Promoting the uptake of HIV testing among men who have sex with men (MSM): systematic review of effectiveness and cost-effectiveness

Theo Lorenc (1) , Isaac Marrero-Guillamón (2) , Peter Aggleton (3) , Chris Cooper (4) , Alexis Llewellyn (5) , Angela Lehmann (5) , Catriona Lindsay (5)

1 LSHTM - London School of Hygiene and Tropical Medicine
2 Birkbeck College [University of London]
3 University of Sussex
4 King‘s College London
5 Matrix Evidence

Objectives: What interventions are effective and cost-effective in increasing the uptake of HIV testing among men who have sex with men (MSM)? Design: Systematic review. Data sources: AEGIS, ASSIA, BL Direct, BNI, Centre for Reviews and Dissemination, Cochrane Database of Systematic Reviews, CINAHL, Current Contents Connect , EconLit, EMBASE, ERIC, HMIC, Medline, Medline In-Process, NRR, PsychINFO, Scopus, SIGLE, Social Policy and Practice, Web of Science, websites, journal hand-searching, citation chasing and expert recommendations. Review methods: Prospective studies of the effectiveness or cost-effectiveness of interventions (RCT, controlled trial, one-group or any economic analysis) were included if the intervention aimed to increase the uptake of HIV testing among MSM in a high-income (OECD) country. Quality was assessed, and data extracted, using standardised tools. Results were synthesized narratively. Results: Twelve effectiveness studies and one cost-effectiveness study were located, covering a range of intervention types. There is evidence that rapid testing and counselling in community settings (one RCT), and intensive peer counselling (one RCT), can increase uptake of HIV testing among MSM. There are promising results regarding the introduction of opt-out testing in STI clinics (two one-group studies). Findings regarding other interventions, including bundling HIV tests with other tests, peer outreach in community settings, and media campaigns, are inconclusive. Conclusions: Findings indicate several promising approaches to increasing HIV testing among MSM. However, there is limited evidence overall, and evidence for the effectiveness of key intervention types (particularly peer outreach and media campaigns) remains lacking.

Mots clés: HEALTH PROMOTION; HIV TESTING; HOMOSEXUAL; MALES

Theo Lorenc, Isaac Marrero-Guillamón, Peter Aggleton, Chris Cooper, Alexis Llewellyn, et al.. Promoting the uptake of HIV testing among men who have sex with men (MSM): systematic review of effectiveness and cost-effectiveness. Sexually Transmitted Infections, 2011, 87 (4), pp.272. ⟨10.1136/sti.2010.048280⟩. ⟨hal-00616886⟩