Approaches to HIV and STI Testing Among Heterosexually Active Women and Men in New York City.

New York City surveillance data document substantial heterosexual transmission of HIV and other sexually transmitted infections (STIs). Existing research provides limited insight into how heterosexual adults approach and use HIV and STI testing, an intervention that can inform the need for treatment and reduce onward transmission. Through in-depth interviews with 50 heterosexually active women and men in New York City conducted in 2023 and 2024, we found that testing for HIV and STIs was widespread and integrated into broader health care routines. Our exploratory study identified three primary approaches that participants used as needed: preemptive testing (used before having sex with new partners or discontinuing condom use); reactive testing (following heightened risk perceptions); and routine screening (as part of ongoing sexual health maintenance). Our findings suggest that for many heterosexually active women and men HIV and STI testing is an accessible and acceptable practice, which public health can promote to reduce transmission.