Changes in HIV Testing Utilization Among Chinese Men Who Have Sex With Men During the COVID-19 Pandemic in Shenzhen, China: An Observational Prospective Cohort Study

Abstract

BackgroundThe Coronavirus Diseases 2019 (COVID-19) directly affects HIV prevention and sexual health services utilization among men who have sex with men (MSM). This study investigated changes in human immunodeficiency virus (HIV) testing utilization among MSM before and after the COVID-19 pandemic received initial control in Shenzhen, China.MethodsThis study was a sub-analysis of a prospective observational cohort study conducted among MSM in Shenzhen, China between August 2020 and May 2021. Participants were recruited through outreaching in gay venues, online recruitment, and peer referral. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. This study was based on 412 MSM who reported to be HIV-negative/unknown sero-status at baseline, 297 (72.1%) of them completed the follow-up online survey. Multilevel logistic regression models (level 1: sources of recruitment; level 2: individual participants) were fitted.ResultsWhen comparing follow-up data with baseline data, a significant increase was observed in the uptake of any type of HIV testing (77.9% at Month 6 vs. 59.2% at baseline, p < 0.001). After adjusting for age group, education level, current employment status and monthly personal income, two predisposing factors were associated with higher uptake of HIV testing during the follow-up period. They were: (1) condomless anal intercourse with male non-regular male sex partners at follow-up only (AOR: 5.29, 95%CI: 1.27, 22.01) and (2) sanitizing before and after sex at baseline (AOR: 1.26, 95%CI: 1.02, 1.47). Regarding enabling factors, utilization of HIV testing (AOR: 3.90, 95%CI: 2.27, 6.69) and STI testing (AOR: 2.43, 95%CI: 1.20, 4.93) 6 months prior to the baseline survey was associated with higher uptake of HIV testing during the follow-up period. Having the experience that HIV testing service providers reduced service hours during the follow-up period was also positively associated with the dependent variable (AOR: 3.45, 95%CI: 1.26, 9.41).ConclusionsHIV testing utilization among MSM might rebound to the level before the COVID-19 outbreak after the pandemic received initial control in China. This study offered a comprehensive overview to identify potential reasons that can influence the uptake of HIV testing among Chinese MSM.

Gay App Use, Sexuality Traits, and High-Risk Sexual Behaviors Among Men Who Have Sex With Men in China: Mediation Analysis

“…A possible reason for this rise in prevalence may be related to the changes in the COVID-19 pandemic and related control measures over time. Studies have shown that high-risk sexual behaviors among MS decreased during the COVID-19 pandemic due to strict lockdown and social isolation measures, and then rebounded to the level before the COVID-19 outbreak after the pandemic received initial control in China [48]. The prevalence of multiple sexual partners in our study was consistent with that of previous studies.…”

Willingness to accept monkeypox vaccine and its correlates among men who have sex with men in Southern China: a web-based online cross-sectional study

“…The findings suggest that positive attitudes toward vaccination and frequent discussions about vaccinations with family and friends can influence individuals’ own attitudes toward vaccination, increasing the likelihood of getting vaccinated ( 44 ). Previous research has indicated that MSM may place importance on the viewpoints of their male sexual partners or peers ( 45 ). Therefore, it can be inferred that they are more likely to be willing to receive vaccinations when their friends or sexual partners are vaccinated, as it provides them with a sense of belonging.…”

“…This preference can be attributed to their perception of being at a high risk of MPX infection, which increases their inclination toward vaccination as a preventive measure. Furthermore, social norms and peer influence may also impact vaccine decision-making ( 45 , 56 ). Therefore, it is imperative to provide monkeypox or smallpox vaccinations to MSM who are at a higher risk of monkeypox exposure in order to aid in controlling the recent outbreak of the virus.…”

An Online Intervention Promoting HIV Testing Service Utilization Among Chinese men who have sex with men During the COVID-19 Pandemic: A quasi-experimental Study

“…According to previous data, about 60% of MSM in Hong Kong received any type of HIV testing in the past six months [ 18 , 23 ]. Given the negative impact of COVID-19 on HIV testing utilization [ 12 , 27 ], we estimated that 45% of local MSM would take up HIV testing within six months during the pandemic [ 10 , 12 ]. A sample size of 280 participants per group would allow us to detect a minimum between-group difference of 12% in this primary outcome (α = 0.05, power = 0.80, two-sided test; PASS 11.0, NCSS LLC).…”