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

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 the prevalence and correlates of frequent STI testing amongst GBMSM. We analysed data on participants of the community-based Reducing Inequalities in Sexual Health (RiiSH) online survey of GBMSM, recruited in November-December 2024 via social media and dating apps. Participants were UK residents aged ≥16 years who reported sex with a man in the previous year. We described the 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 that 2366 (86%) would be recommended quarterly STI testing. Over the past year, 562 individuals (24%) met or exceeded this recommendation (testing ≥4 times), 1107 (47%) had 1-3 tests, and 673 (28%) no tests. Factors associated with frequent testing were: reporting using 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), aged 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 that only 1 in 4 GBMSM who are recommended frequent STI testing meet this recommendation, and testing levels vary by PrEP use, STI history, age, and sexual orientation. Interventions are needed to address these inequalities.