Correlates of HIV and STI Testing in Rural Southern Substance Using-Men who have Sex with Men: A Behavioral Model for Health Services Use Approach.

While research shows rural men who have sex with men (MSM) are less likely to get HIV and STI tested compared to urban MSM, research has not identified which groups of rural MSM are more or less likely to get tested. There is a dearth of literature of within-group differences of HIV/STI testing among rural MSM, especially among substance using-MSM who are more vulnerable to HIV/STI infections. This study examined factors associated with HIV and STI testing among rural substance-using MSM in the South, guided by the Andersen's Behavioral Model of Health Services Use. Participants (N = 284) completed an online cross-sectional questionnaire, and two logistic regressions examined associations of predisposing, enabling, and need factors with past-year HIV and STI testing. For HIV testing, significant factors were education level, having a primary care provider, past-year sexualized drug use, and past-year STI diagnosis. For STI testing, significant factors were education level, sexualized drug use, and drug-related transactional sex. Findings highlight the importance of educational and risk perception campaigns to increase rural MSM accessing services, provider trainings for providers to identify behavioral risk factors and offer testing services, and at-home testing services.