Factors associated with willingness to accept oral fluid HIV rapid testing among most-at-risk populations in China.

Huanmiao Xun,Xijiang Zhang,Zhijian Xu,Tao Huang,Wei Ma,Xiaorun Tao,Shan Yang,Yuesheng Qian,Erin C Wilson,Guoyong Wang,Pengcheng Huai,Zhenxia Jiang,Yapei Song,Gifty Marley,Cuihua Gong,Dianmin Kang,Xiufang Li,Joseph David Tucker

doi:10.1371/journal.pone.0080594

Abstract

BackgroundThe availability of oral fluid HIV rapid testing provides an approach that may have the potential to expand HIV testing in China, especially among most-a-risk populations. There are few investigations about the acceptability of oral fluid HIV testing among most-at-risk populations in China.MethodA cross-sectional study with men who have sex with men (MSM), female sex workers (FSW) and voluntary counseling and testing (VCT) clients was conducted in three cities of Shandong province, China from 2011 to 2012. Data were collected by face-to-face questionnaire.ResultsAbout 71% of participants were willing to accept the oral fluid HIV rapid testing, and home HIV testing was independently associated with acceptability of the new testing method among MSM, FSW and VCT clients (AOR of 4.46, 3.19 and 5.74, respectively). Independent predictors of oral fluid HIV rapid testing acceptability among MSM were having ever taken an oral fluid HIV rapid test (AOR= 15.25), having ever taken an HIV test (AOR= 2.07), and education level (AOR= 1.74). Engagement in HIV-related risk behaviors (AOR= 1.68) was an independent predictor of acceptability for FSW. Having taken an HIV test (AOR= 2.85) was an independent predictor of acceptability for VCT clients. The primary concern about the oral fluid HIV testing was accuracy. The median price they would pay for the testing ranged from 4.8 to 8.1 U.S. dollars.ConclusionHigh acceptability of oral fluid HIV rapid testing was shown among most-at-risk populations. Findings provide support for oral rapid HIV testing as another HIV prevention tool, and provide a backdrop for the implementation of HIV home testing in the near future. Appropriate pricing and increased public education through awareness campaigns that address concerns about the accuracy and safety of the oral fluid HIV rapid testing may help increase acceptability and use among most-at-risk populations in China.

Highlights

In China, the most-at-risk populations for HIV infection have been changing over time, from injection drug users (IDUs) and plasma donors to heterosexuals contracting HIV via commercial sex with female sex workers (FSW) and homosexual transmission among men who have sex with men (MSM) [1]
Students, workers and food beverage workers were the primary occupations among MSM and voluntary counseling and testing (VCT) clients; 87.2% FSW worked on business service (Table 1)
The results from our study showed that knowledge and experience of taking oral fluid HIV rapid test were limited among most-at-risk populations in Shandong Province

Summary

Introduction

In China, the most-at-risk populations for HIV infection have been changing over time, from injection drug users (IDUs) and plasma donors to heterosexuals contracting HIV via commercial sex with female sex workers (FSW) and homosexual transmission among men who have sex with men (MSM) [1]. Almost half of the people living with HIV/AIDS have not yet been tested and diagnosed, there remains a high risk for onward transmission. There are few investigations about the acceptability of oral fluid HIV testing among most-at-risk populations in China. Results: About 71% of participants were willing to accept the oral fluid HIV rapid testing, and home HIV testing was independently associated with acceptability of the new testing method among MSM, FSW and VCT clients (AOR of 4.46, 3.19 and 5.74, respectively). Conclusion: High acceptability of oral fluid HIV rapid testing was shown among most-at-risk populations.

Methods

Results

Conclusion