The mediated effect of HIV risk perception in the relationship between peer education and HIV testing uptake among three key populations in China

Yuxi Lin,Kedi Jiao,Wei Ma,Chuanxi Li,Lin Wang

doi:10.1186/s12981-021-00334-2

Abstract

BackgroundPeer education and HIV risk perception are related to HIV testing uptake among key populations. We aimed to examine the association between peer education, HIV risk perception, and HIV testing uptake, as well as to evaluate the mediated effect of HIV risk perception in the relationship between peer education and HIV testing uptake.MethodsWe conducted a cross-sectional survey among 1188 HIV-uninfected or unknown participants from populations of men who have sex with men (MSM), female sex workers (FSWs), and drug users (DUs) in seven cities of China. Partial correlation analysis and regression analysis were employed to examine the associations among peer education, HIV risk perception, and HIV testing uptake. Mediation analysis was conducted to assess whether HIV risk perception mediated the hypothesized association.ResultsReceiving peer education was associated with higher odds of HIV testing uptake among MSM, FSWs and DUs. Perceiving risk of HIV infection was associated with higher odds of HIV testing uptake among MSM and DUs. Among MSM, the relationship between peer education and HIV testing uptake was mediated by moderate risk perception of HIV (indirect effect: 0.53, 95% CI 0.07 to 1.21), and by high risk perception of HIV (indirect effect: 0.50, 95% CI 0.01 to 1.17). Among DUs, the relationship between peer education and HIV testing uptake was mediated by moderate risk perception of HIV (indirect effect: 1.80, 95% CI 0.57 to 3.45).ConclusionsParticipants who received peer education tended to perceive their risk of HIV infection, which in turn was associated with increased HIV testing uptake among MSM and DUs. Therefore, in addition to peer education interventions, more report about HIV epidemic and risk assessment should also be scaled up to enhance HIV risk perception among key populations.

Highlights

Peer education and Human immunodeficiency virus (HIV) risk perception are related to HIV testing uptake among key populations
Participants A cross-sectional survey was conducted among three groups at-risk for HIV in seven cities of China in 2018, with Men who have sex with men (MSM) recruited from Shijiazhuang and Xiamen, female sex workers (FSWs) recruited from Zhengzhou, Nanchang and Biyang, and drug users (DUs) recruited from Qingdao and Shanghai
Participants who had HIV testing in the past 12 months had a higher proportion of receiving peer education and perceiving moderate or high HIV risk among three populations (p < 0.05) (Table 1)

Summary

Introduction

Peer education and HIV risk perception are related to HIV testing uptake among key populations. The first goal of the 90-90-90 cascade target proposed by the Joint United Nations Programme on HIV/ AIDS (UNAIDS) is that 90% of people living with HIV know their HIV status by 2020 [8]. At present, this goal have only been achieved within limited regions [9, 10], and HIV testing services are still underutilized among key populations around the world, given that multiple factors such as poor HIV-related knowledge, stigma, and discrimination hinder their access to HIV services [11,12,13]. It is imperative to promote HIV testing uptake among key populations to control HIV epidemic

Objectives

Methods

Results

Conclusion