Annual HIV Testing for MSM May Not Be Enough
Sexually active men who have sex with men may benefit from HIV testing more than once a year, perhaps every three to six months, a new CDC report suggests.
CDC recommends HIV testing at least annually for sexually active MSM. Current guidelines use risk behaviors to identify MSM who should be tested more frequently. However, self-reported risk behavior may not be helpful in determining who needs the more frequent testing, the new study found. In it, MSM reporting high-risk behaviors were no more likely to be newly HIV-infected than those without these reported risks.
Researchers in 2008 collected cross-sectional behavioral risk data and conducted HIV testing among a venue-based sample of MSM in 21 U.S. cities with high AIDS prevalence. Overall, 7,271 eligible MSM were included in the analysis (44 percent white; 25 percent Hispanic; 23 percent black; mean age 34 (range: 18-85)). Of the 7,271 participants, 4,453 (61 percent) had tested HIV-negative during the past 12 months. Among these 4,453, 7 percent (15 percent of blacks; 7 percent of Hispanics; 3 percent of whites) nonetheless were found to be HIV-infected when tested by CDC.
Of 3,672 high-risk MSM who tested HIV-negative in the past 12 months, 7 percent were HIV-infected when tested by CDC, compared with 8 percent of those not reporting high-risk factors. After adjusting for time since the most recent test, HIV prevalence remained similar for the two groups, the study noted.
A possible under-reporting of previous positive HIV test results or over-reporting of recent testing could potentially have skewed the proportion of new MSM infections higher, the researchers observed. They further advised that, given venue-based sampling and the high-risk cities surveyed, the data may not represent all MSM generally.
The full report, "HIV Testing Among Men Who Have Sex With Men -- 21 Cities, United States, 2008," was published in Morbidity and Mortality Weekly Report (2011;60(21):694-699).