HIV Serostatus Disclosure Among Men Who Have Sex with Men in China in the Era of U=U and PrEP

Abstract

Given the recent evidence on “Undetectable = Untransmittable” (U=U) and pre-exposure prophylaxis (PrEP), the present study aimed to investigate HIV disclosure behaviors and their associations with sexual risk behaviors and U=U and PrEP awareness among men who have sex with men (MSM) in China. A cross-sectional survey was conducted among 689 MSM recruited through a gay-friendly non-governmental organization located in Chengdu, China in 2018–2019. Information was collected by a structured self-administrated questionnaire. The enrolled sample included 554 (80.4%) participants who were HIV-negative and 135 (19.6%) participants with an unknown HIV status. In terms of disclosure, 41.4% of participants informed all partners about their HIV status all the time (informing behavior), while 30.4% asked all partners about their HIV status all the time (asking behavior). Only one-fifth knew about U=U, but this was not statistically associated with either informing or asking behavior. Half (50.5%) had heard of PrEP but this was not statistically associated with either informing or asking behavior. Common barriers to informing and asking behaviors were lower risk perception of HIV infection, a history of sexually transmitted infections, engagement in receptive sex, and a history of sex with casual partners. We found that both U=U and PrEP awareness and HIV serostatus disclosure were infrequent and not associated in this study of Chinese MSM. These data indicate huge information gaps among MSM in China.

WeChat-Based HIV e-Report, a New Approach for HIV Serostatus Requests and Disclosures Among Men Who Have Sex With Men: Prospective Subgroup Analysis of a Randomized Controlled Trial

“…Finally, previous studies indicated that HIV testing is positively associated with HIV serostatus request and disclosure [ 22 , 27 ], and our study found corroborating results. Furthermore, MSM who had higher HIV testing social norm scores and had intervened in any HIV-related programs were more likely to request HIV serostatus.…”

“…Only a few studies have investigated HIV serostatus request behavior, and our data contribute to the literature [ 5 , 6 ]. Some influence factors have been identified in studies, such as perceived high HIV risk, lower HIV-related stigma, and greater engagement with the MSM community [ 26 , 27 ]. HIV serostatus request, as a proactive behavior, which can elevate the importance of consciousness about HIV serostatus disclosure before sex, has ample room for improvement among MSM.…”

Sexual Risk Behaviors and HIV Incidence Among Men Who Have Sex with Men in Southern China: Investigating the Role of HIV Serostatus Disclosure

“…Our study indicated that MSM who had undergone HIV testing in the last 3 months were more likely to be aware of their partner's HIV serostatus. This nding is in line with previous studies analyzing factors associated with HIV serostatus disclosure and demonstrates that the lack of HIV testing was one of the main reasons for low HIV serostatus disclosure among Chinese MSM [25,27,29]. HIVST as a complement to conventional facility-based HIV testing services, is expected to promote HIV serostatus disclosure among MSM.…”