scholarly journals Sexual risk and HIV testing disconnect in men who have sex with men (MSM) recruited to an online HIV self‐testing trial

HIV Medicine ◽  
2020 ◽  
Vol 21 (9) ◽  
pp. 588-598
Author(s):  
AJ Rodger ◽  
D Dunn ◽  
L McCabe ◽  
P Weatherburn ◽  
FC Lampe ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheryl Johnson ◽  
Moses Kumwenda ◽  
Jamilah Meghji ◽  
Augustine T. Choko ◽  
Mackwellings Phiri ◽  
...  

Abstract Background Despite the aging HIV epidemic, increasing age can be associated with hesitancy to test. Addressing this gap is a critical policy concern and highlights the urgent need to identify the underlying factors, to improve knowledge of HIV-related risks as well as uptake of HIV testing and prevention services, in midlife-older adults. Methods We conducted five focus group discussions and 12 in-depth interviews between April 2013 and November 2016 among rural and urban Malawian midlife-older (≥30 years) men and women. Using a life-course theoretical framework we explored how age is enacted socially and its implications on HIV testing and sexual risk behaviours. We also explore the potential for HIV self-testing (HIVST) to be part of a broader strategy for engaging midlife-older adults in HIV testing, prevention and care. Thematic analysis was used to identify recurrent themes and variations. Results Midlife-older adults (30–74 years of age) associated their age with respectability and identified HIV as “a disease of youth” that would not affect them, with age protecting them against infidelity and sexual risk-taking. HIV testing was felt to be stigmatizing, challenging age norms, threatening social status, and implying “lack of wisdom”. These norms drove self-testing preferences at home or other locations deemed age and gender appropriate. Awareness of the potential for long-standing undiagnosed HIV to be carried forward from past relationships was minimal, as was understanding of treatment-as-prevention. These norms led to HIV testing being perceived as a threat to status by older adults, contributing to low levels of recent HIV testing compared to younger adults. Conclusions Characteristics associated with age-gender norms and social position encourage self-testing but drive poor HIV-risk perception and unacceptability of conventional HIV testing in midlife-older adults. There is an urgent need to provide targeted messages and services more appropriate to midlife-older adults in sub-Saharan Africa. HIVST which has often been highlighted as a tool for reaching young people, may be a valuable tool for engaging midlife-older age groups who may not otherwise test.


Sexual Health ◽  
2019 ◽  
Vol 16 (6) ◽  
pp. 554 ◽  
Author(s):  
Song Fan ◽  
Zuyao Yang ◽  
Fengsu Hou ◽  
Maohe Yu ◽  
Zhenzhou Luo ◽  
...  

Background This study was conducted to summarise the HIV epidemic, sexual behaviours and HIV testing among men who have sex with men (MSM) attending university in China. Methods: Five databases were searched for student MSM information in English and Chinese language publications. Meta-analyses were performed to calculate the pooled prevalence of HIV and syphilis, pooled mean age at first anal intercourse (AFAI) and the rate of other HIV-related behaviours among MSM attending university in China. Univariate meta-regression and subgroup analysis were conducted to explore potential sources of heterogeneity. Publication bias was measured using Egger’s test. Results: Thirty-three articles representing 31 studies were included in the analysis. The pooled HIV prevalence was 4.1% (95% CI 3.1–5.0%). The estimated AFAI was 18.7 years, but 37.5% of students had their first anal intercourse before 18 years of age. Most (88.2%) had their first sexual intercourse with a male partner. Of the MSM attending university, 4.2% of MSM engaged in commercial sex (either selling or buying sex), 10.3% had ever engaged in group sex, 13.1% had had sex with a female partner in the past month and 10.1% had ever used drugs. Most (77.7%) sought sex partners via geosocial networking gay apps or the Internet, and 42.9% had ever tested for HIV. There was a tendency for an increase in lifetime HIV testing rate from 32% in 2005–07 to 53% in 2014–16. Conclusions: This review found high HIV prevalence, early AFAI and a high prevalence of sexual risk behaviours among MSM attending university in China. Interventions aimed at increasing HIV testing and reducing sexual risk behaviours are urgently needed among this young population.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weiming Tang ◽  
Wenting Huang ◽  
Haidong Lu ◽  
Bolin Cao ◽  
Dan Wu ◽  
...  

Abstract Background HIV self-testing (HIVST) is a promising approach to expand HIV testing. HIVST is a process in which a person performs an HIV test and interprets the result. Negative HIVST results may encourage men who have sex with men (MSM) to use HIV prevention services. The objective of this study was to examine behaviors (e.g., facility-based HIV testing, condom use) after a negative HIVST test result among Chinese MSM. Methods We collected data from MSM in eight Chinese cities over a 12-month period. This is a secondary analysis of longitudinal cohort data collected as part of an intervention trial to increase HIV testing. Men completed a survey that described sociodemographic information, sexual behaviors, HIV self-testing, and facility-based HIV testing. Men who completed at least one follow-up survey were included in this analysis. Generalized linear mixed models were used to evaluate whether HIVST increased subsequent facility-based HIV testing and consistent condom use. Results We included 1219 men. Most men (78.7%) were under 30 years old and had never been married (87.0%). 755 (61.9%) men tested for HIV and 593 (49.3%) men self-tested during the study period. At baseline, among men who had never been tested for HIV, 44.9% (314/699) initiated HIVST during the study period. HIVST was associated with subsequent facility-based testing (aOR of 1.87, 95% CI: 1.47–2.37). HIVST was also associated with subsequent consistent condom use (aOR = 1.53, 95% CI: 1.13–2.06). Conclusion HIVST was associated with subsequent facility-based HIV testing and consistent condom use. HIVST may enhance uptake of related HIV prevention services at facilities, suggesting the need for more implementation research.


2020 ◽  
pp. sextrans-2020-054623
Author(s):  
Rayner Kay Jin Tan ◽  
Yin Ying Chan ◽  
Muhamad Alif Bin Ibrahim ◽  
Lai Peng Ho ◽  
Oliver Zikai Lim ◽  
...  

ObjectivesThis study draws on qualitative insights on the barriers and facilitators to HIV testing, as well as perceptions of HIV self-testing (HIVST), to propose a framework to understand not only the benefits but also potential knock-on implications of introducing HIVST in the context of other STI testing.MethodsWe conducted semistructured, in-depth interviews with 30 gay, bisexual and other men who have sex with men aged 18 and 39 years old in Singapore. Interview topics included barriers and facilitators to HIV and other STI testing, as well as perceptions of HIVST. Interviews were audio-recorded, transcribed, coded and analysed using thematic analysis.ResultsFor HIV testing, participants cited the perceived risk of acquiring, susceptibility to and symptoms of HIV as internal motivators, while social influence and accessibility of HIV testing services were external motivators. For STI testing, perceived symptoms and partner notification of STI were reported as internal and external motivators, respectively. Availability of bundle tests, starting a new relationship and instances of mandatory testing motivated both simultaneous HIV and other STI testing. The fear of a positive diagnosis and lack of confidentiality were cited as internal and external barriers to HIV testing, respectively, while low perceived severity of other STI and the cost of STI tests were cited as internal and external barriers to other STI testing, respectively. We identified pathways to HIV and other STI testing and discussed how the introduction of HIVST may reduce opportunities for other STI testing.ConclusionsThe findings of this study suggest that introducing HIVST might weaken linkages to other STI testing if alternative strategies of promoting other STI testing are not simultaneously implemented. We recommend that future interventions address both the risks of HIV and other STI simultaneously, and that structural interventions promoting HIV and other STI preventions be balanced accordingly.


2016 ◽  
Vol 28 (3) ◽  
pp. 242-249 ◽  
Author(s):  
Catherine E Oldenburg ◽  
Katie B Biello ◽  
Amaya G Perez-Brumer ◽  
Joshua Rosenberger ◽  
David S Novak ◽  
...  

The objective of this study was to characterize HIV testing practices among men who have sex with men in Mexico and intention to use HIV self-testing. In 2012, members of one of the largest social/sexual networking websites for men who have sex with men in Latin America completed an anonymous online survey. This analysis was restricted to HIV-uninfected men who have sex with men residing in Mexico. Multivariable logistic regression models were fit to assess factors associated with HIV testing and intention to use a HIV self-test. Of 4537 respondents, 70.9% reported ever having a HIV test, of whom 75.5% reported testing at least yearly. The majority (94.3%) indicated that they would use a HIV home self-test if it were available. Participants identifying as bisexual less often reported ever HIV testing compared to those identifying as gay/homosexual (adjusted odds ratio = 0.52, 95% confidence interval: 0.44–0.62). Having a physical exam in the past year was associated with increased ever HIV testing (adjusted odds ratio = 4.35, 95% confidence interval: 3.73–5.07), but associated with decreased interest in HIV self-testing (adjusted odds ratio = 0.66, 95% confidence interval: 0.48–0.89). The high intention to use HIV home self-testing supports the use of this method as an acceptable alternative to clinic- or hospital-based HIV testing.


2020 ◽  
Author(s):  
Hang Hong ◽  
Hong-bo Shi ◽  
Hai-bo Jiang ◽  
Hong-jun Dong ◽  
Yun-liang Shen

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.


2020 ◽  
Author(s):  
Jing Zhang ◽  
Joseph Tucker ◽  
Weiming Tang ◽  
Hongyi Wang ◽  
Zhenxing Chu ◽  
...  

BACKGROUND Routine HIV testing accompanied with pre-exposure prophylaxis (PrEP) requires innovative support in a real-world setting. OBJECTIVE This study aimed to determine the usage of HIV self-testing (HIVST) kits and their secondary distribution to partners among men who have sex with men (MSM) in China, who use PrEP, in an observational study between 2018 and 2019. METHODS In 4 major cities in China, we prospectively followed-up MSM from the China Real-world oral PrEP demonstration study, which provides daily or on-demand PrEP for 12 months, to assess the usage and secondary distribution of HIVST on quarterly follow-ups. Half of the PrEP users were randomized to receive 2 HIVSTs per month in addition to quarterly facility-based HIV testing. We evaluated the feasibility of providing HIVST to PrEP users. RESULTS We recruited 939 MSM and randomized 471 to receive HIVST, among whom 235 (49.9%) were daily and 236 (50.1%) were on-demand PrEP users. At baseline, the median age was 29 years, 390 (82.0%) men had at least college-level education, and 119 (25.3%) had never undergone facility-based HIV testing before. Three months after PrEP initiation, 341 (74.5%) men had used the HIVST provided to them and found it very easy to use. Among them, 180 of 341 (52.8%) men had distributed the HIVST kits it to other MSM, and 132 (51.6%) among the 256 men who returned HIVST results reported that used it with their sexual partners at the onset of intercourse. Participants on daily PrEP were more likely to use HIVST (adjusted hazard ratio=1.3, 95% CI 1.0-1.6) and distribute HIVST kits (adjusted hazard ratio=1.3, 95% CI 1.1-1.7) than those using on-demand PrEP. CONCLUSIONS MSM who used PrEP had a high rate of usage and secondary distribution of HIVST kits, especially among those on daily PrEP, which suggested high feasibility and necessity for HIVST after PrEP initiation. Assuming that fourth-generation HIVST kits are available, HIVST may be able to replace facility-based HIV testing to a certain extent. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR1800020374; https://www.chictr.org.cn/showprojen.aspx?proj=32481 INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2019-036231


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S450-S451
Author(s):  
Alexander Lankowski ◽  
Hugo Sanchez ◽  
Jose Hidalgo ◽  
Robinson Cabello ◽  
Ann Duerr

Abstract Background In Perú, where the HIV epidemic is concentrated among men who have sex with men (MSM), incidence has not changed appreciably over the last decade despite the rapid scale-up of free antiretroviral treatment (ART). New strategies for delivering effective HIV testing and prevention services to at-risk populations are greatly needed. Because most adult MSM in Perú live at home with family where it may be difficult to bring new sex partners, sex-on-premise venues (SOPVs)—such as saunas, sex clubs, and hourly hotels—might represent opportune sites at which to offer targeted HIV testing and prevention interventions. Methods From November 26, 2018 through April 15, 2019 we conducted a cross-sectional web-based survey using REDCap to assess the prevalence of SOPV attendance and associated sexual risk behaviors among MSM in Lima, Perú. SOPVs were defined as saunas, sex clubs, adult movie theaters, hotels, or bars/discos known to permit sex. We recruited participants by disseminating an anonymous survey link through local gay social media networks, with no monetary incentive to complete the survey. We asked participants how/where they met any sex partners from the prior 3 months, where they went for sex, and about HIV-associated sexual risk factors, including self-reported HIV status. We used the Pearson chi-squared test and Student’s t-test to assess whether the frequency of sexual risk behaviors differed based on SOPV attendance. Results Among n = 324 cis-gender MSM completing the survey, 16% identified as bisexual. Median age was 30 years, 62% lived at home with family, 50% had a university education or higher, and 29% reported being HIV+. 65% of respondents reported attending an SOPV to meet a partner and/or have sex in the prior 3 months. SOPV attendees were significantly more likely to report transactional sex, group sex, sex under the influence of alcohol, popper use, and have a higher number of sex partners (table). Conclusion SOPV attendance is common among MSM in Lima and associated with higher levels of several sexual behavioral risk factors. In light of this, SOPVs warrant further consideration as potential sites of outreach to offer HIV testing and prevention interventions designed to reach MSM at high risk for HIV infection. Disclosures All authors: No reported disclosures.


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