"Too scared to get tested"; anxiety as a barrier for HIV testing among South African MSM

Published: August 1, 2008

“Too scared to get tested”; anxiety as a barrier for HIV testing among South African MSM

Background: Men who have sex with men (MSM) have largely been ignored in research and prevention in the South African AIDS epidemic, with the focus being on heterosexual transmission. Little is known about the ways in which South African MSM access and receive HIV prevention services. Since knowing one’s serostatus has been shown to contribute to the adoption of risk reduction practices, it is important to understand barriers to HIV testing.

Methods: In a diverse sample of 1021 MSM who participated in self-administered surveys conducted in the provinces Gauteng, KwaZulu-Natal and Western Cape, 28.3% (n=289) reported never having been tested. We explored the reasons these men endorsed for not having been tested.

Results: The most frequently endorsed reason for not having been tested was “I am too scared to get tested” (58.6% of untested men). Not considering oneself as at risk was mentioned by 50.2%, while 48.7% mentioned not having been in a situation where transmission could have occurred. Less than a third of these men mentioned not being sexually active as a reason for not having been tested (31.9%). Not knowing how to get tested was mentioned by 12.7% of the men. Men who reported being too scared to get tested were more likely to be sexually active singles (as opposed to men in monogamous relationships; Adjusted OR=4.36, 95% CI=1.74-10.97), endorsed a feminine self-presentation (Adjusted OR=2.35, 95% CI=1.22-4.56) and reported having had an STI in the preceding two years (Adjusted OR=15.68, 95% CI=2.02-122.64).

Conclusions: HIV testing anxiety among MSM who have not been tested for HIV seems to be informed by both behavioral and attitudinal factors. Promotion of HIV testing as part of prevention strategies aimed at South African MSM should take into account that anxiety for HIV testing is a major barrier. Strategies to reduce this anxiety should be developed and tested.

-Abstract available at link below-

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