HIV Screening Rates Among Men Who Have Sex with Men in the United States Open Access

Qin, Shiyun (Spring 2021)

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Background. The Centers for Disease Control and Prevention (CDC) recommend men who have sex with men (MSM) receive annual screening for human immunodeficiency virus (HIV), with MSM at higher risk screening every 3 to 6 months. This analysis aimed to quantify the rates and heterogeneity in HIV screening rates among MSM.

Methods. Using cross-sectional survey data from the web-based ARTnet study of MSM in the U.S. between 2017 and 2019, we estimated the prevalence of screening for HIV and yearly screening rates. Poisson regression with robust error variance and negative binomial regression model were used to quantify the demographic, geographic, and behavioral characteristics associated with HIV screening.

Results. Of 4476 HIV-negative or HIV-unknown MSM, 17% had never screened for HIV. The overall screening rate was 1.32 times per year, which met the CDC recommendations. The annual HIV screening rates were substantially lower among MSM with several characteristics: younger MSM (aged 35–44 versus aged 15–24: rate ratio [RR] = 1.87, 95% CI = [1.68, 2.09]), living in micropolitan or noncore areas (large central metro versus noncore: RR = 1.75, 95% CI = [1.43, 2.13]), and lower education levels (college degree or higher versus high school degree or lower: RR = 2.19, 95% CI = [1.96, 2.45]. Use of HIV PrEP was associated with significantly higher HIV screening rates (non-current users versus never users: adjusted rate ratio [aRR] = 1.86, 95% CI = [1.66, 2.08]; current users versus never users: aRR = 2.72, 95% CI = [2.55- 2.90]). Casual network degree and one-time partnership rates were also positively associated with screening rates (aRR = 1.17 [1.14, 1.20] and 1.06 [1.05, 1.07], respectively).

Conclusions. Overall CDC recommendations for annual HIV screening were met, but significant gaps remained. Targeted screening activities towards these groups and health education campaigns to increase HIV screening engagement are needed. 

Table of Contents

Introduction 1

Methods 2

Results 5

Discussion 8

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