HIV testing coverage rates remain low among men who have sex with men (MSM) in low- and middle- income countries (LMIC). Community engagement has been associated with increased HIV testing in settings with a strong civil society, but this relationship has not been examined in contexts with a limited civil society, like China. This study aimed to identify the sociodemographic, behavioral, and community engagement factors associated with HIV and syphilis testing among high-risk MSM in China.
We defined high-risk as having any condomless sex in the past three months. High-risk MSM older than 16 years old were recruited from social networking websites to complete an online survey in November 2015. Data on sociodemographics, sexual behaviors, HIV/STI testing behaviors, and community engagement were collected. Community engagement was defined as participation in online discussions and in-person community events related to promoting sexual health and was measured by six survey items. Univariate and multivariable logistic regressions were used to identify correlates of HIV and syphilis testing.
One thousand one hundred eighty-nine high-risk MSM in China were recruited. 54% (647/1189) of participants had ever tested for HIV and 30% (354/1189) had ever tested for syphilis. HIV testing was associated with higher education (aOR 1.26, 95% CI 1.11-1.44), higher income (aOR 2.44, 95% CI 1.36-4.36), having multiple male sex partners in the past 3 months (aOR 1.34, 95% CI 1.06-1.69), and all six community engagement measures. Syphilis testing was associated with older age (aOR 1.60, 95% CI 1.14-2.23), higher income (aOR 2.78, 95% CI 1.58-4.89), having not been paid to have sex in the past 12 months (aOR 1.80, 95% CI 1.19-2.74), and five community engagement measures.
HIV and syphilis testing were suboptimal among high-risk MSM in China, especially among subgroups of low-income MSM. HIV testing and syphilis testing were both associated with community engagement measures, suggesting that community engagement may also be useful for promoting testing in contexts with limited civil society.
L. Han, None
W. Tang, None
J. D. Tucker, None