From insight into STI testing strategies to sexual risk dynamics in MSM

This thesis addresses the strategic diversity in STI prevention and management as well as the diverse needs of risk populations, in particular MSM, in support of their sexual health. Studies in this thesis use a multidisciplinary research approach in order to address the complex issues of sexual health. The thesis points to the usefulness of evaluating changes in STI testing strategies and the importance of gaining insight into the risk dynamics of key populations and the role of the knowledge of ones’ HIV-serostatus. The results of these studies may contribute and in part already contributed to improved testing policies and the development of prevention programs.
Chapter 1 provides a short overview of the epidemiology of sexually transmitted infections (STI), Human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) infections and changes in testing and treatment strategies in the Netherlands over the last decade. Furthermore, psycho-social theories are described which can help us understand barriers and motives related to sexual healthy behaviour in men who have sex with men (MSM). The studies in Chapter 2 focuses on the evaluation of STI, HIV, and HCV testing strategies at STI clinics in the Netherlands, in particular Amsterdam. Chapter 3 describes sexual risk dynamics of MSM in various settings. Finally, chapter 4 discusses the main findings of this thesis, relates these to recent developments and literature, and gives recommendations for future studies.