Ren Xian-Long, Wu Zun-You, Mi Guo-Dong, McGoogan Jennifer M, Rou Ke-Ming, Zhao Yan, Zhang Nanci
Division of Prevention Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China.
Office of the Director, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China.
Infect Dis Poverty. 2017 Jun 28;6(1):112. doi: 10.1186/s40249-017-0326-y.
Men who have sex with men (MSM) has become the group with the fastest growing HIV epidemic in China. Since many Chinese MSM are conducting HIV self-testing, we aimed to determine the rate of HIV care seeking after self-testing, examine characteristics of "seekers" compared to "non-seekers," and explore factors associated with HIV care-seeking behaviour.
A cross-sectional study design was used and an online survey was conducted in Beijing, China in 2016, among users of a popular Chinese gay networking smart phone application. Chi-square test was used to compare characteristics of those who sought HIV care ("seekers") and those who did not ("non-seekers"). Univariate and multivariate logistic regression analyses were conducted to assess factors associated with HIV care seeking.
Among 21,785 screened, 2383 participants (10.9%) were included in the study. A total of 380 participants (15.9%) reported seeking HIV care after HIV self-testing while 2003 (84.1%) did not. Lack of knowledge of the "window period" (adjusted odds ratio [AOR] = 0.68, 95% confidence interval [95% CI] = 0.47-0.97, P = 0.04) was associated with reduced odds of seeking HIV care, while lower monthly income (AOR = 1.29, 95% CI = 1.03-1.62, P = 0.03) and obtaining HIV self-testing kits from health facilities (AOR = 2.40, 95% CI = 1.81-3.17, P < 0.001), and non-governmental organizations (AOR = 2.44, 95% CI = 1.79-3.34, P < 0.001) was associated with increased odds of seeking HIV care. Among those who sought HIV care, a large majority (92.4%) had non-reactive HIV self-testing results. Only 29 out of 265 with reactive, uncertain, or unknown results sought HIV care.
We found a very low rate of HIV care seeking among our sample of urban Chinese MSM. The observation that most with reactive, uncertain, or unknown results did not seek HIV care is a cause for concern. These people should be paid more attention and helped to enter the care cascade. Our findings highlight that interventions aimed at improving linkage to care after HIV self-testing are urgently needed. However, further study is required to inform the design and implementation of future interventions aiming to encourage HIV care-seeking behaviour.
男男性行为者已成为中国艾滋病疫情增长最快的群体。由于许多中国男男性行为者正在进行艾滋病自我检测，我们旨在确定自我检测后寻求艾滋病护理的比例，研究“寻求者”与“非寻求者”的特征，并探索与寻求艾滋病护理行为相关的因素。
采用横断面研究设计，2016年在中国北京对一款流行的中国同性恋社交智能手机应用程序的用户进行了在线调查。采用卡方检验比较寻求艾滋病护理者（“寻求者”）和未寻求者（“非寻求者”）的特征。进行单因素和多因素逻辑回归分析以评估与寻求艾滋病护理相关的因素。
在21785名筛查对象中，2383名参与者（10.9%）纳入研究。共有380名参与者（15.9%）报告在艾滋病自我检测后寻求艾滋病护理，而2003名（84.1%）未寻求。对“窗口期”缺乏了解（调整优势比[AOR]=0.68，95%置信区间[95%CI]=0.47-0.97，P=0.04）与寻求艾滋病护理的几率降低相关，而月收入较低（AOR=1.29，95%CI=1.03-1.62，P=0.03）以及从医疗机构（AOR=2.40，95%CI=1.81-3.17，P<0.001）和非政府组织（AOR=2.44，95%CI=1.79-3.34，P<0.001）获得艾滋病自我检测试剂盒与寻求艾滋病护理的几率增加相关。在寻求艾滋病护理的人群中，绝大多数（92.4%）艾滋病自我检测结果为阴性。在265名检测结果为阳性、不确定或未知的人群中，只有29人寻求了艾滋病护理。
我们发现中国城市男男性行为者样本中寻求艾滋病护理的比例非常低。大多数检测结果为阳性、不确定或未知的人未寻求艾滋病护理这一现象令人担忧。这些人应得到更多关注并帮助其进入护理流程。我们的研究结果凸显了迫切需要采取干预措施以改善艾滋病自我检测后与护理的衔接。然而，需要进一步研究为未来旨在鼓励寻求艾滋病护理行为的干预措施的设计和实施提供依据。
