Evaluation of the Relative Effectiveness of Three HIV Testing Strategies Targeting African American Men Who Have Sex with Men (MSM) in New York City

Abstract

African American men who have sex with men (MSM) are disproportionately affected by HIV and constitute more than half of all HIV-infected MSM in the USA. Data from the New York City location of a multi-site study were used to evaluate the effectiveness of three HIV testing strategies for detecting previously undiagnosed, 18 to 64-year-old African American MSM. Effectiveness was defined as the identification of seropositive individuals. Using a quasi-experimental design (N = 558), we examined HIV-positive test results for men tested via alternative venue testing, the social networks strategy, and partner counseling and referral services, as well as behavioral risk factors for 509 men tested through alternative venue testing and the social networks strategy. Detection rates of HIV-positives were: alternative venue testing—6.3%, the social networks strategy—19.3%, and partner services—14.3%. The odds for detection of HIV-positive MSM were 3.6 times greater for the social networks strategy and 2.5 times greater for partner services than alternative venue testing. Men tested through alternative venue testing were younger and more likely to be gay-identified than men tested through the social networks strategy. Men who tested through the social networks strategy reported more sexual risk behaviors than men tested through alternative venue testing. Findings suggest differential effectiveness of testing strategies. Given differences in the individuals accessing testing across strategies, a multi-strategic testing approach may be needed to most fully identify undiagnosed HIV-positive African American MSM.