HIV testing and risks of sexual behavior among HIV-negative men who have sex with men in Ningbo, China

Abstract Background: The human immunodeficiency virus (HIV) testing had been confirmed as a preventive strategy for HIV control. The testing rate and risk behavior of HIV-negative men who have sex with men (MSM) are still unclear. The aim of this study was to examine the factors associated with HIV testing, and high-risk behavior among HIV-negative MSM in Ningbo, China. Methods: This cross-sectional study was conducted between July 2016 and June 2017. Using snowball sampling to recruit MSM. Participants were recruited from Blued (an app for the gay community), QQ/Wechat groups, voluntary counseling and testing clinics, baths, bars, and other types of venues. Before the interview, all participants had HIV testing. MSM were included if their result of HIV screening test were negative. Face-to-face questionnaires were conducted mainly focused on HIV testing in the past year and high-risk behavior in the past 3 months. Results: In total, 988 MSM were included, 57.1% (564/988) of participants had HIV testing in the past year. The proportion of high-risk sexual behavior was 49.9%. Factors associated with HIV testing were bisexual orientation (adjusted odds ratio [AOR] 0.57, 95% confidence interval [CI] 0.42–0.78), drug use to adjust psychological abnormalities (AOR 1.39, 95 CI 1.04–1.85), and receiving HIV interventions (AOR 4.03, 95 CI 3.00–5.42). Being married (AOR 1.72, 95% CI 1.15–2.58), bisexual orientation (AOR 2.13, 95% CI 1.54–2.95), and receiving HIV interventions (AOR 1.65, 95% CI 1.25–2.20) were risk factors for high-risk sexual behavior, while college degree or above (AOR 0.52, 95% CI 0.35–0.77) were the protective factor. Conclusion: We revealed low rate of HIV testing and high rate of risk sexual behavior among HIV-negative MSM in Ningbo. HIV transmission factors are widespread, but the proportion of 90% diagnosed for HIV are still a huge challenge in this population. Attention should be given to married, using substances or bisexual HIV-negative MSM, and HIV intervention should be strengthened to promote HIV testing and reduce risk behavior.