Toronto, June 2 (IANS): Men who live in small cities and have sex with other men are less likely to get an HIV test than their metropolitan counterparts, says a study.

The lower testing rates are likely connected to internalised feelings of homophobia and a reluctance to disclose sexual preferences at a doctor's office, the researchers said.

"This study shows that a lack of feeling accepted appears to not only pose mental health risks, it poses physical health risks," said Susan Holtzman, Associate Professor of Psychology at University of British Columbia in Canada.

"The fact that these men are reluctant to tell their doctor about their sexuality is something that requires attention in our healthcare system if we hope to increase the number of people tested for HIV," Holtzman noted.

The study, conducted in cooperation with the Living Positive Resource Centre in Kelowna, British Columbia, surveyed 153 people recruited through online dating sites and events in the gay community.

The researchers found that 24 per cent of men living in smaller communities had never had an HIV test, compared to the 14 to 17 per cent of untested men living in large Canadian cities such as Vancouver and Toronto.

The findings were published in the journal AIDS Care.