Correlates of HIV and STI Testing in Rural Southern Substance Using-Men who have Sex with Men: A Behavioral Model for...

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Rural men who have sex with men (MSM) exhibit lower HIV and STI testing rates compared to urban counterparts.
• Limited research exists on within-group disparities in testing among rural MSM, particularly those who use substances.
• Substance-using MSM are at higher risk for HIV and STI infections, necessitating targeted research.

Purpose of the Study:

• To examine factors associated with HIV and STI testing among rural, substance-using MSM in the Southern United States.
• To identify predisposing, enabling, and need factors influencing testing behaviors within this population.
• To inform interventions aimed at improving HIV/STI testing access and uptake.

Main Methods:

• Cross-sectional online survey administered to 284 rural substance-using MSM.
• Utilized Andersen's Behavioral Model of Health Services Use to guide analysis.
• Employed logistic regression to assess associations between demographic, behavioral, and health system factors and past-year HIV/STI testing.

Main Results:

• For HIV testing, significant factors included education level, primary care provider access, sexualized drug use, and prior STI diagnosis.
• For STI testing, significant factors were education level, sexualized drug use, and drug-related transactional sex.
• Findings underscore the heterogeneity in testing behaviors within the rural MSM population.

Conclusions:

• Educational campaigns and risk perception initiatives are vital for increasing service access among rural MSM.
• Provider training is essential to identify behavioral risks and offer timely HIV/STI testing.
• Promoting at-home testing services can improve accessibility and uptake for this population.