HIV testing among heterosexual Black men in Toronto: What are the determinants?

African, Caribbean, and Black (ACB) men in Canada face a higher risk of HIV infection relative to other men. Despite this concern, these are nascent studies focused on the usage of HIV testing services among ACB men. To contribute to health policy in Canada, we seek to understand the prevalence and predictors of HIV testing among heterosexual ACB men living in Toronto.

We used a sample of 325 self-identified heterosexual Black men in Toronto, Ontario, who participated in the weSpeak study, which examined HIV vulnerability among ACB men. Guided by Andersen's framework of health services utilization, we fitted negative log-log regression models to cross-sectional data of ACB men 16 years or older.

The findings indicate that (1) ACB men with secondary or lower levels of educational attainment (OR = 0.57, p < 0.1) were less likely to have ever been tested for HIV compared to their counterparts with a university education or higher, (2) foreign-born men were more likely to have ever been tested for HIV than their Canadian-born counterparts (OR = 3.14, p < 0.01), and (3) ACB men who report multiple sexual partners were more likely to have ever been tested for HIV compared to colleagues with one sexual partner (OR = 2.76, p < 0.01).

Based on these findings, we recommend further research to understand the barriers to HIV testing among non-priority risk groups and the design of a more nuanced population-based approach to HIV testing that incorporates case management or various incentives.