Abstract
BackgroundIncreasing human immunodeficiency virus (HIV) testing is critical for HIV control. This study aimed to evaluate the interaction between social norms and self-efficacy on HIV testing among Chinese men who have sex with men (MSM).MethodsWe conducted an online survey in eight Chinese cities in Shandong and Guangdong Provinces in July 2016. We included participants who were born as a male, at least 16 years old, currently living in one of the designated cities, and had ever engaged in anal sex with a man. We collected information regarding socio-demographics, high-risk behaviors, and history of HIV and other STI testing. We coded sensitivity to social norms using six items asking participants about their perceived social norm regarding HIV testing. We coded HIV testing self-efficacy using a separate six-item scale. We interpreted higher mean scores as higher sensitivity to social norms and higher self-efficacy, respectively. We conducted logistic regressions to evaluate the interaction between self-efficacy and social norms on HIV testing.ResultsA total of 2105 men completed the survey. The mean age of the participants was 25.97 ± 6.42 years. Over four-fifths (85.9%) of participants were unmarried, 22.7% were students, and 64.6% at least had a college degree. 62.5 and 32.6% of participants ever and tested HIV in the last three months, respectively.With respect to uptake of HIV testing in the last three months, the adjusted odds ratio was 1.01(95% CI: 0.96–1.06) for higher sensitivity to social norms and 1.09 (95% CI: 1.05–1.14) for higher self-efficacy, with an interaction effect of 1.02 (95% CI: 1.01–1.03), respectively. With respect to uptake of lifetime HIV testing, the adjusted odds ratio was 1.03(95% CI: 0.99–1.07) for higher sensitivity to social norms and 1.15 (95% CI: 1.11–1.19) for higher self-efficacy, with an interaction effect of 1.02 (95% CI: 1.01–1.04), respectively.ConclusionsOur survey demonstrated that there is a significant association between the uptake of HIV testing with sensitivity to the social norm, higher self-efficacy, as well as the interaction between them. Tailored studies for improving HIV testing among MSM in China can combine these two interventions together.
Highlights
Men who have sex with men have become a key population for human immunodeficiency virus (HIV) infection [1]
Previous studies have shown that HIV testing self-efficacy and social norms had an impact on the uptake of HIV testing
Our study showed that sensitivity to HIV testing social norms was positively associated with having received an HIV testing within the past 3 months as well as lifetime HIV testing
Summary
Men who have sex with men have become a key population for HIV infection [1]. Increasing the uptake of HIV testing among MSM is a crucial component of the HIV treatment cascade and the control of the global HIV epidemic [2].To scale up HIV testing services, the Chinese government has established voluntary counseling and testing (VCT) clinics that offer free HIV testing services and provider-initiated testing and counseling (PITC) [3], but only 60% of Chinese men who have sex with men (MSM) have ever tested for HIV [4]. Studies in China and other countries indicated that HIV testing social norm and self-efficacy are two important psychosocial factors can facilitate HIV testing among MSM [7,8,9]. HIV testing self-efficacy refers to people’s level of confidence to have HIV testing [10]. HIV testing social norms refer to people’s social attitudes about HIV testing [11]. Improving HIV testing self-efficacy and perceived positive social norms of HIV testing are two intervention strategies for improving uptake of HIV testing among MSM [8, 9, 12]. This study aimed to evaluate the interaction between social norms and self-efficacy on HIV testing among Chinese men who have sex with men (MSM)
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