Participants and Recipients in Social Network Distribution of HIV Self-Testing Kits Among Men Who Have Sex With Men in China.

BACKGROUND

Secondary distribution of HIV self-testing (HIVST) kits offers a promising strategy to expand testing among marginalized MSM. We compared characteristics of kit distributors (index participants) and recipients, and identified predictors of HIV testing and kit distribution.

METHODS

We analyzed data from a randomized controlled trial among MSM in Zhuhai, China (2019-2020). Regression models identified predictors of HIV testing and kit distribution.

RESULTS

A total of 303 index participants and 264 recipients were included. Index participants were more likely than recipients to have previously tested for HIV (84.5% vs. 62.5%), report recent (past 3 months) male-male anal intercourse (83.2% vs. 60.6%), and have multiple male partners (52.8% vs. 40.6%). Among index participants, HIV testing was associated with older age (per year increase, aOR = 1.14; 95% CI: 1.05-1.24), higher education (college vs. high school or below, aOR = 4.71; 95% CI: 1.94-11.6), and condomless sex (aOR = 3.90; 95% CI: 1.37-12.9). Among recipients, higher income ($451-750, aOR = 2.58; 95% CI: 1.11-6.00; $751-1200, aOR = 2.35; 95% CI: 1.04-5.36, vs. <$450) was linked to prior testing. Approximately 45% of index participants distributed HIVST kits to recipients. Distribution was positively associated with older age (IRR = 1.03; 95% CI: 1.00-1.07), graduate education (vs. high school or below, IRR = 2.18; 95% CI: 1.05-4.54), and number of sexual partners (IRR = 1.09; 95% CI: 1.02-1.17).

CONCLUSIONS

Tailored HIVST interventions using social network-based distribution can enhance HIV testing coverage among MSM. This strategy may improve testing uptake in low- and middle-income countries but requires further investigation.