HIV care-seeking behaviour after HIV self-testing among men who have sex with men in Beijing, China: a cross-sectional study

Abstract

BackgroundMen who have sex with men (MSM) has become the group with the fastest growing HIV epidemic in China. Since many Chinese MSM are conducting HIV self-testing, we aimed to determine the rate of HIV care seeking after self-testing, examine characteristics of “seekers” compared to “non-seekers,” and explore factors associated with HIV care-seeking behaviour.MethodsA cross-sectional study design was used and an online survey was conducted in Beijing, China in 2016, among users of a popular Chinese gay networking smart phone application. Chi-square test was used to compare characteristics of those who sought HIV care (“seekers”) and those who did not (“non-seekers”). Univariate and multivariate logistic regression analyses were conducted to assess factors associated with HIV care seeking.ResultsAmong 21,785 screened, 2383 participants (10.9%) were included in the study. A total of 380 participants (15.9%) reported seeking HIV care after HIV self-testing while 2003 (84.1%) did not. Lack of knowledge of the “window period” (adjusted odds ratio [AOR] = 0.68, 95% confidence interval [95% CI] = 0.47–0.97, P = 0.04) was associated with reduced odds of seeking HIV care, while lower monthly income (AOR = 1.29, 95% CI = 1.03–1.62, P = 0.03) and obtaining HIV self-testing kits from health facilities (AOR = 2.40, 95% CI = 1.81–3.17, P < 0.001), and non-governmental organizations (AOR = 2.44, 95% CI = 1.79–3.34, P < 0.001) was associated with increased odds of seeking HIV care. Among those who sought HIV care, a large majority (92.4%) had non-reactive HIV self-testing results. Only 29 out of 265 with reactive, uncertain, or unknown results sought HIV care.ConclusionsWe found a very low rate of HIV care seeking among our sample of urban Chinese MSM. The observation that most with reactive, uncertain, or unknown results did not seek HIV care is a cause for concern. These people should be paid more attention and helped to enter the care cascade. Our findings highlight that interventions aimed at improving linkage to care after HIV self-testing are urgently needed. However, further study is required to inform the design and implementation of future interventions aiming to encourage HIV care-seeking behaviour.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0326-y) contains supplementary material, which is available to authorized users.

Individual-level characteristics associated with oral HIV test acceptability among Peruvian men who have sex with men and transgender women: a cross-sectional study

“…In a similar study in India, willingness to use an HIV self-test in the future was associated with HIV self-testing performed currently 28. With our result we hypothesise that MSM who agree to future check-ups with an oral HIV test will prefer to perform a self-test at home.…”

“…While our study participants reported a very low frequency of sex under the influence of drugs in the last month, sex with drug use was nonetheless associated with oral HIV test acceptability. Similarly, a recent study in China on the determinants of HIV self-testing found a high association between HIV self-testing and lifetime drug use among MSM 28. Another study of MSM in the USA using injectable drugs during sex found a greater predisposition to non-invasive HIV testing using oral fluids or urine which was explained by their already constant use of needles 29.…”

Uptake of HIV self‐testing and linkage to treatment among men who have sex with men (MSM) in Nigeria: A pilot programme using key opinion leaders to reach MSM

“…The high linkage to treatment in this study is likely due to follow‐up calls by the counsellor after HIVST distribution, the participant's access to their KOLs, and most importantly, the linkage to a well‐trusted MSM‐friendly facility that offers not only HIV prevention services but also HIV treatment. Studies in low‐resource settings among MSM have reported both fairly low and high linkage to HIV care and treatment after self‐testing.…”

Adaptation of a Health Education Program for Improving the Uptake of HIV Self-Testing by Men in Rwanda: A Study Protocol

“…These cultural and traditional masculine identities have been constructed by the societies and often inform men's health seeking behavior [14]. Poor service delivery, long waiting times to obtain the results, concerns over confidentiality, and HIV related-stigma have been reported elsewhere as impeding men's uptake of HTSs [13,15,16]. The World Health Organization (WHO) published the first global guidelines on HIV self-testing (HIVST) in 2016 [17]-an intervention that has shown global potential to increase uptake of HTSs [13,[18][19][20][21].…”