seattle, WA; ‡Gay City Health Project, Seattle, WA; and §Department of Epidemiology, University of Washington, Seattle, WA

Acknowledgments: The authors thank the clients and staff of the Gay City Health Project, in particular Jeff Rinderle, as well as Drs Matthew Golden, James Hughes, Carey Farquhar, and Barbra Richardson of the University of Washington.

Conflicts of interest and sources of funding: D.K. was supported by a grant from the National Institute of Mental Health (R01 MH086360). This publication was made possible with help from the University of Washington Center for AIDS Research, a National Institutes of Health–funded program (P30 AI027757). The authors have no conflicts of interest to declare.

Correspondence: David A. Katz, PhD, MPH, Harborview Medical Center, 325 Ninth Avenue, Box 359777, Seattle, WA 98104. E-mail:

Received for publication January 07, 2013, and accepted May 06, 2013.

© Copyright 2013 American Sexually Transmitted Diseases Association