Assessment of the Density of HIV and STI Testing Providers and the Associations Between Recent Testing of Men Who Have Sex with Men in the United States Open Access

Abstract

Purpose: Increasing trends of bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM) place MSM at greater risk of HIV acquisition. Ensuring utilization of STI and HIV testing services is critical to preventing new infections, yet geographic inequities in testing exist. No studies have examined the association between testing provider density and the prevalence of a recent HIV/STI test.

Methods: Using National Prevention Information Network (NPIN) provider locations and 2019 American Men’s Internet Survey (AMIS) data, we conducted multivariate log-binomial regression to quantify the relationship between state-level testing provider density per 1000 MSM and having had an HIV/STI test within the past 12 months.

Results: Of 9189 total study participants, 61.9% (2549/4115) of MSM residing in low provider density states had recently had an HIV/STI test, and 52.4% (376/717) of MSM residing in high provider density states had a recent test. MSM residing in high provider density states were 19% (aPR = 0.81, CI = 0.72, 0.92) less likely to have been tested in the past 12 months compared to MSM residing in low provider density states.

Conclusions: We found that testing provider density and the prevalence of a recent HIV or STI test among participants had an inverse relationship, that is, MSM who lived in higher provider density states were less likely to have been tested. This relationship may suggest there are geographic and structural barriers that prevent MSM in high provider density states from accessing testing services more frequently than MSM in low provider density states.

Table of Contents

Introduction (1-3)

Methods (3-7)

Results (7-8)

Discussion (8-12)

References (13-15)

Figures (16-23)

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Public Health
Keyword	HIV testing STI testing MSM
Committee Chair / Thesis Advisor	Travis Sanchez, Emory University

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