HIV testing among men who have sex with men in Puerto Rico Open Access

Abstract

Background: Regular HIV testing has been widely supported as a key strategy to increasing awareness of HIV status, linking HIV-infected individuals to care, and preventing the ongoing transmission of HIV among MSM. While studies have investigated HIV testing for Hispanic MSM in the U.S. mainland, limited research has considered HIV testing practices of MSM in U.S. dependent areas such as Puerto Rico.

Objective: This study aimed to identify demographic and behavioral risk factors that are associated with not receiving an HIV test in the last 12 months among MSM in Puerto Rico.

Methods: As part of the National HIV Behavioral Surveillance system, venue-based, time-space sampling was used to recruit men in 2011. Men were interviewed and tested for HIV infection in 21 U.S. cities. Associations between participant characteristics and not having been tested for HIV in the last 12 months were determined through multivariate logistic regression.

Results: In total, 350 participants who self-reported negative or unknown HIV status during their NHBS survey were considered. Overall, 53% had not been tested for HIV in the last 12 months. Those who had fewer male partners in the last 12 months, had not visited a medical provider in the last year, had not told a health provider that they were attracted to men, and/or had not used non-injection drugs in the last year all had increased odds of not receiving an HIV test in the last year. Having fewer partners in the last 12 months (AOR(1 vs. ≥4)=2.7, 95% CI: 1.5, 5.0) and having not told a health provider that they were attracted to men (AOR=2.0, 95% CI: 1.3, 3.2) were significantly associated with not receiving an annual HIV test after adjusting for age, education, and type of health insurance.

Conclusion: MSM in Puerto Rico who had fewer sex partners and/or had not disclosed male-male attraction to a health care provider were more likely to have not been HIV tested in the last year. Future interventions should promote annual HIV testing for all MSM including those with fewer sex partners. HIV testing initiatives should also aim to improve patient-provider communication.

Table of Contents

TABLE OF CONTENTS

LIST OF TABLES

i

CHAPTER I:

A REVIEW OF THE LITERATURE

1

CHAPTER II:

A MANUSCRIPT

10

Introduction

10

Methods

13

Results

19

Discussion

23

CHAPTER III:

CONCLUSIONS

29

REFERENCES

39

TABLES

46

APPENDIX A: SAS Code

56

About this Master's Thesis

Rights statement

• 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	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	HIV HIV testing Puerto Rico MSM Latino health
Committee Chair / Thesis Advisor	Sanchez, Travis, Emory University Sullivan, Patrick S, Emory University
Committee Members	Paz-Bailey, Gabriela, Centers for Disease Control and Prevention
Partnering Agencies	CDC

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