HIV testing and social engagement: A science of where to reach MSM populations in the non-metropolis Midwest

Background: Many public health agencies struggle with reaching populations of men who have sex with men (MSM) in HIV testing campaigns. This study of Midwest gay and bisexual men in a predominately low-resource, rural, and socially conservative state identified venues through the social engagement scale and their relationship to HIV testing behavior in order to focus future programs.

Methods: A community-based participatory research approach was utilized to develop an online anonymous survey. Participants (N=419) were recruited via advertisements, press releases, fliers, and listserves. Participants were individuals who lived, worked, or "played" in Nebraska.

Results: Analysis revealed 5 factors loading on the social engagement scale (á=.857). All subscales had acceptable reliability(á=.699 to .821). Independent sample t-tests indicated significant differences in subscale scores between those who had ever had an HIV test and those who had not for all but the sex and media engagement subscales; bar engagement (t=3.227, p<.01), community engagement (t=2.729, p<.01), and internet engagement (t=2.242, p<.05). For all significant tests, higher levels of engagement were indicative of prior testing for HIV.

Conclusion: Campaigns for HIV testing targeting MSM in Nebraska and western Iowa appear to have been successful in bar, community, and internet venues, though additional efforts are needed to increase testing behaviors. Increased efforts may be needed in sexual venues; media venues included LGBT movies, TV and information-seeking on the internet – areas harder to implement local messages. The social engagement scale may be useful for targeting limited resources to increase testing, particularly in low resource areas.