Bridging the HIV-syphilis testing gap: dual testing among men who have sex with men living in China

Ong, Jason J.; Liao, Meizhen; Lee, Amy; Fu, Hongyun; Pan, Stephen W.; Tang, Weiming; Wei, Chongyi; Wu, Dan; Yang, Bin; Yang, Ligang; Wang, Cheng; Tucker, Joseph D.

doi:10.1136/sextrans-2018-053527

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…[16] Our study also demonstrated that secondary distribution is a feasible approach for promoting syphilis selftesting among MSM with a combined HIV/syphilis testing kit. Integrating syphilis testing into existing HIV testing services has been recommended by the WHO [14,29], however, few studies have examined effective strategies to accelerate the uptake of syphilis self-testing integrated with rapid HIV self-tests.While recent evidence showed that integrating syphilis self-testing into HIV self-testing services may be a feasible strategy to A c c e p t e d M a n u s c r i p t improve syphilis test uptake among MSM [18,30], secondary distribution of a dual HIV/syphilis test kit is a promising strategy for further expanding syphilis test coverage among this at-risk population.The model may also have implications for integrating multiple STIs self-testing services into HIVST secondary distribution programs.…”

Section: Discussionmentioning

confidence: 99%

Social Media–Based Secondary Distribution of Human Immunodeficiency Virus/Syphilis Self-testing Among Chinese Men Who Have Sex with Men

Zhou²,

Yang

et al. 2020

Clinical Infectious Diseases

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Background Social media and secondary distribution (distributing self-testing kits by indexes through their networks) both show strong promise to improve HIV self-testing uptake. We assessed an implementation program in Zhuhai, China, which focused on the secondary distribution of HIV/syphilis self-test kits among men who have sex with men (MSM) via social media. Methods Men of age 16 or above, born biologically male, and ever had sex with another man were recruited as indexes. Banner ads on a social media platform invited the participants to apply for up to five self-test kits every three-months. Index men paid a deposit of 15 USD/kit refundable upon submitting a photograph of a completed test result via an online submission system. They were informed that they could distribute the kits to others (referred to as “alters”). Results A total of 371 unique index men applied for 1150 kits (mean age=28.7±6.9), of which 1141 test results were returned (99%). Among them, 1099 were valid test results, 810 (74%) were from 331 unique index men, and 289 tests (26%) were from 281 unique alters. Compared to index men, a higher proportion of alters were naïve HIV testers (40% VS. 21%, P<0.001). The total HIV self-test reactivity rate was 3%, with alters having a significantly higher rate than indexes(5% VS 2%, P=0.008). A total of 21 people (3%) had a reactive syphilis test result. Conclusions Integrating social media with the secondary distribution of self-test kits may hold promise to increase HIV/syphilis testing coverage and case identification among MSM.

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Section: Discussionmentioning

confidence: 99%

Social Media–Based Secondary Distribution of Human Immunodeficiency Virus/Syphilis Self-testing Among Chinese Men Who Have Sex with Men

Zhou²,

Yang

et al. 2020

Clinical Infectious Diseases

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“…Factors contributing to HIV transmission among MSM in the region include the use of social media and entertainment venues (i.e. bath houses) to seek casual sexual partners, high-risk sex associated with alcohol and recreational drug use [5][6][7][8][9] and concurrent sexually transmitted infections [10][11][12]. While specific vulnerabilities to HIV infection experienced by young MSM are less well understood, lower levels of HIV awareness and self-perceived risk, peer influence from older MSM and the exchange of sex for resources have been identified as transmission drivers [5].…”

Section: Introductionmentioning

confidence: 99%

Alarmingly High HIV Prevalence Among Adolescent and Young Men Who have Sex with Men (MSM) in Urban Indonesia

Johnston

Soe²,

Widihastuti³

et al. 2021

AIDS Behav

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Indonesia’s HIV epidemic is concentrated among key populations. While prevalence among men who have sex with men (MSM) is high, transmission among young MSM (15–24-years-old) remains poorly understood. We conducted a respondent driven sampling survey of 211 young MSM in urban Bandung, Indonesia in 2018–2019 to estimate HIV prevalence and associated risk factors. Thirty percent of young MSM were HIV antibody positive. This is nearly 100-fold greater than Indonesia’s population prevalence and sevenfold higher than average estimates for young MSM across Asia and the Pacific Region. Individual risk factors associated with HIV infection were being 20–24 years old, having a steady partner and preferring the receptive position during sex. Issues of stigma, discrimination and social exclusion were common. Few young MSM who were open with friends and family members about their sexual identity. Among those that were, close to half reported experiencing feelings of aversion from these groups. Wider structural factors that reduce social tolerance, restrict the rights of young MSM and compel concealment of sexual identity are likely to fuel high-risk behaviors and limit access to essential testing care and support services including pre-exposure prophylaxis which is not yet widely available. Urgent health, social, legal and political actions are required to respond to these factors and reduce the disproportionate contribution of young MSM to Indonesia’s HIV epidemic.

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“…Syphilis screening is important for the control of both syphilis and HIV-1 infection. However, a large number of HIV-positive MSM do not receive syphilis testing as recommended ( 10 , 14 , 15 ). In our study, 56.7% of newly diagnosed HIV-infected MSM refused to take syphilis testing although it is provided for free in China.…”

Section: Discussionmentioning

confidence: 99%

“…In China, despite the launch of a nationwide 10-year syphilis control plan in 2010 to promote the integration of HIV-1 and syphilis testing in the clinics of sexually transmitted infections (STIs) (10), there has been a continuous increase of syphilis cases and HIV-1/syphilis co-infections among MSM over the past decade (3,(11)(12)(13), due to low uptake of syphilis testing among HIV-infected MSM and other high-risk individuals in China (10,13,14). Furthermore, the current syphilis screening service might not fully cover all the risk groups.…”

Section: Introductionmentioning

confidence: 99%

Syphilis Testing as a Proxy Marker for a Subgroup of Men Who Have Sex With Men With a Central Role in HIV-1 Transmission in Guangzhou, China

Huang

Yan

et al. 2021

Front. Med.

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Objectives: The objectives of this study were to distinguish the role of men who have sex with men (MSM) with or without syphilis testing in HIV-1 transmission and to provide molecular evidence of syphilis testing as a proxy marker for identifying the subgroup of MSM.Methods: HIV-1 transmission clusters were constructed by HIV-TRACE and Cluster Picker using HIV-1 pol sequences from 729 newly diagnosed HIV-infected MSM from 2008 to 2012 in Guangzhou, China. The role of MSM in HIV-1 transmission networks was determined by a node influence measurement and centrality analysis. The association between syphilis testing and factors related to HIV-1 transmission and antiretroviral treatment (ART) were analyzed by the Cox regression model.Results: Among HIV-infected MSM, 56.7% did not test for syphilis at the time of HIV-1 diagnosis. MSM without syphilis testing was a specific subgroup of MSM with a larger closeness centrality and clustering coefficient than the recipients of syphilis testing (P < 0.001), indicating their central position in the HIV-1 transmission networks. The median degree and radiality within HIV-1 transmission networks as well as the median K-shell scores were also greater for MSM without syphilis testing (P < 0.001), suggesting their relatively greater contribution in transmitting HIV-1 than the receipts of syphilis testing. MSM with syphilis testing usually did not disclose their occupation or were more likely to be unemployed or to take non-skilled jobs, to have a history of sexually transmitted infections (STIs), and to be AIDS patients when diagnosed with HIV-1 infection (P < 0.05). Multivariable Cox regression analysis indicated that syphilis testing per se did not promote the engagement of ART (P = 0.233) or affect the speed of CD4+ T cell count recovery after treatment (P = 0.256).Conclusions: Our study identifies syphilis testing as a proxy marker of a specific subgroup of HIV-infected MSM who refuse syphilis testing during HIV-1 diagnosis with an important role in HIV-1 transmission. Specific prevention and intervention targeting MSM without syphilis testing during HIV-1 care are urgently needed.

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Bridging the HIV-syphilis testing gap: dual testing among men who have sex with men living in China

Abstract: Chinese MSM are dual testing through a variety of test sites, including home self-testing. However, the overall dual testing rate remains low despite recent efforts to integrate HIV and syphilis testing.

Cited by 5 publications

References 7 publications

Social Media–Based Secondary Distribution of Human Immunodeficiency Virus/Syphilis Self-testing Among Chinese Men Who Have Sex with Men

Social Media–Based Secondary Distribution of Human Immunodeficiency Virus/Syphilis Self-testing Among Chinese Men Who Have Sex with Men

Alarmingly High HIV Prevalence Among Adolescent and Young Men Who have Sex with Men (MSM) in Urban Indonesia

Syphilis Testing as a Proxy Marker for a Subgroup of Men Who Have Sex With Men With a Central Role in HIV-1 Transmission in Guangzhou, China

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