Comparing databases: Determinants of sexually transmitted infections, HIV diagnoses, and lack of HIV testing among men who have sex with men Health behavior, health promotion and society

Chantal Den Daas*, Maaike Goenee, Bouko H.W. Bakker, Hanneke De Graaf, Eline L.M. Op De Coul

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Background: Early detection and treatment of STI/HIV are public health priorities. Our objective was to compare characteristics of men who have sex with men (MSM) in Dutch data available in 2010 from EMIS, an international internet survey, Schorer Monitor, a Dutch internet survey, and data from STI- clinic visits, since these might be subject to different and unknown biases. Methods: Data from Dutch MSM Internet Surveys (EMISNL N = 3,787; Schorer Monitor, SMON N = 3,602), and 3,800 STI clinic visits (SOAP) were combined into one dataset. We included factors that were measured in all three databases. The socio-demographics included were age (at the time of the survey), zip code, and ethnicity. Behavioural variables included were the number of sexual partners, condom use with last sexual partner, drug use, being diagnosed with STI, being diagnosed with HIV, and HIV testing. Outcomes we investigated were being diagnosed with STI, HIV, and never been tested for HIV. Results: Logistic regressions showed that determinants for being diagnosed with STI were having more sexual partners, drug use, and having had an HIV test (aORs 1.3 to 17.1) in EMIS and SMON. Determinants for being diagnosed with HIV in all three databases were older age, living in Amsterdam, and having more partners (aORs 1.8 to 4.4). In EMIS and SMON, drug use, non-condom use, and having STI were additional determinants (aORs 1.6 to 8.9). Finally, determinants associated with never been tested for HIV were being younger (only SOAP), living outside of Amsterdam, having fewer partners, no drug use, and no STI (aORs 0.2 to 0.8). Conclusions: Risk factors from internet surveys were largely similar, but differed from STI clinics, possibly because it involves self-reports rather than diagnoses or because of differences in timing. The difference between the internet surveys and STI clinic data is much less pronounced for having never been tested, suggesting both are appropriate for this outcome. These findings shed light on conclusions drawn from different data sources, as well as the comparability of recruitment strategies, the robustness of risk factors, consequences of phrasing questions differently, and on (policy) implications based on different data sources.

Original languageEnglish
Article number1114
JournalBMC Public Health
Issue number1
Publication statusPublished - 12 Nov 2015

Bibliographical note

Authors’ contributions
All authors contributed to the design of the study. CdD led on the data analysis and drafting of the manuscript supported by EOdC, MG, BB and HdG. All authors commented on drafts of the manuscript and approved the final version.

We would like to thank Axel J. Schmidt M.D. MPH, EMIS Scientific Co-ordinator, London School of Hygiene and Tropical Medicine, London, UK, for co-ordinating the EMIS study, and his helpful comments on the manuscript. In addition, we thank all Public Health nurses and physicians of the STI clinics for their contribution to the data collection and medical microbiology laboratories for STI diagnostics.

The EMIS project was funded by: Executive Agency for Health and Consumers, EU Health Programme 2008–2013 (funding period: 14.3.2009 – 13.9.2011); CEEISCat - Centre d’Estudis Epidemiològics sobre les ITS/HIV/SIDA de Catalunya; Terrence Higgins Trust (CHAPS) for Department of Health for England; Maastricht University; Regione del Veneto; Robert Koch Institute. Scientific co-ordination: Robert Koch Institute (Germany); Administrative co-ordination: GIZ–Gesellschaft für Internationale Zusammenarbeit (Germany); Technical Implementation: Sigma Research, London School of Hygiene & Tropical Medicine (UK); Questionnaire drafting: University College, Maastricht (The Netherlands).


  • HIV
  • HIV testing
  • Men who have sex with men (MSM)
  • Sampling methods
  • STI


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