Correlates of HIV self-testing among female sex workers in China: implications for expanding HIV screening

Wang, Cheng; Wang, Ya Jie; Tucker, Joseph D.; Xiong, Ming; Fu, Hong; Smith, M. Kumi; Tang, Wei; Ong, Jason J.; Zheng, Huan; Yang, Bin

doi:10.1186/s40249-020-00765-5

Cited by 9 publications

(8 citation statements)

References 31 publications

(47 reference statements)

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“…In our study, HIV testing was associated with a history of self-reported STIs, which has also been reported in previous studies [ 36 ]. The reason may be that the Chinese government implemented provider-initiated HIV/syphilis testing and counselling (PITC) services to expand HIV testing for potential HIV-positive individuals in STD clinics.…”

Section: Discussionsupporting

confidence: 89%

Trends and associated factors in the uptake of HIV testing among female sex workers in Sino-Vietnam border areas in Guangxi, China: a cross-sectional study

Liang

Huang

et al. 2022

BMC Infect Dis

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Background HIV testing is a primary prevention strategy against the HIV epidemic and an entry point for HIV/AIDS-related care, prevention and treatment. This study aimed to estimate the uptake of HIV testing among Sino-Vietnam female sex workers (FSWs) in Guangxi, China, from 2016 to 2018, and to identify the factors influencing HIV testing uptake. Methods A cross-sectional survey was conducted among FSWs in two Sino-Vietnam border cities of Guangxi, China. The survey was conducted through face-to-face interview, the data were collected by a structured questionnaire, and HIV-1 infection was detected simultaneously. Logistic regression analysis was used to determine the factors associated with uptake of HIV testing. Results In total, 4565 Chinese local FSWs (CL-FSWs) and 636 cross-border migrant Vietnamese FSWs (CMV-FSWs) were recruited into this study. HIV-1 prevalence in CL-FSWs and CMV-FSWs was 0.70% and 3.14%, respectively. The rate of self-reported uptake of HIV testing in CL-FSWs and CMV-FSWs was 54.56% and 45.44%, respectively. The rates of self-reported uptake of HIV testing declined in both groups from 2016 to 2018. Logistic regression analysis indicated that a number of factors, including socio-demographic characteristics (age < 35 years, higher education, location in Chongzuo City), behaviour factors (having received free AIDS education, condom distribution services and peer education services, high risk sexual behaviours such as inconsistent condom use, having regular commercial sexual partners, etc.), psychological factors (perception of vulnerability to HIV/STIs, perception of risk for HIV infection) were the factors significantly related to uptake of HIV testing. Conclusion In recent years, the rate of HIV testing uptake among Sino-Vietnam border FSWs in Guangxi, China was low, which may be an important reason for the high HIV-1 prevalence among FSWs in the region. A number of factors were identified to be associated with HIV-1 testing uptake, suggesting that HIV testing prevention strategies in this region could include accelerating AIDS education training, raising personal awareness of HIV testing, and improving accessibility of HIV testing.

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Section: Discussionsupporting

confidence: 89%

Trends and associated factors in the uptake of HIV testing among female sex workers in Sino-Vietnam border areas in Guangxi, China: a cross-sectional study

Liang

Huang

et al. 2022

BMC Infect Dis

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“…A total of 23 studies investigated the proportion of those who previously self-tested. Only 2 studies reported on the prevalence of HIVST used in the past in HIV high-risk populations other than men who have sex with men (MSM) [ 43 , 51 ], with the lowest proportion of those who previously self-tested being the male clients of female sex workers (2.6%), as reported by Lau et al [ 51 ]. The highest prevalence of HIVST use in the past was observed in the study by Jin et al [ 62 ], that is, 74.5% in HIV-negative MSM.…”

Section: Resultsmentioning

confidence: 99%

“…HIV testing is a key entry point for HIV prevention and treatment programs. Previous studies have shown that HIVST may enhance HIV testing uptake, increase HIV testing frequency, and limit potential harm among key populations [ 9 , 43 ]. According to Figueroa et al [ 65 ], when using HIV rapid diagnostic tests with high accuracy, those who self-test may obtain results similar to those obtained by health care workers in health care settings.…”

Section: Discussionmentioning

confidence: 99%

The Practice and Potential Role of HIV Self-testing in China: Systematic Review and Meta-analysis

Xiu¹,

Qin²,

Bao³

et al. 2022

JMIR Public Health Surveill

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Background HIV self-testing (HIVST) is recommended by the World Health Organization as a valid approach to routine HIV testing services. The scale of HIVST use has gradually been expanded in China over the past 5 years. To take a closer look at the role of HIVST in China, we reviewed the promotion and application of HIVST within China. Objective The main objective of this study was to systematically analyze the proportion of past use and actual uptake of HIVST within China. Moreover, we aimed to quantify the effect of HIVST on HIV prevention and treatment. Methods In all, 5 medical databases and 2 registration systems, including PubMed, Web of Science, MEDLINE, WanFang, China National Knowledge Internet, ClinicalTrials.gov, and the Chinese Clinical Trial Registry were systematically searched for studies reporting the prevalence of HIVST use from January 1, 2010, to December 25, 2021. Meta-analyses of the pooled proportion estimates were carried out by the meta-package in R software (version 4.1.2). Statistical heterogeneity among the studies was estimated using Cochran Q test and the inconsistency index (I2). Results A total of 50 studies were included in our systematic review. The estimated pooled prevalence of HIVST use in China was 29.9% (95% CI 22.5%-37.9%). Among individuals who have ever used HIVST, 47.5% (95% CI 37.2%-57.8%) were tested for HIV for the first time. The pooled reactive rate of HIVST was 4.2% (95% CI 3.1%-5.8%). When HIVST revealed a reactive result, 81.3% (95% CI 70.9%-91.6%) of individuals sought medical care. Conclusions In recent times, HIVST has become a valuable tool for HIV prevention in China. The widespread use of HIVST in non–men who have sex with men populations needs to be endorsed and promoted. The long-term applications of HIVST and the potential consequences of self-financing of HIVST in China have yet to be explored. Trial Registration PROSPERO CRD42022304846; https://tinyurl.com/54d9pxy8

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“…Previously, few studies have assessed frequencies of testing, and instead a lot has been reported on the recent testing outcome (26). With the introduction of self-testing, studies have reported a potential benefit of increasing the frequency of HIV testing among FSWs (35,36) , this study therefore highlights a need for programs and studies to actively track complementary HIV testing outcomes including accessibility to HIV testing services, willingness to test and frequency of HIV testing among FSWs so that the data can be used for evidence based service delivery.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with adherence to HIV testing guidelines among HIV negative female sex workers in Kampala Uganda

Atuhaire

Shumba

Mapahla

et al. 2022

Preprint

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Background Frequent HIV testing at intervals of every three to six months is recommended among HIV negative female sex workers as the first entry point to HIV prevention and treatment. In this study, we examined the extent to which HIV negative female sex workers adhere to the testing guidelines by measuring the frequency of testing in the last 12 months and identified associated factors among female sex workers in Kampala Uganda. Methods We conducted a cross-sectional study using structured questionnaires. Using equal probability selection method, 12 hotspots were selected, and 200 participants interviewed based on proportional allocation in each hotspot. We used descriptive statistics to describe female sex workers' characteristics, and multivariable logistic regression model to determine the factors associated with their adherence to the HIV testing guidelines. Adherence to the HIV testing guidelines was defined as having tested three or more times in the last 12 months. Factors with p-value ≤0.05 significance level were considered statistically significant. Results From the 200 study participants, 43% were aged 25-30 years, joined sex work between the ages of 18 to 24 years, 49% had attained primary and 41% secondary school respectively. 88% reported HIV testing status, of which 56% had tested three or more times in the 12 months preceding the survey. Attaining secondary education, was independently associated with adherence to the HIV testing guidelines (OR 1.86, 95% CI: 1.01 - 3.44, p=0.047). Those that had tested for STIs in the last three months (OR= 2.13, 95% CI: 0.95 - 4.74, p=0.065) and accessed HIV testing in a drop-in centre (OR= 5.90, 95% CI: 0.71 - 49.1, p=0.101) had higher odds of adhering to the HIV testing guidelines Conclusion This study found suboptimal adherence to the HIV testing guidelines among HIV negative female sex workers. Interventions such as HIV self-testing that improve access to, and frequency of HIV testing need to be taken to scale. There is need for rigorous behaviour change program evaluation to continually refine understanding of the message mix, to ensure simplified and easy to comprehend awareness messages are designed for female sex workers with no formal education.

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Correlates of HIV self-testing among female sex workers in China: implications for expanding HIV screening

Cited by 9 publications

References 31 publications

Trends and associated factors in the uptake of HIV testing among female sex workers in Sino-Vietnam border areas in Guangxi, China: a cross-sectional study

Trends and associated factors in the uptake of HIV testing among female sex workers in Sino-Vietnam border areas in Guangxi, China: a cross-sectional study

The Practice and Potential Role of HIV Self-testing in China: Systematic Review and Meta-analysis

Factors associated with adherence to HIV testing guidelines among HIV negative female sex workers in Kampala Uganda

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