August 30, 2012
HIV testing can be performed easily in France's free and anonymous voluntary counseling and testing (VCT) centers. A recent national survey among men who have sex with men revealed that 73 percent of MSM who had previously tested for HIV had done so in the previous two years. However, because nothing is known about the risk behaviors of MSM attending VCT centers, the authors of the current study set out to characterize the sexual risk behavior of MSM undergoing HIV testing in these centers and to identify factors associated with inconsistent condom use (ICU).
From March to December in 2009, a cross-sectional study was conducted in four VCT centers where a self-administered questionnaire was proposed to all MSM presenting for an HIV test. ICU was defined as reported non-systematic use of condoms for anal intercourse with casual male partners.
A total of 287 MSM fully completed the questionnaire; of these, 44 percent reported ICU in the preceding six months. Among those who reported previous testing, 63 percent had tested in the previous two years.
The following factors were found to be independently associated with ICU: never avoiding one-night stands; no recent HIV test; reporting difficulty using condoms with an HIV-negative partner or when under the influence of alcohol and drugs; and reporting a large number of casual male partners in the previous six months.
The study's rate of recently tested men, while high, was lower than that in the last national survey. "Furthermore, those not recently tested were significantly more likely to report high-risk behaviors," the authors concluded. "We therefore recommend that further efforts be made to adapt the offer of both HIV testing and counseling to meet the specific needs of hard-to-reach MSM. Accordingly, an additional community-based offer of HIV testing to reach most at-risk MSM is forthcoming in France."