Abstract
Voluntary counseling and testing (VCT) service plays an essential part in the prevention of human immunodeficiency virus (HIV) infection. The purpose of this study was to investigate the characteristics of participants and analyze the major factors of HIV infection in VCT in Nantong, China. This study was conducted between January 2010 and December 2015, based on the responses to questionnaires and blood test results retrieved from the Chinese National HIV/AIDS Comprehensive Control Information System (CNHCCIS). Multivariate logistic regression analyses were used to identify factors related to HIV infection. Differences between first-time testers and repeat testers were assessed using the chi-squared or Fisher test. Over six years, a total of 11,560 VCT participants were included, and 420 cases were confirmed to be HIV-positive. Overall, the annual number of participants was relatively stable with a mean of 1927, while there was a rapid increase in the HIV detection rate (from 1.03% in 2010 to 7.52% in 2015). In multivariate analysis, referral counseling and having a HIV-positive spouse/fixed sex partners were found to be significantly associated with HIV infection among all participants, while being unmarried or divorced, having commercial heterosexual behaviors, and male-male sexual behaviors are additional HIV-related factors for males. Compared to first-time testers, repeat testers were more willing to engage in high-risk sexual behaviors and had higher HIV detection rates (P < 0.001). In conclusion, the HIV epidemic in Nantong is still not controlled. Therefore, in the future, it is critical to expand VCT services to increase the detection rate of HIV, which can prevent the transmission of HIV effectively.
Highlights
From 2014, more than 10,000 people have been infected with human immunodeficiency virus (HIV) every year in China [1]
voluntary counseling and testing (VCT) provided an opportunity for both a primary prevention and a secondary prevention as it encompasses counseling before and after HIV testing [5]
VCT clinics were open to every participant and provided free HIV/syphilis testing at all times
Summary
From 2014, more than 10,000 people have been infected with human immunodeficiency virus (HIV) every year in China [1]. By the end of August 2018, 841,478 people in China were estimated to be living with HIV, and 226,557 were reported to have died due to HIV [2, 3]. Data from China showed that more than 56% of people living with HIV (PLWH) were unaware of their infection [4]. In 1994, the World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS (UNAIDS) proposed a strategy called HIV voluntary counseling and testing (VCT) to prevent and control HIV/AIDS. VCT provided an opportunity for both a primary prevention (i.e., preventing HIV-negative people from contracting the infection) and a secondary prevention (i.e., avoiding the progression of the disease in infected people by providing early health care and psychosocial support) as it encompasses counseling before and after HIV testing [5]. VCT had been widely accepted as the cornerstone of HIV prevention programs in many countries because of its multiple benefits [6]
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