The impacts of the COVID-19 pandemic on HIV testing utilization among men who have sex with men in China: Cross-sectional online survey

Ke Chun ZHANG, Yuan FANG, He CAO, Hongbiao CHEN, Tian HU, Ya Qi CHEN, Xiaofeng ZHOU, Zixin WANG

Research output: Contribution to journalArticlespeer-review

Abstract

Background: The COVID-19 pandemic has created disruptions in HIV prevention and sexual health services for men who have sex with men (MSM).

Objective: This study compared HIV testing utilization in 3 different reference periods (period 1: before the COVID-19 outbreak, November 2019-January 2020; period 2: after the outbreak, February-April 2020; and period 3: after the pandemic was under initial control, May-July 2020). Factors associated with HIV testing utilization after the COVID-19 outbreak (combined periods 2 and 3) were also investigated.

Methods: Participants were MSM aged >= 18 years living in Shenzhen, China. Those self-reporting as HIV positive were excluded. A total of 595 participants recruited through multiple sources completed a self-administered online survey during August-September 2020. HIV testing utilization after the COVID-19 outbreak was the dependent variable, and multivariate logistic regression models were fitted.

Results: HIV testing utilization was significantly lower in period 2 than in period 1 (n=262 vs 363, 44.0% vs 61.0%, P<.001). However, HIV testing utilization was not significantly higher in period 3 than in period 2 (n=277 vs 262, 46.6% vs 44.0%, P=.21). The prevalence of HIV testing utilization after the COVID-19 outbreak was seen in 331 (55.6%) participants. After adjusting for significant background characteristics, condomless anal intercourse (CAI) with regular male sex partners (RPs; adjusted odds ratio [AOR] 2.15, 95% CI 1.29-3.57) and sexualized drug use (SDU; AOR 2.94, 95% CI 1.41-6.06) both before and after the COVID-19 outbreak, CAI with RPs (AOR 2.07, 95% CI 1.06-4.07) and nonregular male sex partners (NRPs; AOR 3.57, 95%CI: 1.43-8.89) only after the COVID-19 outbreak was positively associated with the dependent variable. Regarding HIV prevention service utilization, HIV testing utilization before the COVID-19 outbreak (AOR 10.75, 95% CI 7.22-16.02) and the use of sexually transmitted infection (STI) testing (AOR 7.02, 95% CI 4.10-12.02), other HIV/STI prevention (AOR 3.15, 95% CI 2.16-4.60), and preexposure prophylaxis (PrEP; AOR 3.58, 95% CI 1.54-8.34) after the COVID-19 outbreak were associated with higher HIV testing utilization. The current perceived risk of HIV infection was higher than that before the COVID-19 outbreak (AOR 1.15, 95% CI 1.01-1.30), and perceived COVID-19 preventive measures taken by HIV testing service providers to be effective (AOR 1.52, 95% CI 1.29-1.78) and perceived higher behavioral control to undergo HIV testing (AOR 1.18, 95% CI 1.00-1.40) were positively associated with HIV testing utilization. Concerns about COVID-19 infection during HIV testing (AOR 0.78, 95% CI 0.68-0.89), avoiding crowded places (AOR 0.68, 95% CI 0.48-0.98), and HIV testing service providers reducing their working hours (AOR 0.59, 95% CI 0.48-0.98) were negatively associated with the dependent variable.

Conclusions: HIV testing utilization among Chinese MSM declined after the COVID-19 outbreak and did not increase after the pandemic was under initial control. Removing structural barriers to accessing HIV testing caused by COVID-19, modifying perceptions related to HIV testing, and making use of HIV self-testing (HIVST) might be useful strategies to improve HIV testing among MSM during the pandemic. Copyright © 2022 Ke Chun Zhang, Yuan Fang, He Cao, Hongbiao Chen, Tian Hu, Ya Qi Chen, Xiaofeng Zhou, Zixin Wang.
Original languageEnglish
Article numbere30070
JournalJMIR Public Health and Surveillance
Volume8
Issue number5
Early online dateApr 2021
DOIs
Publication statusPublished - May 2022

Citation

Zhang, K. C., Fang, Y., Cao, H., Chen, H., Hu, T., Chen, Y. Q., . . . Wang, Z. (2022). The impacts of the COVID-19 pandemic on HIV testing utilization among men who have sex with men in China: Cross-sectional online survey. JMIR Public Health and Surveillance, 8(5). Retrieved from https://doi.org/10.2196/30070

Keywords

  • COVID-19
  • HIV testing
  • Sexual risk behaviors
  • Structural barriers
  • Perception
  • Men who have sex with men
  • China
  • MSM
  • HIV
  • Testing
  • Impact
  • Utilization
  • Cross-sectional
  • Online survey
  • Barrier
  • Access

Fingerprint

Dive into the research topics of 'The impacts of the COVID-19 pandemic on HIV testing utilization among men who have sex with men in China: Cross-sectional online survey'. Together they form a unique fingerprint.