Impacts of the COVID-19 pandemic on HIV testing utilization among men who have sex with men in China: a cross-sectional online survey (Preprint)

BACKGROUND The COVID-19 pandemic creates disruptions on HIV prevention and sexual health services for men who have sex with men (MSM). OBJECTIVE This study compared HIV testing utilization in three different reference periods (i.e., before COVID-19 outbreak, after the outbreak, and after the pandemic was under initial control). Factors associated with HIV testing utilization after COVID-19 outbreak were also investigated. METHODS Participants were Chinese-speaking MSM aged ≥18 years living in Shenzhen, China. Those self-reported as HIV positive were excluded. A total of 595 participants recruited through multiple sources completed a self-administered online survey during August to September 2020. HIV testing uptake between February and July 2020 was the dependent variable, and multivariate logistic regression models were fitted. RESULTS About half of the participants reported any HIV testing uptake between February and July 2020 (n=331, 55.6%). As compared to the time before COVID-19 outbreak (November 2019 to January 2020), HIV testing uptake was significantly lower during February and April 2020 (44.0% versus 61.0%, p<.001). However, HIV testing uptake did not increase significantly after the pandemic was under initial control (May to July 2020) (46.6% versus 44.0%, p=.21). After adjusting for significant background characteristics, factors associated with higher HIV testing uptake between February and July 2020 included: 1) HIV testing uptake prior to COVID-19 outbreak (AOR: 10.75, 95%CI: 7.22, 16.02, p<.001), 2) use of sexually transmitted infections (STI) testing (AOR: 7.02, 95%CI: 4.10, 12.02, p<.001), other HIV/STI prevention (AOR: 3.15, 95%CI: 2.16, 4.60, p<.001) and PrEP (AOR: 3.58, 95%CI: 1.54, 8.34, p=.002) between February and July 2020, 3) CAI with RP (AOR: 2.05, 95%CI: 1.34, 3.13, p=.001) and NRP (AOR: 2.49, 95%CI: 1.39, 4.47, p=.002), and SDU (AOR: 2.72, 95%CI: 1.50, 4.94, p=.001) between February and July 2020, 4) perceived risk of HIV infection at present was higher than the time before COVID-19 outbreak (AOR: 1.15, 95%CI: 1.01, 1.30, p=.03), 5) perceived COVID-19 preventive measures taken up by HIV testing service providers to be effective (AOR: 1.52, 95%CI: 1.29, 1.78, p<.001), and 6) perceived higher behavioral control to take up HIV testing after COVID-19 outbreak (AOR: 1.18, 95%CI: 1.00, 1.40, p=.048). Concerns about COVID-19 infection during HIV testing (AOR: 0.78, 95%CI: 0.68, 0.89, p<.001), avoiding crowed places (AOR: 0.68, 95%CI: 0.48, 0.98, p=0.04) and HIV testing service providers reduced their working hours (AOR: 0.59, 95%CI: 0.48, 0.98, p=0.046) were negatively associated with the dependent variable. CONCLUSIONS HIV testing utilization among Chinese MSM declined after COVID-19 outbreak and did not increase after the pandemic received initial control. Removing structural barriers to access HIV testing caused by COVID-19, modifying perceptions related to HIV testing, and making use of HIV self-testing might be useful strategies to improve HIV testing among MSM during the pandemic.

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Using individual stated-preferences to optimize HIV self-testing service delivery among men who have sex with men (MSM) in Malaysia: results from a conjoint-based analysis

BMC Public Health ◽

10.1186/s12889-020-09832-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Roman Shrestha ◽

Haridah Alias ◽

Li P. Wong ◽

Frederick L. Altice ◽

Sin H. Lim

Keyword(s):

Service Delivery ◽

Hiv Testing ◽

Online Survey ◽

Stated Preference ◽

Relative Importance ◽

Cross Sectional ◽

Self Testing ◽

Telephone Hotline ◽

Testing Uptake ◽

Sex With Men

Abstract Background HIV self-testing (HIVST) has the potential to improve HIV testing uptake and frequency for key populations like MSM who experience multiple barriers accessing clinic-based HIV testing. In the absence of HIVST in Malaysia, there is no guidance to inform HIVST delivery. This study investigated the acceptability of HIVST and preferences about the HIVST service delivery approaches using a standardized stated preference method. Methods A cross-sectional online survey conducted between January and April 2019 assessed the interest in HIVST in 544 MSM in Malaysia. Participants ranked eight hypothetical HIVST service delivery program elements with varied combinations of six, two-level HIVST service delivery program attributes (cost, privacy, accuracy, kit collection site, kit type, and testing support). SPSS conjoint procedure was used to estimate the relative importance of each attribute and preference across eight possible HIVST service delivery programs. Results Overall, 70.4% had previously tested for HIV, and of those, 64.0% had done so in the past 6 months (45.0% of all participants). Of all the participants, 25.2% reported having used HIVST previously. The acceptability for HIVST service delivery models ranged from 44.9 to 77.1%, with mean acceptability of 56.2% across the eight hypothetical HIVST distribution scenarios. The HIVST service delivery scenario with the highest acceptability had the following attributes: no cost (free), anonymity (name not required), 99–100% accuracy, home-delivered, fingerstick, and testing support using telephone hotline or texting. HIVST cost was the most important attribute (relative importance score: RIS = 19.30) associated with acceptability, followed by anonymity (RIS = 18.41), accuracy (RIS = 17.33), kit delivery (RIS = 16.99), fingerstick kit (RIS = 15.86), and support (RIS = 12.08). Conclusions Acceptability for HIVST in Malaysian MSM was high but differed markedly by a number of HIVST delivery scenarios and attributes. These findings could be relevant as the Malaysian Ministry of Health is in the process of developing a regulatory framework for ensuring the quality of kits, as well as policies supporting safe use while broader implementation under national AIDS programs.

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Access to Basic HIV-Related Services and PrEP Acceptability among Men Who Have sex with Men Worldwide: Barriers, Facilitators, and Implications for Combination Prevention

Journal of Sexually Transmitted Diseases ◽

10.1155/2013/953123 ◽

2013 ◽

Vol 2013 ◽

pp. 1-11 ◽

Cited By ~ 44

Author(s):

George Ayala ◽

Keletso Makofane ◽

Glenn-Milo Santos ◽

Jack Beck ◽

Tri D. Do ◽

...

Keyword(s):

Hiv Testing ◽

Service Provider ◽

Service Providers ◽

Hiv Treatment ◽

Service Access ◽

Cross Sectional ◽

Combination Prevention ◽

Gay Community ◽

Hiv Prevention Strategies ◽

Sex With Men

Introduction. Men who have sex with men (MSM) are disproportionately impacted by HIV globally. Easily accessible combination HIV prevention strategies, tailored to the needs of MSM, are needed to effectively address the AIDS pandemic. Methods and Materials. We conducted a cross-sectional study among MSM (n=3748) from 145 countries from April to August 2012. Using multivariable random effects models, we examined factors associated with acceptability of preexposure prophylaxis (PrEP) and access to condoms, lubricants, HIV testing, and HIV treatment. Results. Condoms and lubricants were accessible to 35% and 22% of all respondents, respectively. HIV testing was accessible to 35% of HIV-negative respondents. Forty-three percent of all HIV-positive respondents reported that antiretroviral therapy was easily accessible. Homophobia, outness, and service provider stigma were significantly associated with reduced access to services. Conversely, community engagement, connection to gay community, and comfort with service providers were associated with increased access. PrEP acceptability was associated with lower PrEP-related stigma, less knowledge about PrEP, less outness, higher service provider stigma, and having experienced violence for being MSM. Conclusions. Ensuring HIV service access among MSM will be critical in maximizing the potential effectiveness of combination approaches, especially given the interdependence of both basic and newer interventions like PrEP. Barriers and facilitators of HIV service access for MSM should be better understood and addressed.

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Factors associated with recent HIV testing among high-risk men who have sex with men: a cross-sectional study in Cambodia

BMC Public Health ◽

10.1186/s12889-015-2096-4 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 9

Author(s):

Siyan Yi ◽

Sovannary Tuot ◽

Pheak Chhoun ◽

Carinne Brody ◽

Khuondyla Pal ◽

...

Keyword(s):

High Risk ◽

Hiv Testing ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Sex With Men

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Prevalence and Factors Associated With HIV Self-testing Uptake Among Men Who Have Sex With Men in Ningbo, China: A Cross-sectional Study

10.21203/rs.3.rs-76060/v1 ◽

2020 ◽

Author(s):

Hang Hong ◽

Hong-bo Shi ◽

Hai-bo Jiang ◽

Hong-jun Dong ◽

Yun-liang Shen

Keyword(s):

Hiv Testing ◽

Cross Sectional Study ◽

Sexual Contact ◽

Categorical Variables ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

The Past ◽

Self Testing ◽

Sex With Men

Abstract BackgroundHIV testing and early linkage to care are critical for reducing the risk of HIV transmission. HIV self-testing (HIVST) is an useful tool for increasing HIV testing frequency.This study aimed to investigate HIVST rates among men who have sex with men (MSM), the characteristics of MSM who had HIVST, and factors associated with HIVST uptake among MSM in Ningbo, China. MethodsA cross-sectional study was conducted from April to October 2019 in Ningbo,China. Participants were aged at least 18 years and having had sexual contact with men in the past year. Proportions were used for categorical variables. Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) for characteristics associated with HIVST uptake was processed by multiple logistic regression models.ResultsAmong a sample of 699 MSM recruited, 38.2% had reported previous use of an HIV self-test kit. A greater proportion of HIVST Users had a higher frequency of HIV testing(≥2 times: 70.0% versus 41.2%, p<0.001) in the past one year. Factor associated with HIVST uptake was gay apps use(AOR=1.86,CI=1.13-3.05), multiple male sex partners (AOR=1.90,CI=1.29-2.80), frequency of male-male sexual contact ≥1 times per week(AOR=1.86, CI=1.30-2.66), syphilis infection(AOR=5.48, CI=2.53-11.88).ConclusionsFurther HIVST education should be strengthened for school-aged children and teenagers, and free HIVST kits may be provided to low-income high-risk MSM through gay apps and NGOs to achieve the increased HIV testing frequency.

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Socio-economic Status and Associated Factors in the Uptake of HIV Testing: Findings from the South African Population-based National Household Survey Conducted in 2017

10.21203/rs.3.rs-108686/v1 ◽

2020 ◽

Author(s):

Sean Jooste ◽

Musawenkosi Mabaso ◽

Myra Taylor ◽

Alicia North ◽

Yolande Shean ◽

...

Keyword(s):

Hiv Testing ◽

Perceived Risk ◽

Negative Impact ◽

Economic Status ◽

Household Survey ◽

Population Based ◽

Hiv Treatment ◽

Cluster Sampling ◽

Cross Sectional ◽

Testing Uptake

Abstract Background: Improved understanding of barriers to HIV testing is important for reaching the first of the UNAIDS 90-90-90 targets, which states that 90 percent of HIV positive individuals ought to know their HIV status. This study examined socioeconomic status (SES) factors and related covariates associated with HIV testing uptake in the general population in South Africa. Information on SES and HIV testing may impact the HIV treatment and care cascade and prevention of HIV transmission. Methods: This study used data obtained from a national cross-sectional, population-based household survey conducted in 2017 using a multi-stage stratified random cluster sampling design. A composite SES score was created using multiple correspondence analyses of household assets; households were classified into wealth quintiles and dichotomized into low SES/poorest (lowest 3 quintiles) and high SES/less-poor (highest 2 quintiles). Bivariate and multivariate logistic regression models were fitted to analyse associations between the uptake of HIV testing and a set of socio-demographic and HIV-related variables. Results: HIV testing uptake was 73.8% and 76.7% among low and high SES household, respectively, both of which were below the first 90 target. The findings showed increased uptake of HIV testing was associated with being female and having a higher educational level independent of SES. Decreased uptake of HIV testing was associated with being from White and Indian/Asian race groups, residing in rural formal areas, alcohol consumption, and high self-perceived risk of HIV infection.Conclusions: We found that HIV testing uptake was similar for people from both low and high SES. However, interventions aimed at improving HIV testing in order to reach the first 90 target, should target males, all race groups, those with low education attainment, and those residing in rural formal areas. Reaching the first target will require efforts to improve community knowledge, and awareness about the negative impact of alcohol use and address HIV risk perception.

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Solidarity and HIV Testing Willingness During the COVID-19 Epidemic: A Study Among Men Who Have Sex With Men in China

Frontiers in Public Health ◽

10.3389/fpubh.2021.752965 ◽

2021 ◽

Vol 9 ◽

Author(s):

Hang Lyu ◽

Yi Zhou ◽

Wencan Dai ◽

Shihan Zhen ◽

Shanzi Huang ◽

...

Keyword(s):

Factor Analysis ◽

Hiv Testing ◽

Social Cohesion ◽

Online Survey ◽

Principal Component ◽

Community Connectedness ◽

Hiv Test ◽

Testing Uptake ◽

Sex With Men ◽

The Impact

Background: Solidarity, such as community connectedness and social cohesion, may be useful in improving HIV testing uptake among men who have sex with men (MSM). This study aimed to evaluate the impact of solidarity on HIV testing before the coronavirus disease 2019 (COVID-19) and HIV testing willingness during COVID-19 among MSM in China.Materials and Methods: An online survey was conducted to collect sociodemographic, sexual behavioral, and solidarity items' information from the participants. We first used factor analysis to reveal the principal component of the solidarity items and then used logistic regression to study the impact of solidarity on HIV testing, by adjusting the possible confounding factors, such as age and education.Results: Social cohesion and community connectedness were revealed by the factor analysis. MSM with high community connectedness were more willing to undergo HIV testing before the epidemic adjusted by age [odds ratio (OR): 1.07, 95% CI: 1.01–1.13]. The community connectedness was also related to the willingness of HIV testing during the epidemic, with adjustments of 1.09 (95% CI: 1.03–1.15). People who did not test for HIV before the COVID-19 epidemic were more willing to have the HIV test during the epidemic, which was correlated with the community connectedness, and the OR value was 1.14 (95%: 1.03–1.25).Conclusion: A high level of community connectedness helped to increase the HIV testing rate before COVID-19 and the willingness of HIV testing during the epidemic among MSM. Strategies can strengthen the role of the community in the management and service of MSM.

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Perceptions and Experiences of the University of Nottingham Pilot Asymptomatic Testing Service: A Mixed-Methods Study

10.20944/preprints202012.0060.v1 ◽

2020 ◽

Author(s):

Holly Blake ◽

Jessica Corner ◽

Cecilia Cirelli ◽

Juliet Hassard ◽

Lydia Briggs ◽

...

Keyword(s):

Focus Groups ◽

Perceived Risk ◽

Online Survey ◽

Saliva Sample ◽

Mental Wellbeing ◽

First Year ◽

University Campus ◽

Testing Service ◽

University Life ◽

Testing Uptake

We aimed to explore student and staff perceptions and experiences of a pilot COVID-19 asymptomatic testing service (P-ATS) in a UK university campus setting. This was a mixed-method study comprised of an online survey, and thematic analysis of qualitative data from interviews and focus groups conducted at the end of the 12-week P-ATS programme. Ninety-nine students (84.8% female, 70% first year; 93.9% P-ATS participants) completed an online survey, 41 individuals attended interviews or focus groups, including 31 students (21 first year; 10 final year) and 10 staff. All types of testing and logistics were highly acceptable (virus: swab, saliva; antibody: finger prick) and 94.9% would participate again. Reported adherence to weekly virus testing was high (92.4% completed ≥6 tests; 70.8% submitted all 10 swabs; 89.2% completed ≥1 saliva sample) and 76.9% submitted ≥3 blood samples. Students tested to ‘keep campus safe’, ‘contribute to national efforts to control COVID-19’, and ‘protect others’. 31.3% had high anxiety as measured by the Generalized Anxiety Disorder scale (GAD-7) (27.1% of first year). Students with lower levels of anxiety and greater satisfaction with university communications around P-ATS were more likely to adhere to virus and antibody tests. Increased adherence to testing was associated with higher perceived risk of COVID-19 to self (virus) and others (antibody). Qualitative findings revealed 5 themes and 13 sub-themes: ‘emotional responses to COVID-19’, ‘university life during COVID-19’, ‘influences on testing participation’, ‘testing physical and logistical factors’ and ‘testing effects on mental wellbeing’. Asymptomatic COVID-19 testing (virus/antibodies) is highly acceptable to students and staff in a university campus setting. Clear communications and support for mental wellbeing is likely to be important for testing uptake and adherence. Strategies are needed to facilitate social connections and mitigate the mental health impacts of COVID-19 and self-isolation.

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