Benefits and Potential Harms of HIV Self-Testing Among Men Who Have Sex With Men In China: An Implementation Perspective

Background—HIV self-testing (HIVST) holds great promise for reaching high-risk key populations who do not access facility-based services. We sought to characterize unsupervised HIVST implementation among men who have sex with men (MSM) in China. Methods—We conducted a nationwide online survey in China. Eligible men were at least 16 years, had anal sex with a man, and had recent condomless sex. We assessed benefits (first-time testing, increased testing frequency, confirmatory testing) and potential harms (coercion, violence, suicidality) of HIVST. Among MSM who reported ever testing for HIV, we identified correlates of HIVST as first-time HIV test being a self-test using multivariable logistic regression. Results—Among 1,610 men who met the eligibility criteria and started the survey, 1,189 (74%) completed it. 29% (341/1189) reported ever self-testing for HIV. HIV prevalence was 7% (24/341) among self-testers and 5% (15/306) among non-self-testers. 59% (200/341) of men who self-tested reported HIVST as a first-time HIV test. 31 men (9.1%) experienced coercion with HIVST. 78% (31/40) of men with positive HIV self-tests sought confirmation. Multivariable analysis revealed that HIVST as first-time HIV test was associated with younger age (OR=0.95, 95% CI 0.92, 0.99), not being “out” (OR = 2.28; 95% CI 1.60, 3.28), not using the internet to meet sex partners (OR=0.39, 95% CI 0.22, 0.69), and group sex (OR = 1.74; 95% CI 1.02, 2.9). Correspondence: Chongyi Wei, Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street San Francisco CA, USA 94158, Phone: (415) 476-5793, Fax: (415) 514-8150, chongyiwei@hotmail.com. Conflicts of Interest: The authors declare that no conflicts of interest are part of this work. HHS Public Access Author manuscript Sex Transm Dis. Author manuscript; available in PMC 2018 April 01. Published in final edited form as: Sex Transm Dis. 2017 April ; 44(4): 233–238. doi:10.1097/OLQ.0000000000000581. A uhor M anscript