Abstract
BackgroundHealth services for men who have sex with men (MSM) are inadequate in many areas around the world. HIV and syphilis test uptake remain suboptimal among MSM in China and many other regions. To inform the development of more comprehensive sexually transmitted disease (STD) testing programs among MSM, we collected descriptive data on MSM testing practices and preferences.MethodsMSM in two large urban Chinese cities were recruited through community-based organizations and clinics to participate in semi-structured interviews. We purposively sampled MSM across a range of sociodemographic characteristics and testing history, and assessed preferences for HIV and syphilis testing in the context of facilitators and barriers to testing and previous testing experiences. Each interview transcript was coded and thematically analyzed using Atlas.ti 7.0.Results35 MSM were interviewed. Confidentiality and privacy were the most important factors influencing participants’ decisions about whether and where to get tested. Men preferred rapid testing (results available within 30 minutes) compared to conventional tests where results take several hours or days to return. Participants described concerns about quality and accuracy of rapid tests offered in non-clinical settings such as community-based organizations. Men preferred testing service providers who were MSM-friendly, non-discriminatory, and medically trained. Preferred service center environments included: convenient but discrete location, MSM-friendly atmosphere, and clean/standard medical facilities.ConclusionOur data highlight the need for HIV/syphilis testing services that are confidential and inclusive of MSM. Rapid testing in decentralized (i.e. peripheral health facilities and community-level, non-clinical venues) settings provides an opportunity to reach individuals who have not been tested before, but must be accompanied by quality assurance systems and technical competence. Implementation research could further evaluate HIV/syphilis testing programs responsive to MSM preferences.Short SummaryA qualitative study of MSM in South China found that men preferred rapid STD testing at MSM-focused test centers, but were concerned about test quality assurance and confidentiality.
Highlights
Worldwide, men who have sex with men (MSM) face unique health care challenges exacerbated by persistent stigmatization and discrimination [1]
Our data highlight the need for HIV/syphilis testing services that are confidential and inclusive of MSM
A qualitative study of MSM in South China found that men preferred rapid sexually transmitted disease (STD) testing at MSMfocused test centers, but were concerned about test quality assurance and confidentiality
Summary
Men who have sex with men (MSM) face unique health care challenges exacerbated by persistent stigmatization and discrimination [1]. Sexual health is a significant issue for MSM because of high prevalence of HIV and other sexually transmitted diseases (STDs) coupled with numerous barriers to optimal care and health services [3,4]. Some high-income countries have well-developed MSM sexual health services, MSM remain under-served in many low- and middle-income countries where cultural, political and economic contexts limit HIV/STD surveillance and health programs [3,5]. In China, recent Centers for Disease Control (CDC) efforts have expanded HIV/STD surveillance, but sexual health service uptake among MSM remains low [6]. To inform the development of more comprehensive sexually transmitted disease (STD) testing programs among MSM, we collected descriptive data on MSM testing practices and preferences
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