Regular HIV testing amongst negative/untested higher risk MSM in four countries: Scotland, Wales, Northern Ireland and the Republic of Ireland

Background: HIV testing guidelines recommend regular, at least annual testing amongst sexually active MSM, with more frequent regular testing recommended for those at higher risk of HIV, however, little is currently known about testing regularity amongst negative/untested MSM in the UK.
Methods: Cross-sectional online surveys were conducted with MSM recruited from Facebook and gay sociosexual networking media between November 2012 and February 2013. This analysis includes only higher risk negative/untested MSM recruited in Scotland (n=446), Wales (n=280), Northern Ireland (n=190) and the Republic of Ireland (n=354). Higher HIV risk was defined as reporting unprotected anal intercourse with at least 1 partner within the previous year. Regular HIV testing was defined as testing at least every 6 months.
Results: The mean age of participants was 35.8 years (range 16-82, SD=12.6), 97% were white. Most (81%) identified as gay, with 19% bisexual and 0.4% 'straight'. One quarter (23%) report 10+ AI partners, half (47%) reported =1 HIV test in the previous year, 37% report regular annual testing whilst 20% test at least every 6 months. In multivariate logistic regression analysis, adjusting for age, social and sexual behaviours, the odds of regular HIV testing were significantly higher for men in Scotland (AOR=1.69, 95% CI 1.10-2.62) and Northern Ireland (2.0, 1.15-3.48) than men in the Republic of Ireland. The odds were higher for men who report 10+ anal partners (1.69 1.16-2.46), men who had tested for a sexually transmitted infection (STI) (3.78, 2.03-7.02) in the previous 12 months and those who report regular annual STI testing (13.92, 7.60-25.52). Finally the odds of testing were higher for men who use the commercial gay scene (1.58, 1.08-2.32).
Conclusions: Although half of higher risk MSM reported a recent HIV test, only one third reported regular annual testing and one fifth report regular 6-monthly HIV testing. STI testing and STI testing regularity were highly predictive of HIV testing regularity and may provide a health promotion opportunity. Regional differences in the provision of HIV testing campaigns should be considered, along with an online social media-based component to target men who do not use the commercial gay scene.