AIDS and Behavior

, Volume 17, Issue 6, pp 2084–2092 | Cite as

Which Gay Men Would Increase Their Frequency of HIV Testing with Home Self-testing?

  • Benjamin R. BavintonEmail author
  • Graham Brown
  • Michael Hurley
  • Jack Bradley
  • Phillip Keen
  • Damian P. Conway
  • Rebecca Guy
  • Andrew E. Grulich
  • Garrett Prestage
Original Paper


Many Australian gay men do not get tested for HIV at the recommended frequency. Barriers to HIV testing may be reduced by the availability of home HIV self-testing (HHST). An online cross-sectional questionnaire was conducted with 2,306 Australian gay men during 2009. Multivariate logistic regression identified factors associated with being likely to increase testing frequency if HHST was available, among previously-tested and never-tested men. Among 2,018 non-HIV-positive men, 83.9 % had been tested. Two-thirds indicated they would test more often if HHST was available irrespective of previous testing history. In multivariate analysis, independent predictors of increased testing frequency with HHST included preferences for more convenient testing, not having to see a doctor when testing and wanting immediate results among all men, as well as not being from an Anglo-Australian background and recent unprotected anal sex with casual partners among previously-tested men only. The majority of gay men report that being able to test themselves at home would increase their frequency of HIV testing.


HIV testing Gay men Sexual behaviour Home testing 



The authors would like to thank the participants and the many people and organisations that assisted with recruitment and referral of potential participants to the study. This study was commissioned and funded by the Departments of Health in the states of New South Wales, Victoria, South Australia and Western Australia. Indirect support was also provided by the Queensland Health Department. The Kirby Institute is affiliated with the Faculty of Medicine, University of New South Wales. The Australian Research Centre in Sex Health and Society (ARCSHS) is affiliated with the Faculty of Health Sciences, La Trobe University. The Kirby Institute and ARCSHS receive funding from the Commonwealth of Australia Department of Health and Ageing.


  1. 1.
    Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia: Annual surveillance report 2011. Sydney, NSW: The Kirby Institute, University of New South Wales, 2011. Accessed 17 Sept 2012.
  2. 2.
    Guy R, Goller JL, Spelman T, et al. Does the frequency of HIV and STI testing among men who have sex with men in primary care adhere with Australian guidelines? Sex Transm Infect. 2010;86:371–6.PubMedCrossRefGoogle Scholar
  3. 3.
    STIs in Gay Men Action Group. STI testing guidelines for men who have sex with men (MSM). Sydney, NSW: STIs in Gay Men Action Group; 2010. Accessed 8 Aug 2012.
  4. 4.
    Crepaz N, Marks G, Liau A, et al. Prevalence of unprotected anal intercourse among HIV-diagnosed MSM in the United States: a meta-analysis. AIDS. 2009;23:1617–29.PubMedCrossRefGoogle Scholar
  5. 5.
    Greacen T, Friboulet D, Blachier A, et al. Internet-using men who have sex with men would be interested in accessing authorised HIV self-tests available for purchase online. AIDS Care. 2012. doi: 10.1080/09540121.2012.687823.
  6. 6.
    Greacen T, Friboulet D, Fugon L, et al. Access to and use of unauthorised online HIV self-tests by internet-using French-speaking men who have sex with men. Sex Trans Infect. 2012;88:368–74.CrossRefGoogle Scholar
  7. 7.
    Prestage G, Brown G, Keen P. Barriers to HIV testing among Australian gay men. Sex Health. 2012;9(5):453–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493–505.PubMedCrossRefGoogle Scholar
  9. 9.
    Crawford JM, Rodden P, Kippax S, et al. Negotiated safety and other agreements between men in relationships: risk practice redefined. Int J STD AIDS. 2001;12:164–70.PubMedCrossRefGoogle Scholar
  10. 10.
    Jin F, Crawford JM, Prestage G, et al. Unprotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men. AIDS. 2009;23:243–52.PubMedCrossRefGoogle Scholar
  11. 11.
    Zablotska IB, Imrie J, Prestage G, et al. Gay men’s current practice of HIV seroconcordant unprotected anal intercourse: serosorting or seroguessing? AIDS Care. 2009;21:501–10.PubMedCrossRefGoogle Scholar
  12. 12.
    Jin F, Jansson J, Law M, et al. Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS. 2010;24:907–13.PubMedCrossRefGoogle Scholar
  13. 13.
    Prestage G, McCann PD, Hurley M, et al. Pleasure and Sexual Health: The PASH Study. Sydney, NSW: National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, 2009. Accessed 14 Sept 2012.
  14. 14.
    Wand H, Yan P, Wilson D, et al. Increasing HIV transmission through male homosexual and heterosexual contact in Australia: results from an extended back-projection approach. HIV Med. 2010;11:395–403.PubMedGoogle Scholar
  15. 15.
    Pedrana AE, Hellard ME, Wilson K, et al. High rates of undiagnosed HIV infections in a community sample of gay men in Melbourne Australia. JAIDS. 2012;59:94–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Birrell F, Staunton S, Debattista J, et al. Pilot of non-invasive (oral fluid) testing for HIV within a community setting. Sex Health. 2010;7:11–6.PubMedCrossRefGoogle Scholar
  17. 17.
    Lemoh C, Guy R, Yohannes K, et al. Delayed diagnosis of HIV infection in Victoria 1994 to 2006. Sex Health. 2009;6:117–22.PubMedCrossRefGoogle Scholar
  18. 18.
    De Wit J, Adam P. To test or not to test: psychosocial barriers to HIV testing in high-income countries. HIV Med. 2008;9:20–2.PubMedCrossRefGoogle Scholar
  19. 19.
    Koelmeyer R, Grierson J, Pitts M. Motivations for and barriers to HIV testing in Australia. Melbourne, Victoria: Australian Research Centre in Sex, Health and Society, La Trobe University, 2011. Accessed 17 Sept 2012.
  20. 20.
    Department of Health and Ageing. National HIV Testing Policy. Canberra, ACT: Commonwealth of Australia; 2010. Accessed 16 Sept 2012.
  21. 21.
    Chen MY, Bilardi JE, Lee D, et al. Australian men who have sex with men prefer rapid oral HIV testing over conventional blood testing for HIV. Int J STD AIDS. 2010;21:428–30.PubMedCrossRefGoogle Scholar
  22. 22.
    Healey LM, O’Connor CC, Templeton DJ. HIV result giving. Is it time to change our thinking? Sex Health. 2010;7:8–10.PubMedCrossRefGoogle Scholar
  23. 23.
    Pedrana AE, Guy R, Bowring A, et al. Community models of HIV testing for men who have sex with men (MSM): Systematic review 2011. Melbourne, Victoria: Report commissioned by ACON; 2011. Accessed 17 Sept 2012.
  24. 24.
    Department of Health and Ageing. Sixth National HIV Strategy 2010–2013. Canberra, ACT: Commonwealth of Australia, 2010.$File/hiv.pdf. Accessed 1 Sept 2012.
  25. 25.
    US Food and Drug Administation. FDA approves first over-the-counter home-use rapid HIV test (press release). Silver Spring, MD: US Food and Drug Administration; 2012. Accessed 4 July 2012.
  26. 26.
    Ventuneac A, Carballo-Diéguez A, Leu CS, et al. Use of a rapid HIV home test to screen sexual partners: an evaluation of its possible use and relative risk. AIDS Behav. 2009;13:731–7.PubMedCrossRefGoogle Scholar
  27. 27.
    Haddow L, Robinson A. A case of a false positive result on a home HIV test kit obtained on the internet. Sex Transm Infect. 2005;81:359–60.PubMedCrossRefGoogle Scholar
  28. 28.
    Chen MY, Estcourt CS. Time to roll out rapid testing for HIV? Yes, but with appropriate safeguards. Sex Health. 2009;6:1–3.PubMedCrossRefGoogle Scholar
  29. 29.
    Therapeutic Goods Administration. The use of rapid tests for HIV in Australia. Canberra ACT: Therapeutic Goods Administration. Accessed 17 August 2012.
  30. 30.
    MacKellar DA, Hou SI, Whalen CC, et al. Reasons for Not HIV Testing, Testing Intentions, and Potential Use of an Over-the-Counter Rapid HIV Test in an Internet Sample of Men Who Have Sex With Men Who Have Never Tested for HIV. Sex Trans Dis. 2011;38:419–28.CrossRefGoogle Scholar
  31. 31.
    Hull P, Holt M, Mao L, et al. Gay Community Periodic Survey: Sydney, February 2011. Sydney, NSW: National Centre in HIV Social Research, The University of New South Wales, 2011. Accessed 3 August 2012.
  32. 32.
    Lee E, Holt M, Mao L, et al. Gay Community Periodic Survey: Melbourne, February 2011. Sydney, NSW: National Centre in HIV Social Research, The University of New South Wales, 2011. Accessed 3 August 2012.
  33. 33.
    Prestage G, Down IA, Bradley J, et al. Is optimism enough? Gay men’s beliefs about HIV and their perspectives on risk and pleasure. Sex Transm Dis. 2012;39:167–72.PubMedCrossRefGoogle Scholar
  34. 34.
    Prestage G, Brown G, Down IA, et al. “It’s hard to know what is a risky or not a risky decision”: gay men’s beliefs about risk during sex. AIDS Behav. 2012. doi: 10.1007/s10461-012-0180-7.
  35. 35.
    Kalichman SC, Eaton L, White D, et al. Beliefs about treatments for HIV/AIDS and sexual risk behaviors among men who have sex with men, 1997–2006. J Behav Med. 2007;30:497–503.PubMedCrossRefGoogle Scholar
  36. 36.
    Kalichman SC, Weinhardt L, DiFonzo K, et al. Sensation seeking and alcohol use as markers of sexual transmission risk behavior in HIV-positive men. Ann Behav Med. 2002;24:229–35.PubMedCrossRefGoogle Scholar
  37. 37.
    Prestage G, Mao L, McGuigan D, et al. HIV risk and communication between regular partners in a cohort of HIV-negative gay men. AIDS Care. 2006;18:166–72.PubMedCrossRefGoogle Scholar
  38. 38.
    Holt M, Lee E, Prestage G, et al. The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000–2009. 2012. doi: 10.1080/09540121.2012.686598.
  39. 39.
    Holt M, Mao L, Prestage G, et al. Gay Community Periodic Surveys: National Report 2010. Sydney, NSW: National Centre in HIV Social Research, The University of New South Wales, 2010. Accessed 8 Sept 2012.
  40. 40.
    Zablotska IB, Holt M, de Wit J, et al. Gay men who are not getting tested for HIV. AIDS Behav. 2012. doi:  10.1007/s10461-012-0184-3.
  41. 41.
    Jin FY, Prestage G, Law MG, et al. Predictors of recent HIV testing in homosexual men in Australia. HIV Med. 2002;3:271–6.PubMedCrossRefGoogle Scholar
  42. 42.
    Van de Ven P, Prestage G, Knox S, et al. Gay men in Australia who do not have HIV test results. Int J STD AIDS. 2000;11:456–60.PubMedCrossRefGoogle Scholar
  43. 43.
    Balán IC, Carballo-Diéguez A, Ventuneac A, et al. Are HIV-negative men who have sex with men and who bareback concerned about HIV infection? Implications for HIV risk reduction interventions. Arch Sex Behav. 2012. doi: 10.1007/s10508-011-9886-2.
  44. 44.
    Carballo-Diéguez A, Frasca T, Dolezal, C, et al. Will gay and bisexually active men at high risk of infection use over-the-counter rapid HIV tests to screen sexual partners? J Sex Res. 2012. doi: 10.1080/00224499.2011.647117.
  45. 45.
    Carballo-Diéguez A, Ventuneac A, Dowsett GW, et al. Sexual pleasure and intimacy among men who engage in “bareback sex”. AIDS Behav. 2011;15:57–65.CrossRefGoogle Scholar
  46. 46.
    Carballo-Diéguez A, Frasca T, Balán IC, et al. Use of a rapid HIV home test prevents HIV exposure in a high risk sample of men who have sex with men. AIDS Behav. 2012. doi: 10.1007/s10461-012-0274-2.

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Benjamin R. Bavinton
    • 1
    Email author
  • Graham Brown
    • 2
  • Michael Hurley
    • 2
  • Jack Bradley
    • 1
  • Phillip Keen
    • 1
  • Damian P. Conway
    • 1
  • Rebecca Guy
    • 1
  • Andrew E. Grulich
    • 1
  • Garrett Prestage
    • 1
    • 2
  1. 1.The Kirby InstituteThe University of New South WalesSydneyAustralia
  2. 2.Australian Research Centre in Sex, Health and Society, La Trobe UniversityMelbourneAustralia

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