HIV-testing behavior among young migrant men who have sex with men (MSM) in Beijing, China

Abstract

Previous studies suggested a rapid increase of HIV prevalence among MSM in China in recent years, from 0.4% in 2004 to 5.8% in 2008. However, some MSM had never been tested for HIV. In order to expand the accessibility to HIV testing, understanding HIV testing behavior and barriers among MSM is important. Using data collected from 307 young migrant MSM (aged 18-29 years) in 2009 in Beijing, we aimed to identify psychological and structural barriers to HIV testing. MSM were recruited through peer outreach, informal social networks, internet outreach, and venue-based outreach. Participants completed a confidential self-administered questionnaire.Results show that about 72% of MSM had ever had HIV testing. Logistic regression analysis indicated that the HIV testing behavior was associated with sexual risk behaviors (e.g., multiple sexual partners, inconsistent condom use for anal sex) and history of STDs. Eighty four MSM (28%) who had never had HIV testing reported that the psychological barriers mainly were perceived low risk of HIV infection and fears of being stigmatized. The structural barriers reported included inconvenience of doing test and lack of confidentiality. Future HIV prevention programs should be strengthened among MSM to increase their awareness of HIV risk. Efforts are needed to increase access to quality and confidential HIV testing among MSM and reduce stigma against MSM.

HIV Testing Behaviors Among Female Sex Workers in Southwest China

“…Such rates of testing were higher than the general population in China (2.3-6%), [20,25,26] but lower than other vulnerable populations such as MSM (72.3%) [30]. Comparing with FSW in other Asia countries, such a rate is relatively low.…”

Barriers and Facilitators of Linkage to and Engagement in HIV Care Among HIV-Positive Men Who Have Sex with Men in China: A Qualitative Study

“…12 Since 2003, the establishment and scale-up of the ''Four Free and One Care''[free ARV drugs, free prevention of motherto-child transmission, free voluntary counseling and testing (VCT), free schooling for children orphaned by AIDS, and care to people living with HIV/AIDS] policy 13,14 in China has been the major strategy to facilitate HIV diagnosis and treatment of infected individuals and contain HIV transmission among key populations such as FSW, PWID, former illegal plasma donors, and MSM. 15,16 Free HIV testing is available at Centers for Disease Control and Prevention (CDC) VCT clinics at provincial, city/ prefectural and district/country levels across the country, and free ART is available to HIV-infected individuals with CD4 count <500 cells/lL. 10 For those not on ART, they are eligible to receive one free CD4 and HIV viral load test each year, but patients have to pay for additional tests.…”

HIV Treatment Cascades that Leak: Correlates of Drop-off from the HIV Care Continuum among Men who have Sex with Men Worldwide

“…These gaps are particularly true for MSM as evidenced by persistently high HIV prevalence and incidence rates. For MSM, HIV responses at the country level continue to be seriously hampered by daily experiences of stigma, discrimination, violence and criminalization [17][18][19][20]. MSM who live in countries that criminalize homosexuality have higher mean scores on perceived homophobia scales and decreased access to basic HIV services, including access to ART, compared to MSM who live in countries with more supportive legal frameworks [21].…”