Infrequent HIV testing and late HIV diagnosis are common among a cohort of black men who have sex with men in 6 US cities

Sharon B. Mannheimer, Lei Wang, Leo Wilton, Hong Van Tieu, Carlos Del Rio, Susan Buchbinder, Sheldon Fields, Sara Glick, Matthew B. Connor, Vanessa Cummings, Susan H. Eshleman, Beryl Koblin, Kenneth H. Mayer

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)438-445
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume67
Issue number4
DOIs
StatePublished - 2014

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Pharmacology (medical)

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