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Barriers and Facilitators of Rapid HIV and Syphilis Testing Uptake Among Filipino Transnational Migrants in China

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Abstract

Transnational migrant workers are known to be at high risk for HIV/STIs. This study estimated the point prevalence of HIV/syphilis and examined correlates of HIV/syphilis testing uptake among female migrant domestic workers in Macao, China. Data was obtained from 1363 female Filipino domestic workers who were offered free rapid HIV and syphilis testing. A mixed methods analysis was undertaken to examine correlates of testing and themes about reasons for not testing. Among 1164 women tested, there were no cases of HIV/syphilis observed and 199 (14.6%) refused HIV/syphilis testing. Greater social integration (aOR 1.12; 95% CI 1.02–1.24), having more than one sexual partner (aOR 1.65; 95% CI 1.02–2.65), and longer working hours on the testing day (aOR 0.97; 95% CI 0.94–1.00), were associated with testing uptake. Among those who tested, the majority (> 70%) had never tested before, suggesting the need to improve testing outreach. Qualitative themes about reasons for not testing included low perceived need and insufficient time. Individual and structural testing barriers should be reduced to optimize HIV/STI testing in migrant populations.

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Acknowledgement

This study would not have been possible without the kind support of Dr. Lei Chin Ion, Macau Health Bureau for their support of this study (provision of HIV and Syphilis testing kits, staff training, and other technical support and assistance). We would also like to thank our collaborating NGO, Macau-Caritas, and in particular, Ms. Julia Lam, Ms. Kitty Tam, and Mr. Paul Pun, and the entire Welanser Centre team, for providing the field site and ongoing support to this research. We also thank research assistants Chiela Alexis Pangan, Kay Lao, Paul Yip, Tristan Li, Peng Xiong, and Wei Shi for their assistance in data collection. Finally, maraming salamat! to our Filipino research participants who entrusted us with their testing results and for their participation in this study. Grant support was provided by the Macau Government and the grant R&DAO MYRG-2015-00111.

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Authors and Affiliations

  1. Global and Community Mental Health Research Group, Department of Psychology, Faculty of Social Sciences (E21), The University of Macau, Avenida da Universidade, Taipa, Macao (SAR), People’s Republic of China

    Brian J. Hall, Xinyu Yang, Lei Huang, Grace Yi & Edward W. W. Chan

  2. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Brian J. Hall & Carl A. Latkin

  3. Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Grace Yi

  4. Institute of Global Health and Infectious Disease, University of North Carolina, Chapel Hill, USA

    Joseph D. Tucker

  5. Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK

    Joseph D. Tucker

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  1. Brian J. Hall
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Correspondence to Brian J. Hall.

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Hall, B.J., Yang, X., Huang, L. et al. Barriers and Facilitators of Rapid HIV and Syphilis Testing Uptake Among Filipino Transnational Migrants in China. AIDS Behav 24, 418–427 (2020). https://doi.org/10.1007/s10461-019-02449-0

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