Test More: Understanding Routine STI Testing Among the LGBTQ Community Using the Reasoned Action Approach

Abstract

The United States experiences high rates of sexually transmitted infections (STIs). Sexually active LGBTQ+ young adults represent a population of concern due to elevated risk for certain STIs. Routine STI testing is an important strategy for early detection and prevention of transmission among at-risk populations. Guided by the Reasoned Action Approach, this study examined psychosocial determinants of intentions to obtain routine STI testing (once every six months) among sexually active LGBTQ+ young adults. Salient beliefs informing the measurement of the constructs were identified in a formative study using focus groups with LGBTQ+ young adults. Building on this work, the study surveyed 400 LGBTQ+ individuals aged 18–27 to assess attitudes, perceived normative pressure (injunctive and descriptive norms), perceived behavioral control (autonomy and efficacy), and intentions to obtain routine STI testing. Path analysis examined associations among these constructs and precursor variables relevant to sexual health care seeking. Attitudes and perceived normative pressure were significantly associated with intentions to obtain routine testing, whereas autonomy and efficacy were not significant predictors. Psychological reactance was negatively associated with attitudes and descriptive norms, while sexual esteem was positively associated with attitudes and both normative constructs. Individuals identifying as gay reported higher descriptive norms regarding routine STI testing. Comparisons between intenders and non-intenders revealed significant differences across several psychosocial determinants. The findings identify attitudes and perceived normative pressure as important determinants of intentions to obtain routine STI testing among sexually active LGBTQ+ young adults and highlight the underlying beliefs associated with the salient reasoned action constructs.