the potential to boost HIV diagnosis rates among high-risk and hard-to-reach
men who have sex with men (MSM) in China, according to a study published in the
online edition of the Journal of Acquired
Immune Deficiency Syndromes. A web survey showed that a fifth of men had
self-tested for HIV and that self-testing was associated with being married, having
high numbers of recent anal sex partners and recent HIV testing.
can effectively reach high-risk MSM and facilitate higher frequency testing,”
comment the authors. “Self testing has the potential to increase knowledge of
HIV serostatus and engage key populations in HIV prevention, treatment and
only benefit from HIV treatment and care if they are aware of their infection
status. It’s therefore of concern that globally an estimated 20 million people are unaware they are living with the virus.
Obstacles to HIV
testing can include convenience, concerns about confidentiality and privacy and
also the stigma associated with screening for HIV. Self-testing, when an
individual collects his or her own oral fluid of pin-prick blood sample and
conducts a rapid HIV test, could increase rates of testing.
be useful in China and the sale of self-testing kits is not
restricted by the country’s health authorities.
among gay and other MSM in China is approximately 5%. Little is known about
self-testing in this key population. An international team of investigators
therefore designed an internet-based survey to determine prevalence of
self-testing in this population and the factors associated with self-testing.
appropriate HIV testing interventions in the Chinese context may have
far-reaching consequences because there are a substantial portion of Chinese
MSM who have never received HIV testing,” explain the investigators.
The study protocol
was developed in collaboration with MSM and key stakeholders.
Men were eligible
to participate in the study if they were aged 16 and older and had a lifetime
history of anal sex with another man.
The online survey
was implemented in May 2013 using the largest MSM web portals in Guangdong and
A total of 1342
men completed the survey. They were predominately young (55% were aged 20 to 30
years) and well-educated (53% had a college degree of higher). Approximately three-quarters
identified as gay and 6% were living with HIV.
reported having had an HIV test and 20% said they had self-tested for HIV.
independently associated with self-testing were being married (aOR = 1.60; 95%
CI, 1.08-2.36), having six or more recent anal sex partners (aOR = 4.25; 95%
CI, 2.05-8.79), testing for HIV within the last twelve months (aOR = 2.16; 95%
CI, 1.31-3.55) and having an annual income of at least US$16,000 (aOR = 1.76;
95% CI, 1.02-3.04).
The majority (71%)
of those reporting self-testing reported paying less than US$16 for their testing
kit. These kits were acquired through a variety of sources, including the
internet (35%), community-based organisations (28%), pharmacies (18%), friends
(10%) and sexual partners (7%).
acknowledge their findings are based on a predominately young and well-educated
convenience sample. Nevertheless, they conclude: “Our study suggests that HIV
self-testing may be able to reach sub-groups of high-risk MSM and may enable
more frequent HIV testing.”