Special Report on Prevention Initiatives

Repeated testing advised for at-risk MSM groups

Some may need testing more than once a year

The Centers for Disease Control and Prevention (CDC) generally recommends that people engaging in high-risk behaviors for HIV infection should be tested once a year, but when people believe they may have been exposed to the virus, the testing should be more frequent.

"We found that a fairly large proportion of men who have sex with men (MSM) have had an HIV test and have had a recent HIV test, but a significant number haven’t been tested within the past 12 months even though they reported having engaged in sex with other men," says Travis Sanchez, DVM, MPH, epidemiologist with the CDC.

The 19% who have not been tested within the past year is high enough to be of concern, he points out.

These men were more likely to be older and were less likely to report that a partner has asked them about an HIV test, Sanchez explains.

"They were less likely to role-play or to have one-on-one conversations with a prevention worker about HIV and safer sex," he adds.

"That last note comes with the caveat that the details of the survey can’t distinguish between activities that could have revolved around the HIV testing session, such as pre- and post-test counseling and prevention activities."

It’s most likely that people who were getting prevention counseling also were getting an HIV test at the same time, Sanchez says.

"I think our goal of keeping up these intensive efforts of testing groups at risk for HIV infection and understanding the HIV risk pattern among MSM are important," he notes. "We want to improve HIV testing rates among MSM, and this supports the prevention activities we also think are very important."

One strategy for improving testing rates among high-risk MSM would be for medical providers to offer HIV testing as a routine part of medical care, similar to other types of annual health screenings, Sanchez suggests.

He says one interesting piece of data that came from the study was that of MSM who had had an HIV test, only 30% of those people had a health care provider recommend the test.

"Another strategy specifically related to HIV testing is to look at new models for HIV testing outside of the medical setting," Sanchez adds.

"For instance, the rapid HIV test gives us the possibility of taking the HIV test out to where people at risk can be found, instead of having them come into a facility to be tested."