HIV and STI Testing Preferences for Men Who Have Sex with Men in High-Income Countries: A Scoping Review

Varsicka Kularadhan; Joscelyn Gan; Eric P F Chow; Christopher K Fairley; Jason J Ong

doi:10.3390/ijerph19053002

HIV and STI Testing Preferences for Men Who Have Sex with Men in High-Income Countries: A Scoping Review

Int J Environ Res Public Health. 2022 Mar 4;19(5):3002. doi: 10.3390/ijerph19053002.

Authors

Varsicka Kularadhan¹, Joscelyn Gan², Eric P F Chow^{3

4

5}, Christopher K Fairley^{3

4}, Jason J Ong^{3

4

5

6}

Affiliations

¹ School of Rural Health, Monash University, Bendigo, VIC 3550, Australia.
² Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia.
³ Central Clinical School, Monash University, Melbourne, VIC 3800, Australia.
⁴ Melbourne Sexual Health Centre, Alfred Health, Carlton, VIC 3053, Australia.
⁵ Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia.
⁶ Department of Clinical Research, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.

Abstract

Background: Regular testing for HIV and other sexually transmitted infections (STI) is recommended at least annually for sexually active men who have sex with men (MSM) in most high-income countries. To encourage regular use of HIV and STI testing and treatment services for MSM, we reviewed the literature to summarise the attributes of an HIV/STI testing service that MSM prefer. Method: We conducted a scoping review, searching PubMed, EMBASE, PsycINFO and CINAHL in January 2020 for articles reporting primary data on the preferences of MSM (living in high-income countries) for HIV/STI testing services. Two reviewers independently screened titles and abstracts and any discrepancies were resolved by a third reviewer. We extracted data on the service attributes that MSM preferred and summarised these thematically using a socioecological framework. Results: In total, 1464 publications were identified, 220 full texts were read and 57 were included in the final analysis. We found 21 articles addressing 'individual' attributes, 50 articles addressing 'service' attributes and 17 articles addressing 'societal' attributes. The key themes of preferences for HIV/STI testing services were: (1) the appeal of self-testing due to convenience and privacy; (2) the need to provide a variety of testing options; and (3) the influence of the testing experience, including confidentiality and privacy, tester characteristics and stigma. There were distinct patterns of preferences for subpopulations of MSM across studies, such as the preference of self-testing for young MSM, and of in-clinic testing for those who perceived themselves as high risk (i.e., with symptoms of STIs or exposed to a partner living with HIV). Conclusion: To make HIV/STI testing more accessible for MSM and encourage regular screening, it is important to address 'individual', 'service' and 'societal' attributes, such as enhancing the convenience of testing through self-testing, and providing a service that men feel comfortable and safe accessing. Furthermore, services should accommodate the preferences of diverse sub-populations within the MSM community.

Keywords: HIV; health service delivery; men who have sex with men; sexually transmitted infection.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Developed Countries
HIV Infections* / diagnosis
HIV Infections* / prevention & control
Homosexuality, Male
Humans
Male
Sexual and Gender Minorities*
Sexually Transmitted Diseases* / diagnosis
Sexually Transmitted Diseases* / prevention & control