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HIV testing among men who have sex with men in Puerto Rico

Chapin, Johanna Ruth (2013)
Master's Thesis (96 pages)
Committee Chair / Thesis Advisers: Sanchez, Travis; Sullivan, Patrick S
Committee Members: Paz-Bailey, Gabriela (Centers for Disease Control and Prevention);
Research Fields: Health Sciences, Epidemiology
Partnering Agencies: CDC
Keywords: HIV; MSM; Puerto Rico; HIV testing; Latino health
Program: Rollins School of Public Health, Epidemiology (Global Epidemiology)
Permanent url:


Background: Regular HIV testing has been widely supported as a key strategy to increasing awareness of HIV status, linking HIV-infected individuals to care, and preventing the ongoing transmission of HIV among MSM. While studies have investigated HIV testing for Hispanic MSM in the U.S. mainland, limited research has considered HIV testing practices of MSM in U.S. dependent areas such as Puerto Rico. Objective: This study aimed to identify demographic and behavioral risk factors that are associated with not receiving an HIV test in the last 12 months among MSM in Puerto Rico. Methods: As part of the National HIV Behavioral Surveillance system, venue-based, time-space sampling was used to recruit men in 2011. Men were interviewed and tested for HIV infection in 21 U.S. cities. Associations between participant characteristics and not having been tested for HIV in the last 12 months were determined through multivariate logistic regression. Results: In total, 350 participants who self-reported negative or unknown HIV status during their NHBS survey were considered. Overall, 53% had not been tested for HIV in the last 12 months. Those who had fewer male partners in the last 12 months, had not visited a medical provider in the last year, had not told a health provider that they were attracted to men, and/or had not used non-injection drugs in the last year all had increased odds of not receiving an HIV test in the last year. Having fewer partners in the last 12 months (AOR(1 vs. ≥4)=2.7, 95% CI: 1.5, 5.0) and having not told a health provider that they were attracted to men (AOR=2.0, 95% CI: 1.3, 3.2) were significantly associated with not receiving an annual HIV test after adjusting for age, education, and type of health insurance. Conclusion: MSM in Puerto Rico who had fewer sex partners and/or had not disclosed male-male attraction to a health care provider were more likely to have not been HIV tested in the last year. Future interventions should promote annual HIV testing for all MSM including those with fewer sex partners. HIV testing initiatives should also aim to improve patient-provider communication.

Table of Contents

-- TABLE OF CONTENTS -- -- LIST OF TABLES -- -- i -- -- CHAPTER I: -- -- A REVIEW OF THE LITERATURE -- -- 1 -- -- CHAPTER II: -- -- A MANUSCRIPT -- -- 10 -- -- Introduction -- -- 10 -- -- Methods -- -- 13 -- -- Results -- -- 19 -- -- Discussion -- -- 23 -- -- CHAPTER III: -- -- CONCLUSIONS -- -- 29 -- -- REFERENCES -- -- 39 -- -- TABLES -- -- 46 -- -- APPENDIX A: SAS Code -- -- 56 -- -- -- --


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