The LGBT Health & Development Program

Research Blog–Few Teenage Gay Men Get Tested for HIV

Posted on December 2nd, 2015 by Gregory Phillips II in Featured, Research Blog. No Comments

close up of a finger prick for an HIV test

Gregory Varnum, “HIV Rapid Test being administered,” June 2013.

Young men who have sex with men (YMSM) are one of the groups at highest risk for HIV infection in the US, with new diagnoses continuing to rise between 2009 and 2013 [1].  Despite recommendations by the Centers for Disease Control and Prevention (CDC) that sexually active MSM test every 6 months [2], HIV testing rates for YMSM have been low. According to recent data, MSM ages 18 and 19 had the lowest lifetime testing rate across all ages of MSM (75%) [3], and only 11% of high school males, across sexual identities, had ever been tested [4].

A recent study led by IMPACT examined HIV in this group. A national sample of 302 adolescent gay and bisexual men (AGBM) were enrolled into an intervention that was delivered via text messaging. At baseline, participants were asked to report on their recent and lifetime HIV testing behaviors. They also provided answers to an adapted 9-item scale to measure barriers to HIV testing [5].

One-fifth of participants had ever tested for HIV, with only 43% reporting a test within the last 3 months.  Nearly half did not know where they could get tested for HIV and of those AGBM, only 36% said the nearest testing location was within 15 minutes of their home. Three main barriers to testing for HIV were reported:

  • Barriers due to outside factors, such as not having a way to get to the testing site
  • Barriers due to fear, such as not wanting others to know they had been tested
  • Barriers due to feelings of invincibility, such as not believing they were at risk for HIV

Among AGBM who were sexually active, there were associations between having never tested for HIV and reporting both outside factors and fear as barriers to accessing testing.

Knowing the major obstacles to getting an HIV test is key to building new programs to increase testing rates in this population. Unlike prior work that has shown evidence for thoughts of invincibility as drivers of low testing rates [6], we found that this was not a significant reason for not testing. Instead, our findings showed that testing rates could be increased by providing young men with easier ways to find nearby testing sites, and starting HIV testing programs within schools to normalize the process.

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[1] Centers for Disease Control and Prevention. (2015). HIV Surveillance – Men Who Have Sex with Men.

[2] Workowski KA, Berman S. (2010). Sexually transmitted diseases guidelines, 2010. MMWR Recomm Rep, 59, 1-110.

[3] Finlayson TJ, Le B, Smith A, et al. (2011). HIV risk, prevention, and testing behaviors among men who have sex with men—National HIV Behavioral Surveillance System, 21 U.S. cities, United States, 2008. MMWR Surveill Summ, 60, 1-34.

[4] Kann L, Kinchen S, Shanklin SL, et al. (2014). Youth risk behavior surveillance—United States, 2013. MMWR Surveill Summ, 63 Suppl 4, 1-168.

[5] Awad GH, Sagrestano LM, Kittleson MJ, Sarvela PD. (2004). Development of a measure of barriers to HIV testing among individuals at high risk. AIDS Educ Prev, 16, 115-25. doi: 10.1521/aeap.

[6] Mustanski B, Rendina HJ, Greene GJ, Sullivan PS, Parsons JT. (2014). Testing Negative Means I’m Lucky, Making Good Choices, or Immune: Diverse Reactions to HIV Test Results are Associated with Risk Behaviors. Ann Behav Med, 48, 371-83. doi: 10.1007/s12160-014-9612-0

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