LAUSR

Introduction Little is known about factors associated with STI acquisition and testing among men who have sex with men (MSM) in Jamaica despite reported high HIV prevalence. The study objective was to examine correlates of lifetime STI history and testing among MSM in Jamaica. Methods We conducted a cross-sectional tablet-based survey with MSM recruited using peer-driven sampling methods in Kingston, Ocho Rios, and Montego Bay, Jamaica. We estimated factors associated with ever having an STI test and lifetime history of STI. Bivariable regression assessed the strength of associations between potential factors with outcomes of interest. Logit-link models were used to estimate final multivariable models and fit using backwards-stepwise regression. Results Among 556 participants, 67 (14%) were HIV-positive and 416 (75%) reported a previous STI test. In the final multivariable model, STI testing history was associated with socio-demographic (graduated high school [OR: 2.34, 95% CI: 1.30, 4.20]) and community (perceived sexual stigma [OR: 1.10, 95% CI: 1.03, 1.16]; lesbian, gay, and bisexual community connectedness [OR: 1.12, 95% CI: 1.01, 1.23]) factors. Participants who were casually dating had lower odds of STI testing than those in a relationship (OR: 0.56, 95% CI: 0.34, 0.94). Among participants who had received a STI test and result (n=404), 49 (12%) reported a lifetime STI history. In the final multivariable model, lifetime STI history was associated with increased odds of HIV seropositivity (OR: 3.88; 95% CI 1.80, 8.35), current unemployment (OR: 2.24, 95% CI: 1.12, 4.46), and inconsistent condom use (OR: 2.23; 95% CI: 1.05, 4.75). Conclusion MSM in Jamaica report high prevalence of STI and HIV. STI testing rates are suboptimal and associated with complex multi-level (socio-demographic, relationship, community) factors. Lifetime history of STI was associated with HIV co-infection, structural factors (unemployment), and sexual practices (inconsistent condom use). Results can inform multilevel STI prevention and care programs tailored for MSM in Jamaica.