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Description
HIV remains a major public health problem in the United States, which significantly affects men who have sex with men (MSM), especially in San Diego, CA. In addition, MSM who are younger and those that repeat test for HIV comprise a majority of newly diagnosed HIV infections in San Diego, CA. Studies have found associations between MSM who repeat test for HIV versus first time testers to be more likely to report high-risk behavior including unprotected sexual intercourse, multiple sexual partners, and intravenous drug use. Further research is needed to determine if MSM who repeat test for HIV are more likely to exhibit HIV associated risk factors and HIV seroconversion. This study collected data from 2010-2012 for participants of the "Early Test" HIV screening research study conducted by the University of California San Diego Antiviral Research Center (AVRC) at central San Diego community clinics. Data were collected on HIV risk behaviors at the time of baseline screening, and included demographic characteristics, HIV exposure risks, sexual behavior, recent diagnoses of sexually transmitted infections, and drug use. Participants were all MSM and responded to the questions regarding repeat testing for HIV within 12 months of their first HIV test. Descriptive statistics were run for all variables. Bivariate associations were assessed with chi-square tests. Stepwise logistic regression was used to identify factors independently associated with MSM being a repeat tester for HIV. Among the 3,525 MSM included in this analysis, 939 (26.6%) were repeat testers for HIV. Repeat testers for HIV reported higher sexual and behavioral activity compared to MSM who single time test for HIV within 12 months of their first HIV test. In stepwise logistic regression analysis, being a MSM repeat tester for HIV was 1.9 times more likely to be associated with participants who categorized themselves as other for race/ethnicity (p = 0.0067), 1.5 times more likely for those ages 26-40 (p = 0.0074), and 1.28 times more likely for those who had an STI diagnosed in the last 12 months (p = 0.0472). The strongest association was number of sex partners, with those having a repeat test being twice as likely to have had greater than 12 number of sexual partners in the last 12 months (p = <.0001). The proportion of MSM in San Diego, who repeat tested for HIV within 12 months of their first HIV test for sexual or behavioral risk factors, was significantly associated with any type of STI diagnosed in the last 12 months and more than 12 sexual partners in the last 12 months. In addition, increased STIs and increased risk behaviors such as lack of condom use, are significantly associated with transmission of HIV. The high number of sexual partners and having a history of STIs in MSM repeat testers, identifies this group as an important target population for education and counseling prevention efforts to decrease the transmission of HIV.
