Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands.
Stichting HIV Monitoring, Amsterdam, the Netherlands.
AIDS Patient Care STDS. 2021 Jun;35(6):204-210. doi: 10.1089/apc.2021.0024.
Men who have sex with men (MSM) and who are unaware of their HIV infection contribute to onward HIV transmission and are more likely to progress to severe illness. We therefore assessed determinants of never testing for HIV among MSM living in the Netherlands. Between April and July 2019, 950 HIV-negative and 122 never-tested MSM completed a cross-sectional survey on sociodemographics, HIV testing behavior, and sexual risk taking, which was distributed through gay networking sites/apps. In never-tested MSM, median age was 37 (interquartile range = 22-51) years and 37 (30%) reported recent sexual risk behavior. Never testing was associated with younger age [adjusted odds ratio (aOR) per year increase = 0.98, 95% confidence interval (CI) = 0.97-1.00, = 0.015], having sex with men and women (aOR = 2.85, 95% CI = 1.57-5.62, = 0.001), and not knowing others living with HIV (aOR = 3.85, 95% CI = 2.35-6.32, < 0.001) in multi-variable logistic regression analysis. A significant interaction effect between education level and residential area was observed ( = 0.001). Among higher-educated MSM, those living outside a large urban area had higher odds of never testing compared to those living in an urban area (aOR = 6.26, 95% CI = 2.42-16.24, < 0.001). Lower-educated MSM had higher odds of never testing irrespective of residential area (large urban area: aOR = 12.06, 95% CI = 4.00-36.38; outside large urban area: aOR 9.29, 95% CI = 3.64-23.76; < 0.001 for both). Among MSM recently exposed to sexual risk, never testing was associated with having sex with men and women (aOR = 2.80, 95% CI = 1.09-7.18, = 0.032) and not knowing others with HIV (aOR = 4.91, 95% CI = 1.97-12.24, = 0.001). To conclude, testing interventions for those never tested should be tailored to residential area and education level, and inclusive of bisexuality.
男男性行为者（MSM）如果不知道自己感染了艾滋病毒，会导致艾滋病毒继续传播，并且更有可能发展为严重疾病。因此，我们评估了生活在荷兰的 MSM 从未接受过 HIV 检测的决定因素。2019 年 4 月至 7 月期间，950 名 HIV 阴性和 122 名从未接受过检测的 MSM 通过同性恋社交网站/应用程序完成了一项关于社会人口统计学、HIV 检测行为和性风险行为的横断面调查。在从未接受过检测的 MSM 中，中位年龄为 37 岁（四分位间距=22-51），37%报告最近有性风险行为。从未接受过检测与年龄较小有关[每年增加的调整后优势比（aOR）=0.98，95%置信区间（CI）=0.97-1.00，=0.015]，与男性和女性发生性行为（aOR=2.85，95%CI=1.57-5.62，=0.001）以及不知道其他 HIV 感染者（aOR=3.85，95%CI=2.35-6.32，<0.001）有关。在多变量逻辑回归分析中观察到教育程度和居住地区之间存在显著的交互效应（=0.001）。在受教育程度较高的 MSM 中，与居住在城市地区的 MSM 相比，居住在大城市以外地区的 MSM 从未接受过检测的可能性更高（aOR=6.26，95%CI=2.42-16.24，<0.001）。无论居住地区如何，受教育程度较低的 MSM 从未接受过检测的可能性更高（大城市地区：aOR=12.06，95%CI=4.00-36.38；大城市以外地区：aOR=9.29，95%CI=3.64-23.76；两者均<0.001）。在最近接触性风险的 MSM 中，从未接受过检测与与男性和女性发生性行为有关（aOR=2.80，95%CI=1.09-7.18，=0.032）以及不知道其他 HIV 感染者（aOR=4.91，95%CI=1.97-12.24，=0.001）。总之，对于从未接受过检测的人，检测干预措施应根据居住地区和教育程度进行调整，并包括双性恋。
