Vanderbilt Institute for Global Health, Nashville, TN, USA.
Sex Transm Dis. 2013 Mar;40(3):235-40. doi: 10.1097/OLQ.0b013e31827ca6b9.
HIV testing is the gateway for prevention and care. We explored factors associated with HIV testing among Chinese men who have sex with men (MSM).
In Chongqing City, we recruited 492 MSM in 2010 using respondent-driven sampling in a cross-sectional study. Computer-assisted self-interviews were conducted to collect information on history of HIV testing.
Only 58% of participants reported ever having taken an HIV test. Men who have sex with men who had a college degree (adjusted odds ratio [AOR], 1.7; 95% confidence interval (CI), 1.2-2.6; P = 0.008) were more likely to take a test; those who preferred a receptive role in anal sex were less likely to do so than those with insertive sex preference (AOR, 0.6; 95% CI, 0.35-0.94; P = 0.03); and those who used condoms with the recent male partner during the past 6 months were more likely to get tested (AOR, 2.87; 95% CI, 1.25-6.62; P = 0.01). Principal perceived barriers to testing included the following: fear of knowing a positive result, fear of discrimination if tested positive, low perceived risk of HIV infection, and not knowing where to take a test. Factors reported to facilitate testing were sympathetic attitudes from health staff and guaranteed confidentiality. Prevalence was high: 11.7% HIV positive and 4.7% syphilis positive.
The HIV testing rate among MSM in Chongqing is still low, although MSM prevalence is high compared with other Chinese cities. Men who have sex with men preferring receptive anal sex are less likely to get testing and perceive having lower HIV risk. Along with expanded education and social marketing, a welcoming and nonjudgmental environment for HIV testing is needed.
艾滋病病毒检测是预防和治疗的切入点。我们探究了与中国男男性行为者（MSM）艾滋病病毒检测相关的因素。
我们在重庆市，通过横断面研究中的回应者驱动抽样，于 2010 年招募了 492 名 MSM。通过计算机辅助的自我访谈收集有关艾滋病病毒检测史的信息。
只有 58%的参与者报告曾经接受过艾滋病病毒检测。与具有大专学历的 MSM 相比（调整优势比[OR]，1.7；95%置信区间[CI]，1.2-2.6；P=0.008），更有可能接受检测；与偏好插入性性偏好的参与者相比，更喜欢接受性角色的参与者接受检测的可能性较小（OR，0.6；95%CI，0.35-0.94；P=0.03）；与过去 6 个月与最近的男性伴侣使用安全套的参与者相比，更有可能接受检测（OR，2.87；95%CI，1.25-6.62；P=0.01）。主要的检测障碍包括：害怕知道阳性结果、害怕检测呈阳性时受到歧视、认为感染艾滋病病毒的风险低以及不知道去哪里检测。促进检测的因素包括卫生工作人员的同情态度和保证保密。报告的流行率较高：HIV 阳性率为 11.7%，梅毒阳性率为 4.7%。
尽管与其他中国城市相比，重庆 MSM 的艾滋病病毒检测率仍然较低，但 MSM 的流行率较高。偏好接受性肛交的 MSM 更不可能接受检测，并且认为自己的艾滋病病毒风险较低。除了扩大教育和社会营销之外，还需要为艾滋病病毒检测提供一个欢迎和非评判的环境。
