Men Who Have Sex with Men Who Are College Students with More Social Contacts Are More Likely to Have Repeated HIV Testing: A Longitudinal Study in Northeast China

Abstract

Background: HIV testing promotion is a critical HIV prevention strategy targeting young men who have sex with men. Understanding young people's social networking characteristics could inform HIV testing strategy. Methods: We established a longitudinal study of college MSM as users of the Yiyou App, an HIV sero-status query software popular in China. In northeast China (include Heilongjiang province, Jilin province, and Liaoning province) from April 2017 to June 2018, we secured the consented users' social contacts (cross-sectional data) and HIV testing frequency information (longitudinal data), reported by offline HIV testing service dispensary sites. We used multivariable logistic regression and generalized estimated equations to assess predictors of frequency of HIV testing. We visualized the cross-sectional social networking information using Gephi® software. Findings: We enrolled 752 college MSM and their 390 social contacts into the study. High HIV testing-frequency was more likely among men with recreational drug use (past 6 months, aOR=1.65, 95%CI: 1.00-2.71), having >1 HIV self-test (past 6 months, aOR=2.07, 95%CI: 1.43-3.00) and >1 degree of social contact (aOR=4.58, 95%CI: 3.01-6.97). In the longitudinal analysis, from a cumulative 1299 HIV tests, men having >2 HIV tests were more likely in the past six months to report anal sex (aOR=1.75, 95%CI: 1.37-2.24), recreational drug use (aOR=1.67, 95%CI: 1.24-2.24), and having an HIV self-test (aOR=1.3, 95%CI: 1.02-1.65). Interpretation: Active social media contacts, recreational drug use, and prior HIV self-test experience predicted more frequent HIV testing among college MSM, suggesting a potential utility of using online social mobile application to deliver tailored interventions. Funding Statement: Dr Hu is supported in part by National Natural Science Foundation of China (81673232). Dr. Vermund is supported in part by the Yale Center for Interdisciplinary Research on AIDS supported by NIH grant (P30MH062294). Declaration of Interests: The authors stated: None. Ethics Approval Statement: The study was approved by Capital Medical University Ethics Review Board (2016SY15). The study protocol, contents, and procedure were explained before survey conception. Written informed consent was obtained before HIV testing. Social contact information was secured from consented participants. The behavioral surveys were conducted in the local testing service dispensary sites. Prior to data transfer for analysis, all the identifiable data from the App were de-identified in a procedure that was performed per the study protocol.