A fifth of gay men in a relationship with an HIV-negative male partner have not had an HIV test while in their present relationship, results of US research published in the online edition of the Journal of Acquired Immune Deficiency Syndromes show. Factors associated with not having a test included younger age, lower levels of education, having a sexually “closed” relationship and greater levels of trust. “Interventions are urgently needed that not only encourage and assist at-risk HIV-negative partnered MSM [men who have sex with men] to test for HIV, but to also develop and sustain an interval testing plan that accurately reflects the dynamics of their individual risk and relationship profile,” comment the authors.
Previous research suggests that between 33 and 66% of HIV infections among gay and bisexual men in the US are transmitted within the context of a primary relationship. The Centers for Disease Control and Prevention (CDC) recommend that all sexually active gay men should have an HIV test at least annually, and more frequent screening – every three to six months – is recommended for men with known risk factors for HIV infection, for instance multiple or anonymous sexual partners.
However, relatively little is known about patterns of HIV testing among gay men in relationships. Investigators therefore designed a study to ascertain the frequency of HIV testing among gay men in a relationship with another HIV-negative man. They also examined the demographic and relationship characteristics associated with testing. A total of 275 HIV-negative male couples (550 gay men) were recruited in 2011 via Facebook. All were aged 18 or over, lived in the US and were in a relationship with another man and had had oral or anal sex with their primary partner in the previous three months. Couples where one partner was HIV negative and the other HIV positive were excluded from the study.
Participants completed an online questionnaire. They were prompted to describe their HIV testing history since establishing their current relationship. Demographic data were also collected, and the men were asked to provide information regarding the characteristics of their relationship, including duration, the presence of a sexual agreement (an explicit mutual understanding between the two partners about permitted sexual behaviour), and also levels of trust, communication and commitment.
Almost all the participants identified as gay, and the majority were white, employed and lived in an urban environment.
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