{"id":1179,"date":"2016-05-09T14:00:56","date_gmt":"2016-05-09T13:00:56","guid":{"rendered":"https:\/\/blogs.bmj.com\/sti\/?p=1179"},"modified":"2016-05-05T14:01:31","modified_gmt":"2016-05-05T13:01:31","slug":"is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/","title":{"rendered":"Is the UK meeting its national guidelines for HIV testing of MSM?"},"content":{"rendered":"<p>The potential role of frequent HIV testing in curbing the HIV epidemic among the MSM population has long been recognized. The introduction of the strategy of \u2018opt-out\u2019 testing in the UK (2007), as in other countries at around the same time, brought a steep rise in testing, followed by stabilization (<a href=\"http:\/\/sti.bmj.com\/content\/87\/3\/221.abstract?sid=ba246a24-0eaa-49c5-a205-fad4f45a22c4\">McDaid &amp; Hart (STIs)<\/a>; <a href=\"http:\/\/sti.bmj.com\/content\/90\/2\/133.abstract?sid=f83e5d0c-d78d-4d5d-af80-b77875f3a53a\">Saxton &amp; Hughes (STIs)<\/a> (for New Zealand); <a href=\"http:\/\/sti.bmj.com\/content\/85\/4\/249.abstract?sid=ffa86ba0-73fc-454c-be19-0a6d0d415ee9\">Heijman &amp; Prins (STIs)<\/a>\u00a0 (Netherlands)), and may now \u2018have reached its limit in maximizing routine uptake\u2019 (<a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.12373\/abstract\">McDaid &amp; Flowers<\/a>).\u00a0 Nonetheless, amongst UK MSM at least, HIV incidence is not declining.\u00a0 UK guidelines currently recommend annual HIV testing for MSM, and three-monthly testing for those \u2018at higher risk\u2019.\u00a0 But how far are these goals being met?\u00a0 An audit conducted in UK GUM clinics (<a href=\"http:\/\/sti.bmj.com\/content\/89\/5\/404.abstract?sid=3246d644-c42d-4e86-a459-37be8f1dd709\">Desai &amp; Suillivan\/STIs<\/a>) was reassuring;\u00a0 but a recent (2013) cross-sectional survey of gay bars in Glasgow reports levels of HIV testing over the previous six months of only 37%, and a relatively high proportion of \u2018high-risk\u2019 takers figuring among those who had never tested (OR: 0.51)( <a href=\"http:\/\/sti.bmj.com\/content\/89\/3\/223.abstract?sid=5a8e9fe0-cad1-4778-8e4b-f9722b37c4a1\">McDaid &amp; Flowers (STIs)<\/a>).<\/p>\n<p>Last month saw the publication of study (<a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.12373\/abstract\">McDaid &amp; Flowers<\/a> (M&amp;F)) based on data from three cross-sectional surveys \u2013 Glasgow\/Edinburgh gay commercial venues; an internet-based Scotland-wide survey; London gay social venues \u2013 and including 2409 MSM in total.\u00a0 Frequency of testing was reckoned over a two-year period, and classified as \u2018one or less\u2019, \u2018two or three times\u2019, or \u2018four or more times\u2019.\u00a0 On this basis, the study estimates the proportion testing annually at only 54.9%\u00a0 \u2013 and the proportion of those reporting higher risk unprotected anal intercourse (UAI) (=37.8% of the total) who tested four or more times at only 26.7%. \u00a0So neither in respect to MSM in general, nor in respect to those \u2018at high risk\u2019 are the UK national guidelines being met.\u00a0 Moreover, involvement in higher risk UAI \u2013 unlike number of sexual partners and AI partners \u2013 turns out <em>not<\/em> to be significantly correlated with the highest rates of testing; while more of those reporting higher risk activities claimed to have tested as a result of a perceived risk event, rather than as part of a regular check-up.\u00a0 The authors conjecture the episodes of higher risk UAI may have been less frequent events (albeit reported by a third of participants) after which the participants, being risk-aware, took appropriate preventative action.\u00a0 This seems a plausible interpretation.<\/p>\n<p>Studies of HIV testing in other countries published in STI Journal seem to show a broadly comparable situation, with testing levels for MSM and high-risk MSM consistently falling short of respective national guidelines.\u00a0 Thus <a href=\"http:\/\/sti.bmj.com\/content\/90\/2\/133.abstract?sid=f83e5d0c-d78d-4d5d-af80-b77875f3a53a\">Saxton &amp; Hughes (STIs)<\/a> in location based surveys in Auckland report levels of MSM annual testing rising slowly to 50% in 2011; while <a href=\"http:\/\/sti.bmj.com\/content\/86\/5\/371.abstract?sid=0d0938df-9a9a-4ab7-9137-f6471955b719\">Guy &amp; Hellard (STIs)<\/a> surveying testing in Australian GP clinics give figures for annual testing by MSM, and high-risk MSM, of 35% and 15% respectively as of 2010.\u00a0 As for the US, <a href=\"http:\/\/sti.bmj.com\/content\/87\/Suppl_1\/A209.1.abstract?sid=6dae37bf-21b5-44e0-b1c6-335388f80594\">Katz &amp; Stekler (STIs)<\/a> report levels of annual testing of 77%, but, as the location of this survey was GP clinics, an appropriate UK comparator would be the study reported by <a href=\"http:\/\/sti.bmj.com\/content\/89\/5\/404.abstract?sid=3246d644-c42d-4e86-a459-37be8f1dd709\">Desai &amp; Suillivan\/STIs<\/a>, which reports levels of 92%.<\/p>\n<p>In their recommendations M&amp;F stress the importance of reducing the known barriers to HIV testing, and also draw our attention to the key role that testing will have in facilitating the effectiveness of future PrEP interventions, given the need for participants in PrEP to have an accurate knowledge of their HIV status.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The potential role of frequent HIV testing in curbing the HIV epidemic among the MSM population has long been recognized. The introduction of the strategy of \u2018opt-out\u2019 testing in the UK (2007), as in other countries at around the same time, brought a steep rise in testing, followed by stabilization (McDaid &amp; Hart (STIs); Saxton [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":152,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1642,2380,2646,1614],"tags":[],"class_list":["post-1179","post","type-post","status-publish","format-standard","hentry","category-hiv-testing","category-pre-exposure-prophylaxis","category-retesting","category-united-kingdom"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Is the UK meeting its national guidelines for HIV testing of MSM? - Sexually Transmitted Infections<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Is the UK meeting its national guidelines for HIV testing of MSM? - Sexually Transmitted Infections\" \/>\n<meta property=\"og:description\" content=\"The potential role of frequent HIV testing in curbing the HIV epidemic among the MSM population has long been recognized. The introduction of the strategy of \u2018opt-out\u2019 testing in the UK (2007), as in other countries at around the same time, brought a steep rise in testing, followed by stabilization (McDaid &amp; Hart (STIs); Saxton [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/\" \/>\n<meta property=\"og:site_name\" content=\"Sexually Transmitted Infections\" \/>\n<meta property=\"article:published_time\" content=\"2016-05-09T13:00:56+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/05\\\/09\\\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/05\\\/09\\\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\\\/\"},\"author\":{\"name\":\"\",\"@id\":\"\"},\"headline\":\"Is the UK meeting its national guidelines for HIV testing of MSM?\",\"datePublished\":\"2016-05-09T13:00:56+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/05\\\/09\\\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\\\/\"},\"wordCount\":572,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/#organization\"},\"articleSection\":[\"HIV testing\",\"pre-exposure prophylaxis\",\"Retesting\",\"United Kingdom\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/05\\\/09\\\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/05\\\/09\\\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\\\/\",\"name\":\"Is the UK meeting its national guidelines for HIV testing of MSM? - Sexually Transmitted Infections\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/#website\"},\"datePublished\":\"2016-05-09T13:00:56+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/05\\\/09\\\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/05\\\/09\\\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/2016\\\/05\\\/09\\\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Is the UK meeting its national guidelines for HIV testing of MSM?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/\",\"name\":\"Sexually Transmitted Infections\",\"description\":\"Discussion and suggestion space for readers of STIs\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/#organization\",\"name\":\"Sexually Transmitted Infections\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/files\\\/2017\\\/10\\\/blog-logo-sti.png\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/files\\\/2017\\\/10\\\/blog-logo-sti.png\",\"width\":378,\"height\":34,\"caption\":\"Sexually Transmitted Infections\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/sti\\\/author\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Is the UK meeting its national guidelines for HIV testing of MSM? - Sexually Transmitted Infections","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/","og_locale":"en_US","og_type":"article","og_title":"Is the UK meeting its national guidelines for HIV testing of MSM? - Sexually Transmitted Infections","og_description":"The potential role of frequent HIV testing in curbing the HIV epidemic among the MSM population has long been recognized. The introduction of the strategy of \u2018opt-out\u2019 testing in the UK (2007), as in other countries at around the same time, brought a steep rise in testing, followed by stabilization (McDaid &amp; Hart (STIs); Saxton [...]Read More...","og_url":"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/","og_site_name":"Sexually Transmitted Infections","article_published_time":"2016-05-09T13:00:56+00:00","twitter_card":"summary_large_image","twitter_misc":{"Written by":"","Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/"},"author":{"name":"","@id":""},"headline":"Is the UK meeting its national guidelines for HIV testing of MSM?","datePublished":"2016-05-09T13:00:56+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/"},"wordCount":572,"publisher":{"@id":"https:\/\/blogs.bmj.com\/sti\/#organization"},"articleSection":["HIV testing","pre-exposure prophylaxis","Retesting","United Kingdom"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/","url":"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/","name":"Is the UK meeting its national guidelines for HIV testing of MSM? - Sexually Transmitted Infections","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/sti\/#website"},"datePublished":"2016-05-09T13:00:56+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/sti\/2016\/05\/09\/is-the-uk-meeting-its-national-guidelines-for-hiv-testing-of-msm\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/sti\/"},{"@type":"ListItem","position":2,"name":"Is the UK meeting its national guidelines for HIV testing of MSM?"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/sti\/#website","url":"https:\/\/blogs.bmj.com\/sti\/","name":"Sexually Transmitted Infections","description":"Discussion and suggestion space for readers of STIs","publisher":{"@id":"https:\/\/blogs.bmj.com\/sti\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/sti\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/sti\/#organization","name":"Sexually Transmitted Infections","url":"https:\/\/blogs.bmj.com\/sti\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/sti\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/sti\/files\/2017\/10\/blog-logo-sti.png","contentUrl":"https:\/\/blogs.bmj.com\/sti\/files\/2017\/10\/blog-logo-sti.png","width":378,"height":34,"caption":"Sexually Transmitted Infections"},"image":{"@id":"https:\/\/blogs.bmj.com\/sti\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"","url":"https:\/\/blogs.bmj.com\/sti\/author\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/sti\/wp-json\/wp\/v2\/posts\/1179","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/sti\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/sti\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/sti\/wp-json\/wp\/v2\/users\/152"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/sti\/wp-json\/wp\/v2\/comments?post=1179"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/sti\/wp-json\/wp\/v2\/posts\/1179\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/sti\/wp-json\/wp\/v2\/media?parent=1179"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/sti\/wp-json\/wp\/v2\/categories?post=1179"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/sti\/wp-json\/wp\/v2\/tags?post=1179"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}