HIV testing is the gateway to biomedical means of prevention and treatment. Identifying predictors of HIV testing is important to inform future preventive interventions. Of 444 men who have sex with men without known HIV infection enrolled in a study in Hong Kong, 64% had ever been HIV-tested. Testers were generally older, better educated, had a higher monthly income, and more likely self-identified as gay. Testers often used Internet and frequented saunas for sex networking, compared with non-testers attending bars, massage centres and public toilets. HIV testing habit also varied with the profile of body image type and preferred type in sex networking. Higher acceptance of pre-exposure prophylaxis (PrEP) was observed among testers. Overall, socioeconomic status played an important role in both HIV testing and access to PrEP. Interventions targeting sex networking venues and alternative means of testing provision are needed to increase coverage of HIV testing.
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World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva: World Health Organization; 2015.
INSIGHT START Study Group, Lundgren JD, Babiker AG, et al. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med. 2015;373(9):795–807.
Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.
UNAIDS. 90-90-90: an ambitious treatment target to help end the AIDS epidemic. Geneva: UNAIDS; 2014.
Beyrer C, Baral SD, van Griensven F, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380(9839):367–77.
KCW Chan. Press conference on local HIV/AIDS situation in 2016. [Presentation] Centre for Health Protection, Department of Health. 28th February 2017
Centers for Disease Control, R.O.C. (Taiwan). HIV/AIDS. Available from http://www.cdc.gov.tw/english/info.aspx?treeid=e79c7a9e1e9b1cdf&nowtreeid=e02c24f0dacdd729&tid=7D01A79F5FD3B63D
Huang MB, Ye L, Liang BY, Ning CY, Roth WW, Jiang JJ, et al. Characterizing the HIV/AIDS epidemic in the United States and China. Int J Environ Res Public Health 2015;13(1)
Special Preventive Programme, Centre for Health Protection. Factsheet on HIV and AIDS response indicator survey 2014 for men who have sex with men. Hong Kong: Department of Health; 2015. Available from: http://www.chp.gov.hk/files/pdf/oth_rep2015_msm_e.pdf [Accessed 29th March 2017].
Bezemer D, de Wolf F, Boerlijst MC, et al. A resurgent HIV-1 epidemic among men who have sex with men in the era of potent antiretroviral therapy. AIDS. 2008;22(9):1071–7.
Brito AM, Kendall C, Kerr L, et al. Factors associated with low levels of HIV testing among men who have sex with men (MSM) in Brazil. PLoS ONE. 2015;10(6):e0130445.
Noble M, Jones AM, Bowles K, et al. HIV testing among Internet-using MSM in the United States: systematic review. AIDS Behav. 2017;21(2):561–75.
den Daas C, Doppen M, Schimdt AJ, Op de Coul E. Determinants of never having tested for HIV among MSM in the Netherlands. BMJ Open. 2016;6(1):e009480.
Lee SS, Lam ANS, Lee CK, Wong NS. Virtual versus physical channel for sex networking in men having sex with men of sauna customers in the city of Hong Kong. PLoS ONE. 2012;7(2):e31072.
Leung KK, Wong HTH, Naftalin CM, Lee SS. A new perspective on sexual mixing among men who have sex with men by body image. PLoS ONE. 2014;9(11):e113791.
Allensworth-Davies D, Welles SL, Hellerstedt WL, Ross MW. Body image, body satisfaction, and unsafe anal intercourse among men who have sex with men. J Sex Res. 2008;45(1):49–56.
Marcus U, Gassowski M, Drewes J. HIV risk perception and testing behaviours among men having sex with men (MSM) reporting potential transmission risks in the previous 12 months from a large online sample of MSM living in Germany. BMC Public Health. 2016;16(1):1111.
Lui CW, Dean J, Mutch A, et al. HIV testing in men who have sex with men: a follow-up review of the qualitative literature since 2010. AIDS Behav 2017. https://doi.org/10.1007/s10461-017-1752-3. [Epub ahead of print].
Semple SJ, Strathdee SA, Zians J, Patterson TL. Factors associated with sex in the context of methamphetamine use in different sexual venues among HIV-positive men who have sex with men. BMC Public Health. 2010;10:178.
Amirkhanian YA. Social networks, sexual networks and HIV risk in men who have sex with men. Curr HIV/AIDS Rep. 2014;1(1):81–92.
Li R, Wang H, Pan X, et al. Prevalence of condomless anal intercourse and recent HIV testing and their associated factors among men who have sex with men in Hangzhou, China: a respondent-driven sampling survey. PLoS ONE. 2017;12(3):e0167730.
Mitchell JW, Horvath KJ. Factors associated with regular HIV testing among a sample of US MSM with HIV-negative main partners. J Acquir Immune Defic Syndr. 2013;64(4):417–23.
Knox J, Yi H, Reddy V, Maimane S, Sandfort T. The fallacy of intimacy: sexual risk behaviour and beliefs about trust and condom use among men who have sex with men in South Africa. Psychol Health Med. 2010;15(6):660–71.
Musinguzi G, Bastiaens H, Matovu JKB, et al. Barriers to condom use among high risk men who have sex with men in Uganda: a qualitative study. PLoS ONE. 2015;10(7):e0132297.
Miller B, Behm-Morawitz E. “Masculine guys only”: the effects of femmephobic mobile dating application profiles on partner selection for men who have sex with men. Comput Hum Behav. 2016;62:176–85.
Oldenburg CE, Perez-Brumer AG, Reisner SL, Mimiaga MJ. Transactional sex and the HIV epidemic among men who have sex with men (MSM): results from a systematic review and meta-analysis. AIDS Behav. 2015;19(12):2177–83.
Fields EL, Bogart LM, Smith KC, et al. HIV risk and perceptions of masculinity among young black MSM. J Adolesc Health. 2012;50(3):296–303.
Taywaditep KJ. Marginalization among the marginalized: gay men’s anti-effeminacy attitudes. J Homosex. 2001;42(1):1–28.
Song Y, Li X, Zhang L, et al. HIV-testing behavior among young migrant men who have sex with men (MSM) in Beijing, China. AIDS Care. 2011;23(2):179–86.
Mitchell KJ, Ybarra ML, Korchmaros JD, Kosciw JG. Accessing sexual health information online: use, motivations and consequences for youth with different sexual orientations. Health Educ Res. 2014;29(1):147–57.
Blashill AJ, Tomassilli J, Biello K, O’Cleirigh C, Safren SA, Mayer KH. Body dissatisfaction among sexual minority men: psychological and sexual health outcomes. Arch Sex Behav. 2016;45:1241.
Hoots BE, Finlayson T, Nerlander L, Paz-Bailey G, National HIV. Behavioral surveillance study group. willingness to take, use of, and indications for pre-exposure prophylaxis among men who have sex with men-20 US cities, 2014. Clin Infect Dis. 2016;63(5):672–7.
Krakower D, Ware N, Mitty JA, Maloney K, Mayer KH. HIV providers’ perceived barriers and facilitators to implementing pre-exposure prophylaxis in care settings: a qualitative study. AIDS Behav. 2014;18(9):1712–21.
Li Ka Shing Institute of Health Sciences is acknowledged for providing technical support.
This study was funded by the Research Grants Council of Hong Kong (RGC Ref. No.: 14103315).
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Survey and Behavioural Research Ethics Committee of The Chinese University of Hong Kong.
Informed consent was obtained from all individual participants included in the study.
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Kwan, T.H., Lee, S.S. Predictors of HIV Testing and Their Influence on PrEP Acceptance in Men Who Have Sex with Men: A Cross-Sectional Study. AIDS Behav 22, 1150–1157 (2018). https://doi.org/10.1007/s10461-017-1978-0
- Men who have sex with men
- Pre-exposure prophylaxis
- Body image type