Abstract
HIV self-testing is preferred by many Chinese people for its convenience and confidentiality. However, most studies on HIV self-testing (HIVST) uptake in China overfocused on men who have sex with men and overrelied on obtrusive methods such as surveys and interviews to collect data. We aimed to explore Chinese HIVST kit users' authentic experience via their feedback comments posted on e-commerce platforms using an unobtrusive approach. In total, 21,018 feedback comments about buying and using HIVST kits posted on Chinese e-commerce platforms (Tmall and Pinduoduo) were collected. An inductive thematic analysis based on a random sample of 367 comments yielded several thematic features. These thematic features were developed into coding categories for a quantitative content analysis of another random sample of 1857 comments. Four themes were identified in the first study, including the expression of positive and negative emotions after and before getting the test, respectively, calling for living a clean and moral life in the future, comments on the sellers and HIVST kits, and the reasons for buying HIVST kits. The results from the second study suggested that there were significant associations between different platforms and several thematic features. Nearly 50% of the comments were related to the product itself and the disclosures of HIV-negative test results. More than 25% of the comments showed users' feelings of gratefulness after receiving negative test results such as "thank heavens for sparing my life." The results suggested that Chinese users relied on HIVST kits to reduce and prevent HIV infection, while they also considered HIV infection a punishment related to moral violation such as being sexually promiscuous. The traditional Chinese health belief that health is influenced by one's morality still persists among some Chinese users. Many users also lacked appropriate knowledge about HIV transmission and self-testing kits.
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