Psychosocial Correlates of HIV Testing Frequency Among Men Who Have Sex with Men in Guangzhou, China
We examined sociodemographic and psychosocial factors associated with HIV testing patterns in the past 2 years among 492 HIV-negative men who have sex men (MSM) at an HIV testing center in Guangzhou, China. MSM who tested for HIV frequently were more likely to be older, reside in Guangzhou, and have higher monthly income. Compared with MSM who tested frequently, MSM who never tested were less likely to report that their sexual partner(s) had ever received HIV tests or that their good friends had ever received HIV tests, and were less likely to report having an HIV-positive gay friend or ever discussing HIV with sexual partners; they were more likely to report perceiving barriers to HIV testing. Compared with MSM who tested frequently, those who tested irregularly were less likely to report having HIV-positive gay friends or to disclose their sexual orientation to non-gay friends; reported greater barriers to HIV testing; and higher internalized homophobia.
KeywordsHIV testing Frequency Psychosocial factors China MSM
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. Preliminary results informing this manuscript were presented in poster form at the Lancet-CAMS Summit (2017), an abstract of which has been published here: Cheng, W., Friedman, M. R., Egan, J. E., Liu, Q., Xu, H., & Stall, R. (2017). HIV-testing patterns and psycho-social factors associated with frequency of testing by men who have sex with men: implication for scaling up HIV testing in China. The Lancet, 390, S45.
The authors disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This research was funded by amfAR, the Foundation for AIDS Research, and Medical Science and Technology Foundation of Guangdong Province (A2018459).
Compliance with Ethical Standards
Conflict of interests
We declare no competing interests.
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).
- 1.World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations, 2016 update. 2016 Populations—2016 update. Geneva: World Health Organization; 2014.Google Scholar
- 2.UNAIDS. 90–90–90: An ambitious treatment target to help end the AIDS epidemic. Geneva: UNAIDS; 2014.Google Scholar
- 5.Centers for Disease Control and Prevention, CDC. HIV testing and risk behaviors among gay, bisexual, and other men who have sex with men—United States. Morb Mortal Wkly Rep. 2013;62(47):958–62.Google Scholar
- 6.Excellence TNIfHaC. 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.
- 7.Cheng W, Tang W, Zhong F, Babu GR, Han Z, Qin F, et al. Consistently High Unprotected Anal Intercourse (UAI) and factors correlated with UAI among men who have sex with men: implication of a serial cross-sectional study in Guangzhou, China. BMC Infect Dis. 2014;14(1):696.CrossRefPubMedCentralGoogle Scholar
- 8.MacKellar DA, Valleroy LA, Secura GM, Bartholow BN, McFarland W, Shehan D, et al. Repeat HIV testing, risk behaviors, and HIV seroconversion among young men who have sex with men: a call to monitor and improve the practice of prevention. J Acquir Immune Defic Syndr. 2002;29(1):76–85.CrossRefGoogle Scholar
- 11.Adam PC, de Wit JB, Toskin I, Mathers BM, Nashkhoev M, Zablotska I, et al. Estimating levels of HIV testing, HIV prevention coverage, HIV knowledge, and condom use among men who have sex with men (MSM) in low-income and middle-income countries. J Acquir Immune Defic Syndr. 2009;52(Suppl 2):S143–51.CrossRefGoogle Scholar
- 16.UNAIDS. Country and regional responses to AIDS. Countries 2009.Google Scholar
- 25.Ministry of Health of the People’s Republic of China. China AIDS response progress report. Beijing: UNAIDS; 2012.Google Scholar
- 35.Cheng WB, Xu HF, Zhong F, Cai YS, Chen XB, Meng G, et al. Application of “Internet Plus” AIDS prevention services among men who have sex with men in Guangzhou, China: results from 2010 to 2015. Zhonghua Yu Fang Yi Xue Za Zhi. 2016;50(10):853–7.Google Scholar
- 42.Tucker JD, Muessig KE, Cui R, Bien CH, Lo EJ, Lee R, et al. Organizational characteristics of HIV/syphilis testing services for men who have sex with men in South China: a social entrepreneurship analysis and implications for creating sustainable service models. BMC Infect Dis. 2014;14:601.CrossRefPubMedCentralGoogle Scholar
- 52.Pyun T, Santos GM, Arreola S, Do T, Hebert P, Beck J, et al. Internalized homophobia and reduced HIV testing among men who have sex with men in China. Asia–Pac J Public Health. 2014;26(2):118–25.Google Scholar