Changing trends of HIV testing and HIV self-testing in men who have sex with men on a gay social networking app

Abstract

Objective: To understand the changing trends of HIV testing rates, with a focus on HIV self-testing, and to evaluate the impact of HIV self-testing on expanding HIV testing among MSM in China in past few years. Methods: MSM were recruited online nationwide via a gay social networking app (Blued) from 2013 to 2016 and 2018. The survey collected information about socio-demographic backgrounds, sexual behaviors, and prior HIV testing experiences, including HIV self-testing. Trend analyses were conducted. Results: Respectively, 1 342, 1 424, 1 173, 2 105 and 699 MSM were recruited nationwide from 2013 to 2016, and in 2018. The mean age was (30.6±6.6)years in 2013 and showed a decreasing trend afterwards. The HIV testing rate was 60.0% (805/1 342) in 2013 and there was a rising trend from 2013 to 2016, and 2018 (trend Z =19.3, P <0.001), reaching a peak at 77.3% (540/699) in 2018. Further, the HIV self-testing rate increased from 19.3% (259/1 342) in 2013 to 58.1% (406/699) in 2018 (χ2=237.5, P <0.001). The proportion of MSM who had HIV self-testing among prior HIV testers significantly increased from 32.2% (259/805) to 75.2% (406/540) during the study period (trend Z =14.3, P <0.001). Conclusions: The HIV testing rate, HIV self-testing rate and proportion of men who had HIV self-testing among former HIV testers among web-based Chinese MSM showed substantial increases from 2013 to 2016,and 2018. This suggests that HIV self-testing may have a significant effect on the expansion of HIV testing coverage in MSM, and has important public health implications for HIV/AIDS prevention in China.