Sexually Transmitted Diseases. 33(3):183-192, March 2006.

Duncan A. MacKellar, MA, MPH; Linda A. Valleroy, PhD; John E. Anderson, PhD; Stephanie Behel, MPH; Gina M. Secura, MPH; Trista Bingham, MPH, MS; David D. Celentano, ScD; Beryl A. Koblin, PhD; Marlene LaLota, MPH; Douglas Shehan; Hanne Thiede, DVM, MPH; Lucia V. Torian, PhD; Robert S. Janssen, MD From Centers for Disease Control and Prevention, Atlanta, Georgia.

Abstract
We evaluated the correlates and contexts of HIV testing within the past year, subsequent risk reduction, and HIV seroconversion among young men who have sex with men (MSM).

Methods
Young men aged 23 to 29 years were approached, interviewed, counseled, and tested for HIV at 181 randomly sampled MSM-identified venues in six U.S. cities from 1998 through 2000. Analyses were restricted to 2,797 MSM who reported never testing HIV-positive. 

Results
Of the 2,797 MSM, 1,281 (46%) either never previously tested or had not tested in the past year (never/remote testers); 1,516 (54%) had tested in the past year (recent testers); and 271 (10%) tested HIV-positive as part of the study. Of 1,885 recent sex partners reported by HIV-infected participants, 68% were partners of never/remote testers. Of recent testers, 50% tested anonymously, 51% tested because of specific risks, 59% were counseled, 47% reported reducing their risks after testing, and 8% tested HIV-positive (percent HIV-infected by race: blacks, 24%; Hispanics, 6%; whites, 4%; Asians, 1%).

Conclusion
Nearly half of young MSM participants had not tested in the past year and HIV-infected never/remote testers accounted for approximately two thirds of recent partners potentially exposed to HIV. Of those who had tested recently, many MSM, especially those who are black, had already acquired HIV. To reduce HIV transmission and facilitate early diagnosis and entry into care, increased HIV testing among young at-risk MSM in the United States, especially those who are black, is needed.

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