Abstract
INTRODUCTION: Understanding levels of human immunodeficiency virus (HIV) testing among populations at risk for acquisition is essential to meeting the goal of the United Nations that 95% of individuals living with HIV know their status. This study assessed HIV testing prevalence among men who had sex with men (MSM), characteristics of MSM who have never tested for HIV, and missed testing opportunities in Hanoi, Vietnam. METHODS: We measured the prevalence of never testing for HIV and missed opportunities for testing in the baseline data of a cohort study of MSM recruited in 2017 to 2019 in Hanoi. Logistic regression analysis characterized MSM who had never tested before cohort participation. RESULTS: Of 1893 MSM enrolled in the cohort, 39.4% had never previously tested for HIV. Men who had sex with men with children (adjusted odds ratio, 1.75; 95% confidence interval, 1.09-2.82) and those who did not know or remember having a male partner living with HIV (adjusted odds ratio, 1.41; 95% confidence interval, 1.07-1.84) were more likely to have never tested. Older age, university education, higher income, and having a male partner living with HIV were associated with a lower likelihood of never having been tested. The most common missed testing opportunities to test MSM who had never been tested were when receiving free condoms from health educators (35.3%), testing for other sexually transmitted infections (STIs) (23.3%), reporting their MSM status to health care workers (16.4%), and receiving an STI diagnosis (13.0%). The most common barriers identified by MSM who had never tested were fear of seeking health care due to their sexual orientation (82.7%) and having been refused health care due to their sexual orientation (76.2%). CONCLUSIONS: Facilitating provider-initiated HIV testing in STI clinics and other health care services, community-based testing, and HIV self-test kits should enhance HIV testing options for young MSM, especially those with lower education and income.