Research from the BC-CfE’s Metro Vancouver-based Momentum Health Study found 80% of gay, bisexual and other men who have sex with men had tested for HIV within the past two years. However, one in ten had not tested in the past two years and a further one in ten had never had an HIV test.
The study aimed to find out why individuals were or were not accessing HIV tests. The most common reason for getting tested for HIV was that it was part of a regular routine. Participating in high-risk events and starting new relationships were also triggers for accessing HIV tests.
“Test and treat” is a mantra of the Treatment as Prevention¨ strategy to curb the spread of HIV. In BC, where TasP¨ has been implemented provincewide, HIV testing guidelines recommend that all individuals be tested for HIV-regardless of age, sexual orientation or perceived risk of acquiring HIV.
These guidelines further recommend that populations with a higher burden of HIV should obtain an HIV test every year. This includes gay, bisexual and other men who have sex with men. Among Momentum Health Study participants, 23.4% are living with HIV. Gay and bisexual men in Vancouver make up the majority of new cases in the city.
Among Momentum study participants, the main reasons for individuals to not test were that they thought they weren’t at risk or had not yet gotten to it. Of those who had not tested in the past two years, nearly one in five reported condomless anal sex with a person with an unknown or serodiscordant HIV status (meaning one sexual partner has an HIV and the other does not).
Men who had never tested were more likely to be older, to identify as bisexual, and to live outside the city of Vancouver. “Individuals who are not closely or actively linked to the gay and bi community may not be directly reached by health messages and interventions around HIV,” said Dr. Heather Armstrong, post-doctoral fellow at the BC-CfE and the lead author on the study published in AIDS and Behavior. “It’s important for testing messages to be inclusive and cognizant of community differences and subcultures.”
Men who had not tested in the past two years tended to report fewer male anal sex partners, were less likely to have ever tested for other STIs (sexually transmitted infections) and were more likely to consider themselves to be very unlikely of acquiring HIV in their lifetimes.
There may be structural factors involved in not seeking HIV tests. For example, sexual health clinics may be inaccessible to those outside downtown areas. There can also be stigma associated with walking into HIV and STI testing sites, although very few participants reported this as reason for not testing.
This study also found that rapid point-of-care testing (POCT) was able to engage some hard-to-reach populations. “Increasing the visibility and availability of POCT in venues such as doctors’ offices, especially in more suburban or rural areas, may encourage more people to test. Mobile or online POCT offers another avenue to increasing testing uptake,” said Dr. Armstrong.
It should be noted that recent uptake in pre-exposure prophylaxis (PrEP) could increase HIV testing, as it is recommended every three months for individuals taking PrEP in the BC guidelines for the use of the HIV prevention drug.
The Momentum Health Study is based in the Metro Vancouver area and open to gay, bisexual and other men who have sex with men who are recruited through other study participants.
For a plain text summary of this and other research from Momentum, please visit the BC-CfE website.
