To test or not? HIV antibody testing amongst gay men

Abstract

This paper reviews the literature regarding levels of HIV antibody testing amongst gay men and rationales both for and against testing. Whilst marked differences in levels of reported testing were identi®ed (regionally, nationally and across time), some consensus was found regarding reasons both for and against HIV antibody testing. Reasons for testing included accessing medical treatments, planning for the future and hoping for peace of mind. Reasons against testing included the negative psychological and social consequences of positive test results. The ®ndings of the review are discussed in terms of recent medical discourses, which provide a powerful rationale for the uptake of HIV antibody testing amongst all gay men where treatments are available. Critically, we illustrate the lack of current research that seeks to reappraise HIV testing in the light of new HIV treatments, and discuss the implications for both research and practice.

HIV Testing, Gay Community Involvement and Internet USE: Social and Behavioural Correlates of HIV Testing Among Australian Men Who have Sex with Men

“…These proportions are in line with those found in surveys of adult Australians and MSM but show a much lower level of HIV testing than usually found in surveys of Australian 'gaycommunity-attached' men [7-10, 13, 19]. The proportion of men who had ever been tested for HIV found here is similar to that seen in Danish, French, Swiss and US studies of MSM but much higher than that seen in other countries [9][10][11].…”

“…National surveys of Australian MSM conducted between 1996 and 2000 found similar levels of testing among gay and bisexual men [8]. These levels of HIV testing among MSM are similar to those in Denmark, France, Switzerland and the USA, but much higher than those found in Canada, the Netherlands and UK [9][10][11]. Previous research has found that HIV testing is far more common among 'gay-community-attached' men (gay-identified men from metropolitan areas who have gay friends and spend time with gay men) than other MSM [12].…”

“…part of a regular testing pattern) or driven by events, such as a condom breaking or having unprotected sex with a HIV-positive partner [10,11,23,24]. While men who rely on HIV testing as a prevention strategy (using their or their partners' statuses to assess the risk of HIV transmission during a sexual encounter) are more likely to test frequently, fear of a positive test result and the stigma associated with HIV may reduce the likelihood of testing [10,11,23,24]. However, it is nearly 10 years since the social and behavioural correlates of recent HIV testing among Australian MSM were assessed [14].…”

HIV Testing Among Spanish Youth: Analysis of the Mediating Role of the Big Five Personality and Other Psychological Factors

“…It seems that the anxiety about the self-perceived negative consequences of testing (perhaps being HIV-positive) and perceived severity of illness diagnosed can generate some uncertainty about the decision to test (35). In the preventive field, there are significant barriers to testing, and stigmatized disease such as AIDS is associated with resistance to being tested for HIV (41,42); from the social perspective there is the barrier of discrimination to which people living with HIV are subjected (43,44). Nevertheless, positive attitudes towards the HIV antibody testing such as the possibility of adequate medical treatment or coping with the stress of an ambiguous situation are the main reasons founded in subjects agreeing to be tested (45)(46)(47)(48)(49).…”

“…In most of the studies reviewed, the fear of a possible positive outcome has been shown as the main obstacle to being tested. Within the negative attitudes mentioned are: fear of stigmatization and discrimination (37,38), loss of social status, fear of rejection from loved ones such as family members or friends (39)(40)(41) or inability to cope with the psychological and social implications of the diagnosis (42). It seems that the anxiety about the self-perceived negative consequences of testing (perhaps being HIV-positive) and perceived severity of illness diagnosed can generate some uncertainty about the decision to test (35).…”