Guadamuz Thomas E, Cheung Doug H, Wei Chongyi, Koe Stuart, Lim Sin How
Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand; Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand.
Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America.
PLoS One. 2015 May 14;10(5):e0126658. doi: 10.1371/journal.pone.0126658. eCollection 2015.
Poor HIV testing uptake by MSM may be attributable to unique challenges that are localized in Southeast Asia.
To characterize MSM who never tested for HIV, to identify correlates of never testing, and to elucidate the perceived barriers to HIV testing.
The present study used data from the Asian Internet MSM Sex Survey (AIMSS) and restricted the analysis to 4,310 MSM from the ten member countries of the Association of South East Asian Nations (ASEAN).
Among MSM participants from ASEAN in our sample, 1290 (29.9%) reported having never been tested for HIV, 471 (10.9%) tested for HIV more than 2 years ago, and 2186 (50.7%) reported their last test date was between 6 months and two years ago, with only 363 (8.4%) of these men having been tested in the past 6 months. In multivariable logistic regression, younger MSM (age 15-22 years old [AOR: 4.60, 95% CI: 3.04-6.96]), MSM with lower education (secondary school or lower [AOR: 1.37, 95% CI: 1.03-1.83]), MSM who identify as bisexual or heterosexual (compared to gay-identified) (AOR: 1.94, 95% CI: 1.60-2.35), and MSM who had never used a condom with male partners (AOR: 1.61, 95% CI: 1.32-1.97) had higher odds of never been HIV tested. Main reason for not being tested was a low risk perception of HIV exposure (n = 390, 30.2%).
Current HIV prevention response must not leave MSM "in the dark," but instead meet them where they are by utilizing the Internet creatively through social media and smart phones. As ASEAN Economic Community (AEC) is quickly becoming a reality, so must there be an equally fast and united response to slowing down the HIV epidemics among MSM in ASEAN.
男男性行为者（MSM）对HIV检测的接受度较低，这可能归因于东南亚地区特有的挑战。
描述从未进行过HIV检测的男男性行为者的特征，确定从未检测的相关因素，并阐明HIV检测的感知障碍。
本研究使用了亚洲互联网男男性行为者性调查（AIMSS）的数据，并将分析限制在来自东南亚国家联盟（东盟）十个成员国的4310名男男性行为者。
在我们样本中的东盟男男性行为者参与者中，1290人（29.9%）报告从未进行过HIV检测，471人（10.9%）在两年多前进行过HIV检测，2186人（50.7%）报告他们最近一次检测日期在6个月至两年前，其中只有363人（8.4%）在过去6个月内进行过检测。在多变量逻辑回归中，较年轻的男男性行为者（15 - 22岁[AOR：4.60，95%CI：3.04 - 6.96]）、教育程度较低的男男性行为者（中学或以下[AOR：1.37，95%CI：1.03 - 1.83]）、自我认同为双性恋或异性恋的男男性行为者（与同性恋认同者相比）（AOR：1.94，95%CI：1.60 - 2.35）以及从未与男性伴侣使用过避孕套的男男性行为者（AOR：1.61，95%CI：1.32 - 1.97）从未进行HIV检测的几率更高。未进行检测的主要原因是对HIV暴露的风险感知较低（n = 390，30.2%）。
当前的HIV预防应对措施绝不能让男男性行为者“蒙在鼓里”，而应通过社交媒体和智能手机创造性地利用互联网，在他们所处的环境中与他们接触。随着东盟经济共同体（AEC）迅速成为现实，对于减缓东盟男男性行为者中的HIV流行，也必须有同样快速和统一的应对措施。
