Comparison between HIV self-testing and facility-based HIV testing approach on HIV early detection among men who have sex with men: A cross-sectional study

Yi Zhou; Shaoli Huang; Mingting Cui; Zhihui Guo; Haotong Tang; Hang Lyu; Yuxin Ni; Ying Lu; Yunlong Feng; Yuyu Wang; Fengshi Jing; Shanzi Huang; Jiarun Li; Yao Xu; Wenhua Mei

doi:10.3389/fimmu.2022.857905

Comparison between HIV self-testing and facility-based HIV testing approach on HIV early detection among men who have sex with men: A cross-sectional study

Front Immunol. 2022 Sep 13:13:857905. doi: 10.3389/fimmu.2022.857905. eCollection 2022.

Authors

Yi Zhou^{1

2}, Shaoli Huang³, Mingting Cui⁴, Zhihui Guo⁴, Haotong Tang², Hang Lyu¹, Yuxin Ni^{5

6}, Ying Lu^{5

6}, Yunlong Feng⁷, Yuyu Wang⁷, Fengshi Jing^{8

9}, Shanzi Huang¹, Jiarun Li¹, Yao Xu¹⁰, Wenhua Mei¹

Affiliations

¹ Department of HIV Prevention, Zhuhai Center for Disease Control and Prevention, Zhuhai, China.
² Faculty of Medicine, Macau University of Science and Technology, Macao, Macao SAR, China.
³ Zhejiang University-University of Edinburgh Institute, Zhejiang University-University, Hangzhou, China.
⁴ School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
⁵ Dermatology Hospital of South Medical University, Guangzhou, China.
⁶ University of North Carolina Project-China, Guangzhou, China.
⁷ Department of Public Health and Preventive Medicine, School of Medicine Jinan University, Guangzhou, China.
⁸ Institute for Healthcare Artificial Intelligence, Guangdong Second Provincial General Hospital, Guangzhou, China.
⁹ School of Data Science, City University of Hong Kong, Hong Kong, Hong Kong SAR, China.
¹⁰ Department of Paediatrics, School of Clinical Science, Monash University, Melbourne, VIC, Australia.

Abstract

Background: To assess whether HIV self-testing (HIVST) has a better performance in identifying HIV-infected cases than the facility-based HIV testing (HIVFBT) approach.

Methods: A cross-sectional study was conducted among men who have sex with men (MSM) by using an online questionnaire (including information on sociodemographic, sexual biography, and HIV testing history) and blood samples (for limiting antigen avidity enzyme immunoassay, gene subtype testing, and taking confirmed HIV test). MSM who were firstly identified as HIV positive through HIVST and HIVFBT were compared. Chi-square or Fisher's exact test was used to explore any association between both groups and their subgroups.

Results: In total, 124 MSM HIV cases were identified from 2017 to 2021 in Zhuhai, China, including 60 identified through HIVST and 64 through HIVFBT. Participants in the HIVST group were younger (≤30 years, 76.7% vs. 46.9%), were better educated (>high school, 61.7% vs. 39.1%), and had higher viral load (≥1,000 copies/ml, 71.7% vs. 50.0%) than MSM cases identified through HIVFBT. The proportion of early HIV infection in the HIVST group was higher than in the HIVFBT group, identified using four recent infection testing algorithms (RITAs) (RITA 1, 46.7% vs. 25.0%; RITA 2, 43.3% vs. 20.3%; RITA 3, 30.0% vs. 14.1%; RITA 4, 26.7% vs. 10.9%; all p < 0.05).

Conclusions: The study showed that HIVST has better HIV early detection among MSM and that recent HIV infection cases mainly occur in younger and better-educated MSM. Compared with HIVFBT, HIVST is more accessible to the most at-risk population on time and tends to identify the case early. Further implementation studies are needed to fill the knowledge gap on this medical service model among MSM and other target populations.

Keywords: HIV self-testing; HIV/AIDS; RITA; facility-based HIV testing; recent infection testing algorithms.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
HIV Infections* / diagnosis
HIV Infections* / epidemiology
HIV Testing
Homosexuality, Male
Humans
Male
Self Care
Self-Testing
Sexual and Gender Minorities*