Community Vs. hospital HIV testing sites in Jerusalem, Israel - who's tested and who's at risk?

Isr J Health Policy Res. 2020 May 18;9(1):10. doi: 10.1186/s13584-020-00368-3.

Abstract

Background: After decades of constant increase in HIV diagnoses among men who have sex with men (MSM), a gradual decrease has been reported in recent years. Timely detection of HIV leads to early treatment and behavioral changes which decrease further transmissions. This cross-sectional study aimed to assess demographic and behavioral characteristics of individuals who were tested for HIV in Jerusalem, Israel.

Methods: This study compared individuals who were tested at Hadassah AIDS Center (HAC) with those tested at the Jerusalem Open House (JOH) - an LGBTQ community center. Participants completed anonymous questionnaires regarding their demographic, HIV-testing history, and sexual behaviors. High-risk sexual behavior (HRSB) was defined as a diagnosis of sexually transmitted disease or condomless anal/vaginal sex during the last year.

Results: Among 863 participants, 104 (12.1%) were tested in HAC and 759 (87.9%) in JOH. Of those, 19 (18.3%) and 227 (29.9%) were HRSB, respectively. Two MSM were tested positive in JOH. JOH received more MSM, HRSB and individuals who were previously tested for HIV, while HAC received more migrants and health-care workers. HRSB-participants were more commonly younger, males, non-Jewish, with lower income, previously tested for HIV, reported more sexual partners, payed for sex or used drugs.

Conclusions: MSM and HRSB-individuals were more likely to be tested in JOH, while migrants and health-care workers in HAC, possibly due to the geographic location, reputation and specific atmosphere. In order to encourage HIV-tests among HRSB and non-Jews, additional interventions should be employed, including outreach activities, extending opening hours and reducing testing costs should be employed.

Keywords: AIDS; Gays; Men who have sex with men; Migrants; Primary prevention; Sexual behavior.

MeSH terms

  • Adult
  • Community Health Centers / organization & administration
  • Community Health Centers / statistics & numerical data*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology
  • HIV Testing / methods*
  • HIV Testing / statistics & numerical data
  • Hospitals / statistics & numerical data*
  • Humans
  • Israel / epidemiology
  • Male
  • Risk Assessment / methods
  • Risk Assessment / statistics & numerical data
  • Risk Factors
  • Sexual Behavior / psychology*
  • Surveys and Questionnaires