Frequent HIV Testing: Impact on HIV Risk Among Chinese Men Who Have Sex with Men

Abstract

Background The HIV epidemic continues to expand among men who have sex with men (MSM) in China. The NIMH Project Accept/HPTN 043 trial suggested a borderline significant trend towards HIV incidence reduction among persons with higher testing rates. Methods We assessed HIV testing histories and infection status among a community-based Beijing MSM. HIV serostatus was lab-confirmed. We ascertained demographic/behavioral factors via questionnaire-based interviews. Associations of prior HIV testing with odds of current HIV infection were assessed, seeking improved like-with-like risk comparisons through multivariable logistic regression analysis with propensity score adjustment and restricted cubic spline modeling. Results Among 3,588 participants, 12.7% were HIV-infected; 70.8 % reported having ever tested for HIV. Compared to MSM who never tested, those ever testing had a 41% reduction in the odds of being HIV-positive (adjusted odds ratio [aOR], 0.59; 95% confidence interval [CI]: 0.48, 0.74). Higher HIV testing frequencies were associated with a decreasing trend in the odds of being infected with HIV vs. a referent group with no prior testing (>6 tests [aOR: 0.27; 95%CI: 0.18, 0.41]; 4–6 [aOR: 0.55; 95%CI: 0.39, 0.78]; 2–3 [aOR: 0.61; 95%CI: 0.45, 0.82]; P for trend <0.001). The multivariable adjusted model with restricted cubic spline of HIV testing frequency showed a higher frequency of prior HIV testing associated with lower odds of HIV infection, particularly among men with ≥10 lifetime male sexual partners. Conclusions Using risk probability adjustments to enable less biased comparisons, frequent HIV testing was associated with a lower HIV odds among Chinese MSM.

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“…for transportation costs. Detailed measures of the variables and laboratory techniques are documented elsewhere [23, 24, 26]. …”

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