HIV prevalence and undiagnosed infection among a community sample of gay men in Scotland.

Objective: To examine HIV prevalence among men in gay bars in Glasgow and Edinburgh, Scotland.
Methods: Self-complete questionnaires and Orasure oral fluid collection kits (OraSure Technologies, Inc., Bethlehem, PA), to collect samples to be tested anonymously for HIV antibodies, were distributed. A total of 1744 men completed questionnaires (66.1% response rate), and 1350 provided samples (51.6% response rate).
Results: HIV prevalence was 4.4% (95% confidence interval: 3.5% to 5.7%). Positivity was associated with older age (mean of 36 years for positive men vs. 32 years for negative men), having 10 or more anal intercourse (AI) partners (12.8% positive vs. 3.4% of men with <10 AI partners, P < 0.05), and self-reported sexually transmitted infections (STIs) in the previous year (12.3% positive vs. 3.5% of men without STIs in the previous year; P < 0.05). Of the HIV-positive men, 41.7% were undiagnosed. More than half had had a negative HIV test result and perceived themselves to be HIV-negative. Men who had not used a genitourinary medicine clinic or had an STI in the previous year were more likely to be undiagnosed (65.0% and 52.5%, respectively).
Conclusions: This is the first study to assess HIV prevalence among a community sample of gay men in Scotland. There is an urgent need for HIV prevention efforts to address the high level of undiagnosed infection and incorrect assumptions of status.