Twelve effectiveness studies were included in the review (32,582 participants, range 140 to 8047); three RCTs, three non-randomised controlled trials and six before and after studies. Three studies were considered to be high quality, four of medium and five of low quality. Follow-up (measured from start of intervention delivery) ranged from immediate to three years.
Type of test/testing protocol (two RCTs, one non-randomised controlled trials; 3,674 participants): Some evidence was found that rapid testing could increase HIV testing; two studies that looked at type of test or testing protocol found an improvement in uptake or adherence for rapid serum testing and oral fluid testing and oral fluid testing and blood spot home testing. A third study found no significant difference in uptake between HIV tests included with a package of other tests and HIV tests alone.
Peer education and recruitment (one RCT, two non-randomised controlled trials; 10,768 participants): One RCT found a small but significant increase in HIV testing rates in participants of an intensive weekend residential programme for black men who have sex with men led by trained peers. However, no significant effect was found for peer-led community-based risk reduction schemes in two non-randomised studies.
Media and web-based campaigns (three before and after studies; 8,397 participants): Of two non-comparative studies investigating community-based media campaigns one found a significant increase in HIV testing while the other found no increase in the number of men who have sex with men reporting an HIV test in the previous year. One web-based campaign to promote HIV testing among men who have sex with men also found a significant increase in HIV testing.
Sexually transmitted infection clinic service delivery (three before and after studies; 9,743 participants): Three non-comparative studies found an increase in HIV testing among men who have sex with men after the initiation of an opt-out policy in sexually transmitted infection clinics, two of which were reported as significant (it was unclear if the increase reached significance in the third study).