HIV testing uptake and yield among sexual partners of HIV-positive men who have sex with men in Zhejiang Province, China, 2014-2016: A cross-sectional pilot study of a choice-based partner tracing and testing package.

Mingyu Luo,Guomin Zhang,Lin Chen,Shichang Xia,Xiaohong Pan,Qiaoqin Ma,Katrina Hann,Jun Jiang,Chongyi Wei

doi:10.1371/journal.pone.0232268

Abstract

Measures to effectively expand tracing and testing to identify undiagnosed HIV infections are significant for the control of HIV/AIDS epidemic among men who have sex with men (MSM). We piloted a choice-based tracing and testing package aimed at improving partner tracing, uptake, and yield of HIV testing for sexual partners of newly diagnosed HIV-positive MSM. This package was piloted in the cities of Hangzhou and Ningbo, Zhejiang province, China from June 2014 to June 2016. The package adopted four modes: couples' HIV counseling and testing (CHCT), information assisted partner notification (IAPN), assisted HIV self-testing (HIVST) and patient referral. Data regarding sociodemographic factors and sexual behaviors between HIV-positive MSM and their sexual partners, as well as tracing and testing outcomes of each mode, were collected. Among 2,495 newly diagnosed HIV-positive MSM, 446(18%) were enrolled as index cases (ICs) through two rounds of contact tracing. The ICs disclosed a total of 4,716 sexual partners, of whom 548 (12%) were reachable. The pilot study resulted in a testing uptake of 87% (478/548), and a yield of 16% (74/478) among sexual partners. The generalized linear mixed model showed that the odds of a reachable sexual partner enrolled via IAPN taking an HIV test were 290% greater than that of a partner traced via CHCT (95% CI: 1.6, 9.3). A choice-based tracing and testing package can feasibly expand HIV testing uptake and case finding among sexual partners of HIV-positive MSM. IAPN may be an acceptable option to reach sexual partners for whom limited contact information is available.

Highlights

Men who have sex with men (MSM) have a substantial risk of contracting HIV/AIDS infections in China, where newly diagnosed infection increased almost six-fold between 2010 to 2016, and where the prevalence of HIV infections in men who have sex with men (MSM) was 7.75% in 2016 [1,2]
Measures to effectively expand tracing and testing to identify undiagnosed HIV infections are significant for the control of HIV/AIDS epidemic among men who have sex with men (MSM)
The index cases (ICs) disclosed a total of 4,716 sexual partners, of whom 548 (12%) were reachable

Summary

Introduction

Men who have sex with men (MSM) have a substantial risk of contracting HIV/AIDS infections in China, where newly diagnosed infection increased almost six-fold between 2010 to 2016, and where the prevalence of HIV infections in MSM was 7.75% in 2016 (similar to European countries) [1,2]. The introduction of VCTs in China allowed MSM to visit testing sites and determine their infection status through passive-case finding, in which MSM initiate HIV testing, even in areas with significant NGO outreach efforts [12]. As 25% of HIV infections among MSM remain undiagnosed [13], active case-finding approaches in which healthcare providers target this key population may be a significant step in addressing this testing gap. Measures to effectively expand tracing and testing to identify undiagnosed HIV infections are significant for the control of HIV/AIDS epidemic among men who have sex with men (MSM).

Methods

Results

Conclusion