In 2011, MSM accounted for 54% of all new HIV diagnoses in Spain [1]. HIV

testing is an important part of HIV prevention activities, as it is required to diagnose HIV infection. Based on the results of HIV testing, prevention programmes focused on the HIV status of the person may be very appropriate to reduce acquisition and transmission of the infection. The advantage of being tested regularly for HIV is that early diagnosis is vital for timely access to treatment and to control the spread of the virus. Some studies have reported that, once people know they are HIV-positive, many of them reduce high-risk sexual behaviours compared with untested people [2]. Diagnosis is also desirable because it allows GSK2118436 mw early initiation of antiretroviral therapy, which reduces viral load, which in turn may reduce the risk of transmission GSI-IX in vivo of HIV. Serostatus awareness is beneficial at the individual and population levels, and is in line with the

‘test and treat’ approach to control the spread of HIV [3]. Undiagnosed HIV infection is a major potential source of the spread of infection. An important number of new infections are acquired from sexual partners whose infection is undiagnosed [4, 5]. Therefore, to monitor the epidemic among MSM, it is important to know why, when and where they are tested or, conversely, why individuals do not seek HIV testing or refuse it if it is offered. In view of the relatively limited knowledge regarding MSM who have never been tested for HIV in Spain, the aims of this study were to describe the sociodemographic profile of MSM who have never been tested for

HIV, and to analyse factors associated with never having been tested for HIV. A total of 13 753 participants completed the survey. The inclusion criteria were: being male; living in Spain; being at Carnitine dehydrogenase or over the age of sexual consent in Spain; having sexual attraction to men and/or having had sex with men; indicating having understood the nature and purpose of the study; and providing consent to take part in the study. After exclusion of individuals who did not fulfill the inclusion criteria or with inconsistent data, the final sample consisted of 13 111 men. The questionnaire was available in 25 European languages simultaneously and included core questions on sociodemographic characteristics, risk behaviours, history of diagnoses of HIV infection and other STIs, HIV prevention needs (information, access to condoms, etc.), and service uptake. The European MSM Internet Survey (EMIS) was approved by the Research Ethics Committee of the University of Portsmouth, UK (REC application number 08/09:21). This study had a collective approach, including public health, academic and nongovernmental organization (NGO) sectors, and social media. The EMIS was available online for completion over the course of 12 weeks in 2010. Promotion occurred mainly through national and transnational commercial and NGO websites, and social networking websites.