While HIV awareness campaigns and education has helped to encourage HIV–testing among queer male populations, there's still a gap between men who have sex with men (MSM) in cities and those who live outside urban centres when it comes to getting tested.

UBC Okanagan conducted an HIV–testing study with Kelowna's Living Positive Resource Centre by surveying 153 men in the B.C. Interior recruited through LGBT online dating sites and events.

The study, "Predictors of HIV testing among men who have sex with men: a focus on men living outside major urban centres in Canada" by UBC associate professor of psychology Susan Holtzman, was published in AIDS Care.

In the past, most studies conducted on HIV–testing have focused primarily on major urban centres.

The UBC study discovered that testing rates among men living in smaller and rural communities are lower in comparison to men living in larger cities.

Among men living in small communities, 24 percent had never had an HIV test. In comparison, 14 to 17 percent of men living Vancouver and Toronto reported being untested.

The study also found that lower testing rates coincided with internalized homophobia and a reticence to inform healthcare providers about same-sex sexual activity. About one-third (35 percent) of participants in the did not disclose their sexual orientation to their healthcare provider.

Internalized homophobia and a lack of disclosure have been both linked to risky sexual behaviour. For instance, the study points out that MSM who are not out to their doctor may avoid requesting an HIV test due to fears about being perceived as gay.

Being involved or not involved in LGBT communities did not have any correlation to testing.

The study suggests that increased open communication between MSM and healthcare providers about same-sex sexual activity could increase HIV–testing rates. Also, internet-based initiatives and campaigns may be more effective in rural areas and smaller population centres, and may require different execution from how such strategies are conducted in urban centres.

According to the Public Health Agency of Canada, MSM represented 53 percent of HIV infections in 2014.