Abstract

Partner notification and testing could expand HIV testing and link infections to care. We performed a meta-analysis on HIV testing rate and prevalence among couples of people diagnosed with HIV in China. Six electronic databases (PubMed, Cochrane Library, Embase, Web of Science, the China National Knowledge Internet, and WanFang) and abstracts of five HIV/sexually transmitted infections conferences were searched up to February 1, 2020. Meta-analysis was conducted using a random-effects model to assess HIV testing rate and prevalence among couples of Chinese people diagnosed with HIV. Of 3,657 records retrieved, 42 studies were identified. Among them, three studies were conducted among pregnant women and 10 among men who have sex with men. The pooled uptake rate of couples HIV testing among Chinese people diagnosed with HIV was 65% (95% confidence interval, 57% -73%; 23 studies). The pooled HIV prevalence among couples who had an HIV test was 28% [24%-32%] (38 studies). Subgroup analyses showed that the pooled couples HIV testing uptake rates among pregnant women and men who have sex with men were 76% [66%-86%] (3 studies) and 49% [30%-68%] (8 studies), and the pooled HIV prevalence in two populations was 53% [27%-78%] (3 studies) and 14% [10%-17%] (10 studies), respectively. Nearly two-thirds of couples of people diagnosed with HIV have had an HIV test, of whom 28% were positive. Couples of MSM with a positive HIV diagnosis had a lower testing rate, which indicates more effective strategies need to be carried out to improve couples HIV testing among Chinese MSM.

Highlights

  • Intravenous drug use played a major role in HIV transmission in China; currently, sexual intercourse is the main mode of HIV transmission [1, 2]

  • The pooled uptake rate of couples HIV testing among Chinese people diagnosed with HIV was 65% (95% confidence interval, 57% -73%; 23 studies)

  • Subgroup analyses showed that the pooled couples HIV testing uptake rates among pregnant women and men who have sex with men were 76% [66%-86%] (3 studies) and 49% [30%-68%] (8 studies), and the pooled HIV prevalence in two populations was 53% [27%-78%] (3 studies) and 14% [10%-17%] (10 studies), respectively

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Summary

Introduction

Intravenous drug use played a major role in HIV transmission in China; currently, sexual intercourse is the main mode of HIV transmission [1, 2]. 68% of people living with HIV (PLWH) are aware of their positive status [3], which is well below from the 90% awareness target by 2020 as set by the Joint United Nations Programme on HIV and AIDS [4] This suggests that there is still a significant gap of HIV testing in China. Couples HIV Testing (CHT) is an approach to have couples tested for HIV and promote HIV testing [5] This strategy can increase their knowledge of their serostatus and encourage disclosure among people who are in an ongoing sexual relationship [6, 7].

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