Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men
HIV incidence among young adult men-who-have-sex-with-men (YMSM) is among the highest in the United States (US), yet YMSM have lower rates of HIV testing than most other MSM. Among 1,835 U.S. Black, Hispanic, and White YMSM who reported condomless anal intercourse (CAI) in the prior year, 30% (95% c...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-05-01
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| Series: | SAGE Open |
| Online Access: | https://doi.org/10.1177/21582440211016835 |
| _version_ | 1818361731372548096 |
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| author | Sarah J. Marks Roland C. Merchant Melissa A. Clark Tao Liu Joshua G. Rosenberger Jose A. Bauermeister Kenneth H. Mayer |
| author_facet | Sarah J. Marks Roland C. Merchant Melissa A. Clark Tao Liu Joshua G. Rosenberger Jose A. Bauermeister Kenneth H. Mayer |
| author_sort | Sarah J. Marks |
| collection | DOAJ |
| description | HIV incidence among young adult men-who-have-sex-with-men (YMSM) is among the highest in the United States (US), yet YMSM have lower rates of HIV testing than most other MSM. Among 1,835 U.S. Black, Hispanic, and White YMSM who reported condomless anal intercourse (CAI) in the prior year, 30% (95% confidence interval [CI]: [28%, 32%]) had not been tested for HIV in the past year as recommended by national guidelines, and 19% (95% CI: [17%, 21%]) had never been tested. Factors associated with not being tested in the past year included not having a primary care provider (PCP)) (odds ratio [OR]: 2.00, 95% CI: [1.53, 2.60]), discomfort with asking a PCP for an HIV test (OR: 2.66, 95% CI: [2.05, 3.44]), living in a smaller community (OR: 1.71, 95% CI: [1.35, 2.18]), younger age (OR: 2.00, 95% CI: [1.53, 2.60]), and greater self-perception of having an undiagnosed HIV infection (OR: 1.46, 95% CI: [1.07, 1.99]). YMSM who had not been tested in the prior year were less likely to know where to get tested, yet were interested in trying home-based HIV self-testing. This study shows that knowledge, clinician-relationship, geographic, and perceptional barriers must be overcome to improve HIV testing among YMSM. Home-based HIV self-testing may address some of these barriers, particularly for YMSM living in smaller communities. |
| first_indexed | 2024-12-13T21:21:21Z |
| format | Article |
| id | doaj.art-ef4f1a2aae4f4cf79460ad7e9c1a291c |
| institution | Directory Open Access Journal |
| issn | 2158-2440 |
| language | English |
| last_indexed | 2024-12-13T21:21:21Z |
| publishDate | 2021-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open |
| spelling | doaj.art-ef4f1a2aae4f4cf79460ad7e9c1a291c2022-12-21T23:31:07ZengSAGE PublishingSAGE Open2158-24402021-05-011110.1177/21582440211016835Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With MenSarah J. Marks0Roland C. Merchant1Melissa A. Clark2Tao Liu3Joshua G. Rosenberger4Jose A. Bauermeister5Kenneth H. Mayer6Brigham and Women’s Hospital, Boston, MA, USAIcahn School of Medicine at Mount Sinai, New York, USABrown University, Providence, RI, USABrown University, Providence, RI, USAThe Pennsylvania State University, University Park, USAUniversity of Pennsylvania, Philadelphia, USAThe Fenway Institute, Boston, MA, USAHIV incidence among young adult men-who-have-sex-with-men (YMSM) is among the highest in the United States (US), yet YMSM have lower rates of HIV testing than most other MSM. Among 1,835 U.S. Black, Hispanic, and White YMSM who reported condomless anal intercourse (CAI) in the prior year, 30% (95% confidence interval [CI]: [28%, 32%]) had not been tested for HIV in the past year as recommended by national guidelines, and 19% (95% CI: [17%, 21%]) had never been tested. Factors associated with not being tested in the past year included not having a primary care provider (PCP)) (odds ratio [OR]: 2.00, 95% CI: [1.53, 2.60]), discomfort with asking a PCP for an HIV test (OR: 2.66, 95% CI: [2.05, 3.44]), living in a smaller community (OR: 1.71, 95% CI: [1.35, 2.18]), younger age (OR: 2.00, 95% CI: [1.53, 2.60]), and greater self-perception of having an undiagnosed HIV infection (OR: 1.46, 95% CI: [1.07, 1.99]). YMSM who had not been tested in the prior year were less likely to know where to get tested, yet were interested in trying home-based HIV self-testing. This study shows that knowledge, clinician-relationship, geographic, and perceptional barriers must be overcome to improve HIV testing among YMSM. Home-based HIV self-testing may address some of these barriers, particularly for YMSM living in smaller communities.https://doi.org/10.1177/21582440211016835 |
| spellingShingle | Sarah J. Marks Roland C. Merchant Melissa A. Clark Tao Liu Joshua G. Rosenberger Jose A. Bauermeister Kenneth H. Mayer Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men SAGE Open |
| title | Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men |
| title_full | Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men |
| title_fullStr | Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men |
| title_full_unstemmed | Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men |
| title_short | Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men |
| title_sort | barriers to hiv testing and opportunities for expansion using home based hiv self testing results of a national study of higher hiv risk young men who have sex with men |
| url | https://doi.org/10.1177/21582440211016835 |
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