{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:32:17Z","timestamp":1775147537908,"version":"3.50.1"},"reference-count":18,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,11,2]]},"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Men who have sex with men (MSM) who are unaware of their HIV infection are more likely to infect others, and unable to receive treatment. Therefore, we aimed to identify the proportion and characteristics of Dutch MSM who never tested for HIV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 2010, the European MSM Internet Survey (EMIS) recruited 174\u2005209 men from 38 countries through an anonymous online questionnaire in 25 languages. We analysed data from participants living in the Netherlands (N=3787). The outcome we investigated was having never (lifetime) been tested for HIV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 770 MSM (20.4%) had never been tested for HIV. In multivariate regression analyses, not being from Amsterdam (adjusted OR, aOR 1.54, CI 1.17 to 2.03), with low education (aOR 1.28, CI 1.04 to 1.57) and low knowledge on HIV-testing (aOR 2.23, CI 1.37 to 3.64) were significantly associated with never having tested. Lower sexual risk (including having fewer sexual partners (aOR 2.19, CI 1.57 to 3.04) and no anal intercourse (aOR 5.99, CI 3.04 to 11.77)), and less social engagement (including being less out (aOR 1.93, CI 1.55 to 2.40)) were also associated with having never been tested. Additionally, 36.1% of MSM who never tested for HIV reported high-risk sexual behaviour that may have put them at HIV risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MSM make their own risk assessments that inform their choices about HIV-testing. Nevertheless, MSM who were never tested may have been at risk for HIV, and remain important to target for HIV interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-009480","type":"journal-article","created":{"date-parts":[[2016,1,13]],"date-time":"2016-01-13T13:57:34Z","timestamp":1452693454000},"page":"e009480","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Determinants of never having tested for HIV among MSM in the Netherlands"],"prefix":"10.1136","volume":"6","author":[{"given":"Chantal","family":"den Daas","sequence":"first","affiliation":[{"name":"Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martine","family":"Doppen","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel J","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Sigma Research, Department of Social & Environmental Health Research, London School of Hygiene and Tropical Medicine, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eline","family":"Op de Coul","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,1,12]]},"reference":[{"key":"2025121219423632000_6.1.e009480.1","unstructured":"Joint United Nations Programme on HIV\/AIDS: 90-90-90: An ambitious treatment target to help end the AIDS epidemic. UNAIDS, 2014. http:\/\/www.unaids.org\/en\/resources\/documents\/2014\/90-90-90 . 2014."},{"key":"2025121219423632000_6.1.e009480.2","unstructured":"Stichting HIV Monitoring. Monitoringrapport 2014. HIV infectie in Nederland, 2014."},{"key":"2025121219423632000_6.1.e009480.3","doi-asserted-by":"crossref","first-page":"e0133232","DOI":"10.1371\/journal.pone.0133232","article-title":"Changing patterns of undiagnosed HIV infection in the Netherlands: who benefits most from intensified HIV test and treat policies?","volume":"10","author":"Op de Coul","year":"2015","journal-title":"PLoS ONE"},{"key":"2025121219423632000_6.1.e009480.4","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32834171bc"},{"key":"2025121219423632000_6.1.e009480.5","unstructured":"van Oeffelen AAM , Van Aar F , Van den Broek IV , et al . Sexually transmitted infections including HIV, in the Netherlands in 2014. Bilthoven: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM) , 2015."},{"key":"2025121219423632000_6.1.e009480.6","first-page":"226","article-title":"Effectiveness of an opting-out strategy for HIV testing: evaluation of 4 years of standard HIV testing in a STI clinic","volume":"85","author":"Dukers-Muijrers","year":"2009","journal-title":"STI"},{"key":"2025121219423632000_6.1.e009480.7","first-page":"249","article-title":"Opting out increases HIV testing in a large sexually transmitted infections outpatient clinic","volume":"85","author":"Heijman","year":"2009","journal-title":"STI"},{"key":"2025121219423632000_6.1.e009480.8","unstructured":"SOA AIDS Nederland. \u201cStrategie voor de aanpak van soa's en hiv onder MSM in Nederland 2013\u20132018\u201d [in Dutch]. Amsterdam, The Netherlands: SOA AIDS Nederland, 2013."},{"key":"2025121219423632000_6.1.e009480.9","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3282fd167c"},{"issue":"(Suppl 3)","key":"2025121219423632000_6.1.e009480.10","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/hiv.12058","article-title":"HIV testing among Portuguese men who have sex with men\u2013results from the European MSM Internet Survey (EMIS)","volume":"14","author":"Carvalho","year":"2013","journal-title":"HIV Med"},{"key":"2025121219423632000_6.1.e009480.11","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-011-9883-4"},{"key":"2025121219423632000_6.1.e009480.12","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-012-0184-3"},{"key":"2025121219423632000_6.1.e009480.13","unstructured":"The EMIS Network. EMIS 2010: the European Men-Who-Have-Sex-With-Men Internet Survey. Findings from 38 countries. Stockholm: European Centre for Disease Prevention and Control. 2013. http:\/\/www.emis-project.eu"},{"key":"2025121219423632000_6.1.e009480.14","unstructured":"van empelen P , van Berkel M , Roos E , Zuilhof W : Schorer Monitor 2011. Amsterdam, The Netherlands: Schorer; 2011."},{"key":"2025121219423632000_6.1.e009480.15","doi-asserted-by":"publisher","DOI":"10.1007\/s13178-013-0119-4"},{"key":"2025121219423632000_6.1.e009480.16","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052014"},{"key":"2025121219423632000_6.1.e009480.17","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckp231"},{"key":"2025121219423632000_6.1.e009480.18","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1186\/s12889-015-2445-3","article-title":"Comparing databases: determinants of sexually transmitted infections, HIV diagnoses, and lack of HIV testing among men who have sex with men","volume":"15","author":"den Daas","year":"2015","journal-title":"BMC Public Health"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2015-009480","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T03:42:46Z","timestamp":1765597366000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2015-009480"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,1,12]]},"published-print":{"date-parts":[[2016,1]]}},"alternative-id":["10.1136\/bmjopen-2015-009480"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2015-009480","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1]]}}}