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Infrequent HIV Testing and Late HIV Diagnosis Are Common Among a Cohort of Black Men Who Have Sex With Men in 6 US Cities

Mannheimer, Sharon B.; Wang, Lei; Tieu, Hong Van; del Rio, Carlos; Fields, Sheldon; Glick, Sara; Connor, Matthew B.; Eshleman, Susan H.; Koblin, Beryl; Mayer, Kenneth H.

Objective:
US guidelines recommend at least annual HIV testing for those at risk. This analysis assessed frequency and correlates of infrequent HIV testing and late diagnosis among black men who have sex with men (BMSM).

Methods:
HIV testing history was collected at enrollment from participants in HPTN 061, an HIV prevention trial for at-risk US BMSM. Two definitions of late HIV diagnosis were assessed: CD4 cell count <200 cells per cubic millimeter or <350 cells per cubic millimeter at diagnosis.

Results:
HPTN 061 enrolled 1553 BMSM. HIV testing questions were completed at enrollment by 1284 (98.7%) of 1301 participants with no previous HIV diagnosis; 272 (21.2%) reported no HIV test in previous 12 months (infrequent testing); 155 of whom (12.1% of the 1284 with testing data) reported never testing. Infrequent HIV testing was associated with: not seeing a medical provider in the previous 6 months (relative risk [RR]: 1.08, 95% confidence interval [CI]: 1.03 to 1.13), being unemployed (RR: 1.04, CI: 1.01 to 1.07), and having high internalized HIV stigma (RR: 1.03, CI: 1.0 to 1.05). New HIV diagnoses were more likely among infrequent testers compared with men tested in the previous year (18.4% vs. 4.4%; odds ratio: 4.8, 95% CI: 3.2 to 7.4). Among men with newly diagnosed HIV, 33 (39.3%) had a CD4 cell count <350 cells per cubic millimeter including 17 (20.2%) with CD4 <200 cells per cubic millimeter.

Conclusions:
Infrequent HIV testing, undiagnosed infection, and late diagnosis were common among BMSM in this study. New HIV diagnoses were more common among infrequent testers, underscoring the need for additional HIV testing and prevention efforts among US BMSM.

Infrequent HIV Testing and Late HIV Diagnosis Are Common Among a Cohort of Black Men Who Have Sex With Men in 6 US Cities. Available from: https://www.researchgate.net/publication/265419180_Infrequent_HIV_Testing_and_Late_HIV_Diagnosis_Are_Common_Among_a_Cohort_of_Black_Men_Who_Have_Sex_With_Men_in_6_US_Cities [accessed Feb 4, 2016].

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Also Published In

Title
Journal of Acquired Immune Deficiency Syndromes
DOI
https://doi.org/10.1097/QAI.0000000000000334

More About This Work

Academic Units
Medicine
Epidemiology
Lamont-Doherty Earth Observatory
Publisher
Lippincott, Williams and Wilkins
Published Here
February 4, 2016
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