Skip to main content

Advertisement

SpringerLink
Log in

Effectiveness of HIV Self-testing on Regular HIV Testing Among Ever-Tested Men Who Have Sex Men in China: A Pragmatic Randomized Controlled Trial

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

The purpose of this study was to demonstrate the effectiveness of HIV self-testing (HIVST) on promoting regular HIV testing, which defined as having uptake HIV testing every three to 6 months, among men who have sex with men (MSM) in Guangzhou, China. 491 ever-tested MSM were recruited from a community-based HIV clinic and randomly assigned into either intervention arm that provided text message plus HIVST service (n = 250) or standard of care arm (n = 241) being a text message promoting HIV testing every 3 months. Overall, 73.7% (330/448) of the participants had uptake HIV testing, and 27.7% (124/448) of them reported ever used of an HIV self-test during study period. HIVST significantly increased regularly HIV testing among participants in the intervention arm compared with standard of care arm (77.4% vs 69.5%). HIVST as a supplement to the existing facility-based testing services is promising in promoting regular HIV testing among MSM in China. Trial registration number: ChiCTR1800016811.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data Availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. The LH. Divergent paths to the end of AIDS. Lancet HIV. 2017;4(9):e375.

    Article  Google Scholar 

  2. Chanda MM, Ortblad KF, Mwale M, Chongo S, Kanchele C, Kamungoma N, et al. HIV self-testing among female sex workers in Zambia: a cluster randomized controlled trial. PLoS Med. 2017;14(11):e1002442.

    Article  Google Scholar 

  3. Kelvin EA, George G, Mwai E, Kinyanjui S, Romo ML, Odhiambo JO, et al. A randomized controlled trial to increase HIV testing demand among female sex workers in Kenya through announcing the availability of HIV self-testing via text message. AIDS Behav. 2019;23(1):116–25.

    Article  Google Scholar 

  4. Zhu X, Zhang W, Operario D, Zhao Y, Shi A, Zhang Z, et al. Effects of a mobile health intervention to promote HIV self-testing with MSM in China: a randomized controlled trial. AIDS Behav. 2019;23:3129.

    Article  Google Scholar 

  5. Jamil MS, Prestage G, Fairley CK, Grulich AE, Smith KS, Chen M, et al. Effect of availability of HIV self-testing on HIV testing frequency in gay and bisexual men at high risk of infection (FORTH): a waiting-list randomised controlled trial. Lancet HIV. 2017;4(6):e241–50.

    Article  Google Scholar 

  6. Kelvin EA, George G, Kinyanjui S, Mwai E, Romo ML, Oruko F, et al. Announcing the availability of oral HIV self-test kits via text message to increase HIV testing among hard-to-reach truckers in Kenya: a randomized controlled trial. BMC Public Health. 2019;19(1):7.

    Article  Google Scholar 

  7. CDC. HIV testing and risk behaviors among gay, bisexual, and other men who have sex with men - United States. MMWR Morb Mortal Wkly Rep. 2013;62(47):958–62.

    Google Scholar 

  8. The National Institute for Health and Care Excellence. Increasing the uptake of HIV testing to reduce undiagnosed infection and prevent transmission among men who have sex with men 2011. https://www.nice.org.uk/guidance/ph34

  9. Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1–137.

    Article  Google Scholar 

  10. Patel RR, Patel S, Clarke E, Khan AW, Doshi B, Radcliffe KW. Guidance and practice on frequency of HIV and sexually transmitted infection testing in men who have sex with men - what is the European situation? Int J STD AIDS. 2014;25(3):213–8.

    Article  Google Scholar 

  11. Furegato M, Mitchell H, Ogaz D, Woodhall S, Connor N, Hughes G, et al. The role of frequent HIV testing in diagnosing HIV in men who have sex with men. HIV Med. 2018;19(2):118–22.

    Article  CAS  Google Scholar 

  12. Vargas SK, Konda KA, Leon SR, Brown B, Klausner JD, Lindan C, et al. The relationship between risk perception and frequency of HIV testing among men who have sex with men and transgender women, Lima, Peru. AIDS Behav. 2018;22:26.

    Article  CAS  Google Scholar 

  13. Zou H, Hu N, Xin Q, Beck J. HIV testing among men who have sex with men in China: a systematic review and meta-analysis. AIDS Behav. 2012;16(7):1717–28.

    Article  Google Scholar 

  14. Cheng W, Egan JE, Liu Q, Xu H, Stall R, Friedman MR. Psychosocial correlates of HIV testing frequency among men who have sex with men in Guangzhou, China. AIDS Behav. 2020;24(2):363–72.

    Article  Google Scholar 

  15. Fernandez MI, Perrino T, Bowen GS, Royal S, Varga L. Repeat HIV testing among Hispanic men who have sex with men-a sign of risk, prevention, or reassurance? AIDS Educ Prev. 2003;15:105–16.

    Article  Google Scholar 

  16. Matkovic Puljic V, Kosanovic Licina ML, Kavic M, Nemeth BT. Repeat HIV testing at voluntary testing and counseling centers in Croatia: successful HIV prevention or failure to modify risk behaviors? PLoS ONE. 2014;9(4):e93734.

    Article  Google Scholar 

  17. Bai X, Xu J, Yang J, Yang B, Yu M, Gao Y, et al. HIV prevalence and high-risk sexual behaviours among MSM repeat and first-time testers in China: implications for HIV prevention. J Int AIDS Soc. 2014;17:18848.

    Article  Google Scholar 

  18. Qin Y, Tang W, Nowacki A, Mollan K, Reifeis SA, Hudgens MG, et al. Benefits and potential harms of human immunodeficiency virus self-testing among men who have sex with men in China: an implementation perspective. Sex Transm Dis. 2017;44(4):233–8.

    Article  Google Scholar 

  19. Zhong F, Tang W, Cheng W, Lin P, Wu Q, Cai Y, et al. Acceptability and feasibility of a social entrepreneurship testing model to promote HIV self-testing and linkage to care among men who have sex with men. HIV Med. 2017;18(5):376–82.

    Article  CAS  Google Scholar 

  20. Wang Z, Lau JTF, Ip M, Ho SPY, Mo PKH, Latkin C, et al. A randomized controlled trial evaluating efficacy of promoting a home-based HIV self-testing with online counseling on increasing HIV testing among men who have sex with men. AIDS Behav. 2018;22(1):190–201.

    Article  Google Scholar 

  21. Katz DA, Golden MR, Hughes JP, Farquhar C, Stekler JD. HIV self-testing increases HIV testing frequency in high-risk men who have sex with men: a randomized controlled trial. J Acquir Immune Defic Syndr. 2018;78(5):505–12.

    Article  Google Scholar 

  22. Wray TB, Chan PA, Simpanen E, Operario D. A pilot, randomized controlled trial of HIV self-testing and real-time post-test counseling/referral on screening and preventative care among men who have sex with men. AIDS Patient Care STDS. 2018;32(9):360–7.

    Article  Google Scholar 

  23. Merchant RC, Clark MA, Liu T, Romanoff J, Rosenberger JG, Bauermeister J, et al. Comparison of home-based oral fluid rapid HIV self-testing versus mail-in blood sample collection or medical/community HIV testing by young adult black, Hispanic, and white MSM: results from a randomized trial. AIDS Behav. 2018;22(1):337–46.

    Article  Google Scholar 

  24. Figueroa C, Johnson C, Verster A, Baggaley R. Attitudes and acceptability on HIV self-testing among key populations: a literature review. AIDS Behav. 2015;19(11):1949–65.

    Article  Google Scholar 

  25. Stekler JD, Ure G, O’Neal JD, Lane A, Swanson F, Maenza J, et al. Performance of determine combo and other point-of-care HIV tests among Seattle MSM. J Clin Virol. 2016;76:8–13.

    Article  Google Scholar 

  26. Figueroa C, Johnson C, Ford N, Sands A, Dalal S, Meurant R, et al. Reliability of HIV rapid diagnostic tests for self-testing compared with testing by health-care workers: a systematic review and meta-analysis. Lancet HIV. 2018;5(6):e277–90.

    Article  Google Scholar 

  27. Lim MS, Hocking JS, Hellard ME, Aitken CK. SMS STI: a review of the uses of mobile phone text messaging in sexual health. Int J STD AIDS. 2008;19(5):287–90.

    Article  Google Scholar 

  28. Cohen CE, Coyne KM, Mandalia S, Waters AM, Sullivan AK. Time to use text reminders in genitourinary medicine clinics. Int J STD AIDS. 2008;19(1):12–3.

    Article  CAS  Google Scholar 

  29. Stubbs ND, Geraci SA, Stephenson PL, Jones DB, Sanders S. Methods to reduce outpatient non-attendance. Am J Med Sci. 2012;344(3):211–9.

    Article  Google Scholar 

  30. Han L, Wei C, Muessig KE, Bien CH, Meng G, Emch ME, et al. HIV test uptake among MSM in China: Implications for enhanced HIV test promotion campaigns among key populations. Glob Public Health. 2017;12(1):31–44.

    Article  Google Scholar 

  31. Tang W, Mao J, Tang S, Liu C, Mollan K, Cao B, et al. Disclosure of sexual orientation to health professionals in China: results from an online cross-sectional study. J Int AIDS Soc. 2017;20(1):21416.

    Article  Google Scholar 

Download references

Acknowledgements

The authors are grateful to the amfAR GMT Program, which provided funding for the first author to receive training in HIV-related social and behavioral research at the University of Pittsburgh. We especially thank Michael Cowing, Kent Kozad, and Monica Coniglio at amfAR for their stewardship. The authors thank all the staff of the Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, and Lingnan Partner Community Support Center for their contribution in helping the data collection. We also feel grateful for voluntary participation of subjects in the study.

Funding

This work was supported by amfAR, the Foundation for AIDS Research (GMT 109335-9). The funders had no role in the study design, data collection, data analysis, data interpretation, or writing of the manuscript.

Author information

Authors and Affiliations

  1. Guangdong Second Provincial General Hospital, No. 466 Xinguangzhong Road, Haizhu District, Guangzhou, 510317, Guangdong, China

    Weibin Cheng

  2. Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China

    Weibin Cheng, Fei Zhong & Huifang Xu

  3. Department of Behavioral and Community Health Sciences, Graduate School of Public Health, Center for LGBT Health Research, University of Pittsburgh, Pittsburgh, PA, USA

    James E. Egan, Ron Stall & M. Reuel Friedman

  4. Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    M. Reuel Friedman

Authors
  1. Weibin Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. James E. Egan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fei Zhong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Huifang Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ron Stall
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Reuel Friedman
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

WC, JEE, RS, and MRF conceived the study. WC wrote the protocol and received inputs from all the authors. WC and FZ involved in field survey data collection. FZ and HX were involved in HIV testing verification. FZ was involved in the randomization, data management, and statistical analysis. HX and RS provided expert knowledge and oversaw the study. WC and MRF prepared the manuscript. All authors contributed to the interpretation of results and contributed to the writing of the paper, and approved the final version for submission.

Corresponding author

Correspondence to Weibin Cheng.

Ethics declarations

Conflict of interest

We declare no competing interests.

Ethical Approval

Ethics approval was obtained from the ethics review boards of the Guangzhou Center for Disease Control and Prevention and the University of Pittsburgh (protocol 15040542).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Electronic supplementary material 1 (DOCX 18 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cheng, W., Egan, J.E., Zhong, F. et al. Effectiveness of HIV Self-testing on Regular HIV Testing Among Ever-Tested Men Who Have Sex Men in China: A Pragmatic Randomized Controlled Trial. AIDS Behav 25, 3494–3502 (2021). https://doi.org/10.1007/s10461-021-03161-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-021-03161-8

Keywords

Search

Navigation