IDSA: HIV Testing in High-Risk Group Unchanged

Published: October 21, 2011

BOSTON – Despite government guidance encouraging more testing for human immunodeficiency virus infection, researchers said here they found no significant increase in testing among men at high risk for acquiring the pathogen that causes AIDS.

When compared with testing data in 2002, the rate of testing among men at risk of contracting HIV from high-risk heterosexual contacts was unchanged at 24% (P=0.97) in the 2006-2008 review of data, said Candice Kwan, MD, an epidemic intelligence service officer with the CDC in Atlanta.

Among men who have sex with men, there was an increase of testing from 37% to 42%, but that difference was not statistically significant (P=0.56), Kwan said at the annual meeting of the Infectious Diseases Society of America.

"We are still seeing low rates of annual HIV testing among men at risk," she said in her oral presentation. "There was no significant increase from 2002 to 2006-2008. Interventions are needed to increase rates of annual HIV testing for men at risk, particularly men who have sex with men."

The researchers looked at data collected through the National Survey of Family Growth, specifically focusing on men and women ages 15 to 44 years who self-reported sexual behavior and reproductive health.

The survey defined heterosexual men at risk of HIV infection as those who had no sex with men in the previous 12 months and:

    Had two or more female sexual partners; or
    Had a female partner who engaged in nonmonogamous sex, injected drugs, or was HIV-infected; or
    Had sex with a woman in exchange for drugs or money

Kwan said men in this group were more likely than other men to be tested for HIV than men without sexual risk. About 10% of men were tested for HIV if they had no sexual risks according to the definition, while 24% of the men at heterosexual risk of HIV were tested (P<0.01).

Among men who have sex with men — defined as having one or more male partners in the past 12 months — 39% were tested for HIV (P<0.01 compared with men who had no sexual risk). These figures for general testing included both the 2002 and the 2006-2008 cohorts.

"I think this study is too early to capture changes in testing among these groups," suggested Rochelle Walensky, MD, associate professor of medicine at Massachusetts General Hospital/Harvard Medical School, Boston.

Walensky, who was the moderator of the oral abstract session and did not participate in the CDC study, told MedPage Today that the new guidance from the CDC was issued in late 2006, and uptake of the recommendation for yearly testing of at-risk men may not have become routine by the time the 2006-2008 survey was conducted.

"Nevertheless," she said, "this study shows that we have a lot more work to do in getting men at risk of HIV infection to get tested."

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