HIV Testing Among Middle-Aged and Older Men Who Have Sex With Men (MSM): A Blind Spot?

Alvaro Francisco Lopes Sousa, Artur Acelino Francisco Luz Nunes Queiroz, Inês Fronteira, Luís Lapão, Isabel Amélia Costa Mendes, Sandra Brignol

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Middle-aged and older men who have sex with men (MSM) are one of the most underestimated populations with regard to HIV/AIDS infection, despite the worldwide trend of increasing prevalence in recent years. This population also has low rates of testing, although rare studies are done exclusively with middle-aged and older MSM assessing the factors associated with this prevalence. Thus, based on data from an exclusive online survey with middle-aged and older MSM who use geolocation-based dating applications, the purpose of the study was to analyze factors associated with not taking the HIV test among middle-aged (50 years old) and older MSM in Brazil. Using a modification of time-location sampling adapted to virtual reality, 412 volunteers were approached in Grindr®, Hornet®, SCRUFF®, and Daddyhunt®. The multivariate logistic regression model was adopted to produce adjusted odds ratios (ORa), considering a significance level at.05. There were factors associated with not taking the test: being in a relationship (ORa: 0.24; 95% CI [0.10, 0.53]); knowing partner through the applications (ORa: 1.84; 95% CI [1.07, 3.15]); not knowing the serological status (ORa: 5.07; 95% CI [1.88, 13.67]); ejaculating outside of anal cavity (ORa: 1.79; 95% CI [1.04, 3.05]); practicing sex without penetration (ORa: 2.30; 95% CI [1.17, 4.50]); not taking the test as a form of prevention (ORa: 2.83; 95% CI [1.05, 7.68]); and rarely using Viagra in sexual intercourse (ORa: 1.91; 95% CI [1.20, 3.65]). There is a blind spot in the prevalence of HIV testing in older MSM because this population is not being covered by services, which compromises the overall response to HIV, the goals set for universal health coverage.

Original languageEnglish
Number of pages10
JournalAmerican Journal of Men's Health
Issue number4
Publication statusPublished - 1 Jul 2019


  • Barriers to HIV testing
  • Geolocation-based dating applications
  • HIV testing
  • Men who have sex with men
  • Sexual behavior
  • Social networks

UN Sustainable Development Goals (SDGs)

  • SDG 3 - Good Health and Well-Being

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