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Correlates of Unknown HIV Status Among MSM Participating in the 2014 American Men’s Internet Survey (AMIS)

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Abstract

Increasing serostatus awareness is a key HIV prevention strategy. Despite expanded testing efforts, some men who have sex with men (MSM) remain unaware of their HIV status. This study explored demographic characteristics, sexual identity, sexual role, and behavioral factors associated with unknown HIV status among MSM in the United States. Data from 9170 MSM in the 2014 American Men’s Internet Survey were analyzed using logistic regression to identify correlates of unknown HIV status. Young age, race, low education, rural residence, and lack of recent healthcare visits were significantly associated with unknown HIV status. In addition, nondisclosure of one’s sexual orientation (OR = 3.70, 95% CI 2.99–4.59) and a self-identified sexual role as “bottom” (OR = 1.45, 95% CI 1.24–1.70) were predictors of unknown HIV status. Post-hoc analysis showed HIV-negative MSM not tested in the last year had fewer self-reported risk behaviors than recent testers, suggesting that repeat testing among MSM may be aligned with individual risk.

Resumen

Incrementar el conocimiento del seroestatus es una estrategia clave en la prevención del VIH. A pesar del aumento de esfuerzos para realizar pruebas de detección, algunos hombres que tienen sexo con hombres (HSH) todavía desconocen su estatus de VIH. Este estudio exploró características demográficas, identidad sexual, rol sexual, y factores conductuales asociados al estatus de VIH desconocido entre HSH en los Estados Unidos. Los datos de 9,170 HSH en la Encuesta por Internet de Hombres Americanos del 2014, fueron analizados usando regresión logística para identificar correlaciones con el estatus de VIH desconocido. Se encontró que la edad joven, raza, nivel de educación bajo, residencia rural y ausencia de visitas recientes de cuidados de salud están asociados de manera significativa con el estatus de VIH desconocido. También se encontró que no revelar la orientación sexual (OR = 3.70, 95% CI 2.99–4.59) y auto-percibirse como “pasivo” en el rol sexual (OR = 1.45, 95% CI 1.24–1.70) fueron predictores del estado de VIH desconocido. Un análisis post hoc mostró que los HSH VIH (−) que no se habían hecho la prueba en el último año auto reportaban un menor número de comportamiento riesgoso comparado con aquellos que se han hecho la prueba recientemente, lo cual sugiere que para los HSH el repetir la prueba puede estar alineado con riesgos individuales.

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Acknowledgements

The data used in this study were derived from the American Men’s Internet Survey conducted by PRISM Health at Emory University.

Funding

The data for this analysis were collected through funding received from the National Institutes of Health (Emory Center for AIDS Research, P30AI050409) and the MAC AIDS Fund.

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Authors and Affiliations

  1. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

    S. M. Traynor & D. J. Feaster

  2. College of Human Medicine, Michigan State University, East Lansing, MI, USA

    A. M. Brincks

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  1. S. M. Traynor
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Correspondence to S. M. Traynor.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed as part of the American Men’s Internet Survey study involving human participants were conducted in accordance with the ethical standards of the Emory University Institutional Review Board (IRB) and in compliance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this secondary analysis of de-identified data, formal consent was not required as determined by the University of Miami IRB.

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Traynor, S.M., Brincks, A.M. & Feaster, D.J. Correlates of Unknown HIV Status Among MSM Participating in the 2014 American Men’s Internet Survey (AMIS). AIDS Behav 22, 2113–2126 (2018). https://doi.org/10.1007/s10461-017-1894-3

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  • DOI: https://doi.org/10.1007/s10461-017-1894-3

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