Objectives: In the UK, men who have sex with men (MSM) bear a disproportionate sexually transmitted infection (STI) burden. We investigated MSM's STI knowledge; whether their STI testing behaviour met national guidelines (annually if sexually active; 3-monthly if engaging in STI risk behaviours); and the relationship between STI testing in the last 3 months, STI knowledge and STI risk behaviours by HIV status. Methods: Sexually active (in the last year) men aged > 15 years who were UK residents and were recruited from gay-orientated online dating platforms completed an anonymous online survey about STI knowledge, STI risk behaviours, and STI testing (March–May 2017). This included 11 true statements about STIs. Respondents scored 1 for each statement they ‘knew’, with those scoring < 6 overall treated as having ‘poor’ STI knowledge. Descriptive and multivariable analyses were conducted, separately by HIV status, to test our hypothesis and calculate adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results: Compared to HIV-positive men (n = 489), the proportion of HIV-negative/unknown-status men (n = 3157) with ‘poor’ STI knowledge was significantly higher (46.4% versus 22.9% for HIV-positive men) and the proportion with STI testing in the last 12 months was lower (71.6% versus 87.2%, respectively). In the last 3 months, 56.9% of HIV-negative/unknown-status and 74.1% of HIV-positive men reported STI risk behaviours, of whom 45.8% and 55.1%, respectively, had been tested for STIs during this time. Among HIV-negative/unknown-status men, those reporting STI risk behaviours were more likely (AOR 1.52; 95% CI 1.26–1.84) and those with poor STI knowledge less likely (AOR 0.73; 95% CI 0.61–0.89) to have been tested during the last 3 months. However, neither factor was independently associated with 3-monthly testing among HIV-positive men. Conclusions: Improving STI knowledge, especially among HIV-negative/unknown-status men, and promoting frequent STI testing among men engaging in STI risk behaviours are vital to address the poor sexual health of MSM.
Bibliographical noteFunding Information:
Financial disclosure: This research study and following reseachers: SW, SF, PB, and DR are funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with Public Health England (PHE) and in collaboration with the London School of Hygiene and Tropical Medicine. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research, the Department of Health, or Public Health England.
DR set up the study with advice and support from PW, SW, GH and CM. DR secured ethics approval and coordinated and managed the implementation of the survey. SF and PB conducted the data cleaning and management. SW undertook all the analysis and wrote the first and subsequent drafts of the manuscript. All authors contributed to the drafting of the paper and approved the final version. CM and GW secured funding from the National Institute for Health Research for the Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England [PHE, in collaboration with the London School of Hygiene and Tropical Medicine (LSHTM)].
- health knowledge
- men who have sex with men
- sexual behaviours
- sexually transmitted infection
- sexually transmitted infection testing