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HIV testing among gay men in Edinburgh and the Lothians

Main Findings – HIV Testing and HIV Stigma

The majority of men (62%) had had an HIV test. Of these, 82% reported a negative result, 7% a positive result and 11% were either unsure of the result or failed to provide this information. Most men (78%) reported having had only one test, 13% were repeat testers and 9% did not give details. Of the men who had tested, 79% indicated they did not regret having a test.

Over half (53%) of the sample said they were unsure if their friends had had an HIV test, indicating that testing is seen more as an individual decision than as a gay community issue. There appears to be stigma attached to testing itself.

The participants tended to agree that there were many benefits to testing with over 70% agreeing that having an HIV test can put your mind at rest and 55% agreeing that having a test can help you plan your life.

Although 26% of men acknowledged that fear of a positive result is a reason to avoid or delay testing, only 9% agreed that it is better to live with uncertainty than to know you are HIV positive.

In general, respondents were reasonably happy with clinic opening times and testing procedures.

The majority of men would not have anal or oral sex with someone they knew to be HIV positive. There was evidence of sexual exclusion of men who are HIV positive. 37% of men always assumed their sexual partners to be HIV negative.

Almost half the men said they intended to have an HIV test in the future but, of the men who had never had a test, 38% said it was unlikely or highly unlikely that they would have one in the future and 46% of these men were unsure.

Of those who reported testing positive, 46% said they had some regret about having had a test. Respondents readily acknowledged the high levels of stigma and discrimination experienced by people with HIV and 44% agreed that discrimination against people with HIV occurred on the gay scene. In general, percentages of men who thought people with HIV were discriminated against in various contexts were very high.

Comparing ‘testers’ to ‘non-testers’: non- testers were less likely to have negative attitudes to having sex with HIV positive men, less likely to perceive themselves as being at risk and less likely to see benefits of testing. They perceived more barriers to testing and more problems with clinics, seemed more aware of treatment / testing arguments and were more optimistic about new treatments. Non-testers had not avoided testing simply because they had never engaged in risky sexual behaviour: many non-testers have engaged in risky sexual behaviour and have high levels of fear of a positive test result.

Comparing men who intend to test in the near future to those who do not: those with a stronger intention to test were significantly more likely to have had a previous test and were less likely to have regrets about previous tests. They perceived many more benefits of testing and had much less fear of a positive result. Psychological factors such as perceived benefits of testing and fear of positive results appear to be central in shaping men’s future testing decisions.