# Characteristics associated with frequent sexually transmitted infection (STI) testing in a community-based sample of gay, bisexual, and other men who have sex with men (GBMSM), United Kingdom, 2024

## TL;DR

A UK survey found that only 24% of gay, bisexual, and other men who have sex with men (GBMSM) who should be tested for STIs quarterly actually meet this recommendation, with factors like HIV-PrEP use and age influencing testing frequency.

## Contribution

The study provides the first large-scale community-based data on STI testing frequency and its correlates among GBMSM in the UK.

## Key findings

- Only 24% of GBMSM recommended quarterly STI testing met or exceeded this frequency.
- HIV-PrEP use was strongly associated with frequent STI testing.
- Younger age and recent STI diagnosis were also linked to more frequent testing.

## Abstract

In the UK, gay, bisexual, and other men who have sex with men (GBMSM) at risk of sexually transmitted infections (STIs) are recommended quarterly testing, but it is not known how many are following this recommendation. We described prevalence and correlates of frequent STI testing amongst GBMSM. We analysed data from the community-based Reducing Inequalities in Sexual Health (RiiSH) online survey of GBMSM, with recruitment in November-December 2024 via social media and dating apps. Participants were UK residents aged ≥16 years reporting sex with a man in the previous year. We described frequency of STI testing amongst individuals recommended quarterly testing, using proxies for national guidelines for quarterly testing eligibility (over the past three months: new male sexual partner, condomless anal sex, ≥ 10 male partners, or chemsex). We explored factors associated with frequent testing (≥4 tests/past year) using univariate and multivariable logistic regression, adjusting for country of birth and residence, ethnicity, employment, and education. Among 2758 participants (median age 45 years, 88% white), we estimated 2366 (86%) would be recommended quarterly STI testing. Among 2342 with testing information, 562 individuals (24%) met or exceeded this recommendation (≥4 tests), 1107 (47%) had 1–3 tests, and 673 (29%) none. Factors associated with frequent testing were: reporting using HIV-PrEP in the past year (adjusted odds ratio 7.66 (95% confidence intervals 5.77-10.30)), STI diagnosis in the past three months (1.96 (1.45-2.64)), and younger age (1.50 (1.04-2.16), 16–29 years vs ≥ 45 years). Straight/bisexual orientation was associated with less frequent testing than gay/homosexual (0.71 (0.52-0.96)). Overall, data from a large UK community survey suggest only 1 in 4 GBMSM who are recommended quarterly STI testing meet this recommendation, and testing levels vary by HIV-PrEP use, STI history, age, and sexual orientation. These findings provide baseline data for consideration in any updates to STI testing guidelines.