The impact of HIV self-testing on risk behaviors among men who have sex with men: a mixed-methods study

Rong Su; Yi Liu; Peilong Li; Lin Ge; Meizhen Liao; Yong Fu; Xin Song; Duo Shan; Houlin Tang; Dongmin Li

doi:10.3389/fpubh.2024.1369931

The impact of HIV self-testing on risk behaviors among men who have sex with men: a mixed-methods study

Front Public Health. 2024 Feb 27:12:1369931. doi: 10.3389/fpubh.2024.1369931. eCollection 2024.

Authors

Rong Su¹, Yi Liu¹, Peilong Li¹, Lin Ge¹, Meizhen Liao², Yong Fu³, Xin Song³, Duo Shan¹, Houlin Tang¹, Dongmin Li¹

Affiliations

¹ National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
² Shandong Provincial Center for Disease Control and Prevention, Ji'nan, China.
³ Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China.

Abstract

Background: Men who have sex with men (MSM) have a high prevalence of HIV and a low rate of HIV testing in China. HIV self-testing (HIVST) presents a viable strategy for expanding HIV testing among MSM. However, the impact of HIVST on risk behaviors among MSM remains controversial. Our study sought to ascertain this impact.

Methods: From April 2021 to January 2022, a mixed-methods study was conducted in Qingdao City, employing both quantitative and qualitative methodologies. The quantitative component entailed a cohort study among MSM who had used HIVST. Generalized estimating equations fitting Poisson regressions were used to analyze the changes in risk behaviors of MSM in short time after HIVST (ST-HIVST) and longer time after HIVST (LT-HIVST) compared to before HIVST. Subsequently, we conducted in-depth interviews with 18 MSM who completed the follow-up to delve deeper into the impact of HIVST on MSM.

Results: A total of 410 MSM were recruited in the cohort, of whom 83 were lost to follow-up. Compared to before HIVST, there were no significant changes in risk behaviors in ST-HIVST (p > 0.05), while the proportion of recreational drugs abuse (20.7% vs. 33.3%), commercial sex (14.6% vs. 22.9%), and unprotected anal sex (95.9% vs. 98.5%) increased significantly in LT-HIVST (p < 0.05). Specific changes varied across demographic characteristics. According to qualitative interviews, MSM might have decreased risk perception and increased risk behaviors after HIVST.

Conclusion: The use of HIVST may promote MSM to engage in risk behaviors. In the future, customized HIVST promotion programs need to be developed to expand HIV testing among MSM and simultaneously control their risk behaviors.

Keywords: HIV; impact; men who have sex with men; risk behaviors; self-testing.

Publication types

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

MeSH terms

Cohort Studies
HIV
HIV Infections* / epidemiology
HIV Testing
Homosexuality, Male
Humans
Male
Risk-Taking
Self Care / methods
Self-Testing
Sex Work
Sexual and Gender Minorities*

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the National Science and Technology Major Project (Grant No. 2017ZX10201101-002-005).