HIV self-testing offers an alternative to facility-based testing that could expand HIV testing among MSM. We organized an online survey of MSM in China to better understand the frequency and correlates of HIV self-testing. A total of 1342 individuals completed the survey. 20.3% of MSM reported prior HIV self-testing. Self-testing was correlated with being married, having six or greater male anal sex partners in the past three months, and having HIV tested within 12 months in the multivariable analysis. Our study suggests that HIV self-testing may be able to reach sub-groups of high-risk MSM and enable more frequent HIV testing.

BackgroundHuman immunodeficiency virus (HIV) infection disproportionately affects men who have sex with men (MSM). Over half of all HIV-positive MSM in China may not know their HIV status. Mobile phones and Web interventions (eHealth) are underutilized resources that show promise for supporting HIV education, testing, and linkage to care.ObjectiveThis mixed-methods study among MSM in China assessed technology utilization and eHealth acceptability for sexual health care.MethodsWe conducted in-depth interviews and an online survey. Qualitative analyses informed the development of the Internet survey, which was administered through two popular MSM websites. Bivariate and multivariate analysis assessed characteristics of MSM interested in eHealth for sexual health care.ResultsThe qualitative sample included MSM across a range of ages, education, marital status, sexuality, and HIV testing experience. Qualitative findings included the importance of the Internet as the primary source of information about sexual health, HIV and other sexually transmitted diseases (STDs), use of the Internet to enable HIV testing opportunities by facilitating connections with both the gay community and health care providers, and mixed perceptions regarding the confidentiality of eHealth tools for sexual health. Among the Internet sample (N=1342), the average age was 30.6 years old, 82.81% (1098/1342) were single, and 53.42% (711/1331) had completed college. In the past 3 months, 38.66% (382/988) had condomless sex and 60.53% (805/1330) self-reported having ever tested for HIV. The majority of men owned computers (94.14%, 1220/1296) and mobile phones (92.32%, 1239/1342), which many had used to search for HIV/STD information and testing sites. In multivariate analysis, interest in using computers or mobile phones to support their sexual health care was associated with being a student, prior use of computers or mobile phones to search for general health information, prior use of computers or mobile phones to search for HIV/STD information, and confidentiality concerns.ConclusionsMSM in this sample had high utilization of technology and interest in eHealth despite confidentiality concerns. Future eHealth interventions can thoughtfully and creatively address these concerns as a priority for successful implementation.

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Massive rural–urban migration in China has drawn attention to the prevalence of mental health problems among migrants. Research on the mental health of Chinese migrants has a narrow focus on rural–urban migrants, emphasizing the institutional role of hukou in migrant mental health. We argue that the heterogeneity of migrants, including their place of origin and whether they are temporary or permanent migrants, should be taken into account when trying to understand the meaning of migration as an actual movement from one place to another. The data used for this study is from a cross-sectional survey (N = 855) conducted in Shenzhen to compare the differences in migrants’ mental health that arise when using the two definitions (e.g., hukou and birthplace). Binary logistic regression models were estimated to assess the associations between people’s mental health and migration, while controlling for settlement experiences, self-reported physical health, and sociodemographics. The results reveal inconsistent findings across both definitions: general migrants by birthplace were found to be unlikely to have mental problems compared to non-migrants, whereas temporary migrants were at higher risk of mental problems. The study provides important evidence that different migrant groups have different mental health outcomes. The choice of the definition used influences both migrant group selection and the actual linkage between migration and mental health.

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