HIV self-testing and potential linkage to care among men who have sex with men in China: a cross-sectional online survey

Fan Yang1,2,3, Weiming Tang1,2,3, Yuan Xiong1,2, Cheng Wang3

1. University of North Carolina at Chapel Hill Project-China, Guangzhou, China;

2. SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China;

3. Southern Medical University Dermatology Hospital, STD Control Department, Guangzhou. China


 HIV self-testing (HIVST) was recommended by the World Health Organization as an additional way for improving HIV testing due to its advantage in privacy and convenience. Studies showed that HIVST was well accepted among men who have sex with men (MSM) in China. This study aims to investigate the situation of HIVST usage, its correlates and implications for linkage to care among Chinese MSM.



 Data were collected from a nationwide online survey. Men who ever had sex with another man, were 16 years or older, born as a male, and ever tested for HIV were eligible. Survey collected information on HIVST. Sociodemographic and behavioral data were also collected and assessed in relation to HIVST through bivariate analyses. We characterized linkage to care after receiving a HIV-positive confirmatory results among self-testers and facility-based testers (i.e. who never self-tested).



 Among 699 men who ever tested for HIV (age: 27.3±6.6), most were never married (84.7%, 592/699) and completed college (52.2%, 365/699). 58.1% (406/699) reported having been self-tested.    70% (489/699) considered themselves as gay and  61.8% of them (302/489) had ever received HIV self-testing. Over 60% (352/699)   reported never had sex while they and/or their partners were drunk in the last three months, and of these 352 men, 64.5% had ever self-tested for HIV. MSM who did not disclose their sexuality with family or friends were less likely to take HIVST than those who disclosed their sexuality (OR=0.51, 95%CI: 0.37-0.70).  The chance of taking HIVST was significantly lower in MSM who paid to have sex only with woman or both man and woman than those who never paid to have sex (OR=0.25, 95%CI: 0.11-0.57).



   Many men received HIVST. Men with higher education, had disclosed their sexuality with family or friends, or never paid to have sex were more likely to be ever self-tested.