Uptake of provider-initiated HIV and syphilis testing among heterosexual STD clinic patients in Guangdong, China: results from a cross-sectional study

Abstract

ObjectivesUnderscreening of HIV and syphilis in clinical settings is pervasive in resource-constrained settings. Heavy patient loads and competing health priorities in these settings inhibit provider’s ability to meet screening coverage targets. The objective of this study was to examine determinants of provider-initiated HIV and syphilis testing uptake at sexually transmitted disease (STD) clinics in China.DesignA cross-sectional study was performed between July 2016 and December 2016.SettingSeven STD clinics in Guangdong Province, China.ParticipantsHeterosexual STD clinic patients met the inclusion criteria, regardless of their interest in receiving HIV or syphilis testing.Outcome measuresThe syphilis and HIV testing uptake determined by patient receipt of results.ResultsA total of 1943 individuals were recruited in this study. Among those participants, 60.6% (1177/1943) and 74.3% (1443/1943) conducted HIV testing and syphilis testing during the study, respectively, of whom, 2.2% (26/1177) and 21.5% (310/1443) were found to be HIV-positive and syphilis-positive, respectively. The most common reason for rejecting HIV and syphilis testing was a low self-perceived risk of HIV and syphilis infection. After adjusting for covariates, condom use in the last sexual act, consistent condom use in the last 6 months, having paid sex in the last 6 months and having received any kind of HIV/STD-related knowledge during the last 12 years were positively associated with both HIV and syphilis testing uptake.ConclusionsThe low-level of HIV and syphilis testing uptake, alongside with the high-level of engagement in risky sexual behaviours among heterosexual STD clinic patients, warranted a more targeted and intensive behavioural interventions to promote HIV and syphilis testing in this population.

Different Trends of Distinct Time Points of AIDS Events Following HIV Diagnosis in Various At-risk Populations: A Retrospective Nationwide Cohort Study in Taiwan

“…Barriers to aVCT cascade include a low perceived risk of HIV infection and the fear of discrimination or stigma [ 46 ]. Consistent with other studies [ 5 , 47 ], late presenters are even more common among heterosexual populations than among MSM; this is attributable to the lower HIV testing rates among heterosexual people because of the low perceived risk [ 48 , 49 ]. More alarming, however, is the high proportion of AIDS events in MSM due to late presentation.…”

The impact of COVID-19 pandemic on HIV care continuum in Jiangsu, China

“…For example, there was a gap between the number of newly diagnosed HIV cases and the estimated number of HIV cases expected. Also, sexual transmission became the dominant transmission route [ 11 ], and the prevalence of unsafe sexual behaviors among high-risk populations such as men who have sex with men (MSM) increased [ 12 – 14 ].…”

Missed opportunities for HIV testing among those who accessed sexually transmitted infection (STI) services, tested for STIs and diagnosed with STIs: a systematic review and meta-analysis.

“…Amongst clients tested for HIV while attending an STI service, integration of HIV counselling and education (e.g. peer-based education targeting youth, provider-initiated testing and counselling (PITC)) into HIV testing was associated with increased HIV testing uptake [20, 27].…”

“…Three studies of varying population types (clients with STIs, clients attending an STI clinic and people attending a genitourinary medicine clinic) elaborated that a low perceived susceptibility to HIV acted as deterrence for testing; this included people who felt that they had no or little exposure to HIV risk factors [19][20][21]. Amongst those tested for STIs, two studies mentioned that most participants chose not to accept an HIV test as they had previously been tested [20,22]. Fear of HIV testing (including the fear of result disclosure, needle phobia, fear of financial costs) was a common reason for refusing the test amongst all clients [21][22][23].…”