Behavioral intention to take up different types of HIV testing among men who have sex with men who were never-testers in Hong Kong

Human immunodeficiency virus (HIV) testing is an important global prevention strategy but underutilized by local men who have sex with men (MSM). This study investigated the prevalence of behavioral intention to take up HIV testing (specific or any type), in the next six months among MSM who had not been tested for HIV in the last three years (never-testers) in Hong Kong. The data was based on 141 never-testers of 430 MSM who completed the anonymous baseline telephone survey of an ongoing randomized controlled trial from January 2015 to August 2015. Only 17.7% of them showed strong intention to take up any type of HIV testing in the next six months. Adjusted analysis showed that perceived benefit of HIV testing (adjusted odds ratio [AOR]: 1.29, 95% confidence interval [CI]: 1.01, 1.66), perceived psychological barriers of HIV testing (AOR: 0.85, 95%CI: 0.73, 1.00), and perceived self-efficacy in taking up HIV testing (AOR: 1.28, 95%CI: 1.07, 1.52) were significantly associated with behavioral intention to take up any HIV testing. Perceived cue to action from non-governmental organization staff was positively associated with a marginal p-value of 0.077 (AOR: 2.37, 95%CI: 0.97, 5.77). It is warranted to strengthen perceived benefit, remove psychological barriers, and increase perceived self-efficacy related to HIV testing. Innovative and effective health promotions are greatly needed to increase HIV testing coverage among never-testers.     

HIV testing and HIV knowledge among men who have sex with men in Natal,Northeast Brazil

Background

Men who have sex with men (MSM) account for the highest prevalence of HIV in Brazil. HIV testing allows to implement preventive measures, reduces transmission, morbidity, and mortality.

HIV抗体快速检测试剂在北京MSM中应用的真实性评价

目的评价艾滋病病毒（HIV）抗体快速检测试剂,应用于男男性行为人群（MSM）中检测的真实性。方法用两种HIV抗体口腔黏膜渗出液快速检测试剂和指尖血HIV抗体快速检测试剂,对MSM进行快速检测。同时每位调查对象抽取静脉血,用酶联免疫吸附试验（ELISA）检测HIV抗体,阳性者用蛋白免疫印迹法（WB）进行确认检测。以ELISA和WB结果作为金标准,将快速检测结果与之相比较。结果 HIV抗体口腔黏膜渗出液快速检测试剂1的阴性样本检测错误百分比为6.4%（6/94）,阳性样本检测错误百分比为0.1%（1/800）。HIV抗体口腔黏膜渗出液快速检测试剂2的阴性样本检测错误百分比为25.2%（26/103）,阳性样本检测错误百分比为0（0/795）。指尖血检测的阴性样本检测错误百分比为0（0/197）,阳性样本检测错误百分比为0.1%（1/1595）。结论两种口腔黏膜渗出液快速检测试剂都可能导致一部分HIV感染者漏检。在选择口腔黏膜渗出液快速检测试剂时需要进行多方比较和评价,同时加强对开展HIV抗体快速检测的MSM志愿者的培训。对HIV抗体口腔黏膜渗出液快速检测结果的咨询显得尤为重要。     

MSM中HIV快速检测实际利用情况及需求调查

目的了解男男性行为人群（MSM）对艾滋病病毒（HIV）快速检测的实际利用情况,获取影响MSM接受HIV快速检测的相关需求。方法 2012年10-12月,在杭州市下城区、江干区和富阳市MSM活动场所、自愿咨询检测门诊招募MSM,开展问卷调查。结果在接受调查的501名MSM中,268人回答知道HIV快速检测,占53.5%,其中93.7%（251/268）接受过快速检测,74.3%（199/268）知道快速检测可以较快获得检测结果。在需要做HIV检测时,52.7%（264/501）选择快速检测。在接受快速检测同时,希望接受艾滋病/性病咨询、梅毒检测和丙型肝炎病毒检测的比例分别为71.5%、60.9%、48.9%。79.6%希望接受快速检测的场所为疾病预防控制中心,89.2%愿意动员性伴接受快速检测。影响调查对象接受快速检测的主要因素为获得检测结果的时间（54.7%）、检测结果的准确性（54.5%）、个人信息的保密性（45.7%）等。结论 MSM对检测场所、隐私以及其他检测咨询等有不同的服务需求。因此,要加强对快速检测及相关特点的宣传,在开展快速检测时,从MSM实际需求出发进行改进,促进更多的MSM接受快速检测,扩大检测覆盖面。     

Factors associated with recency of HIV testing amongst men residing in Scotland who have sex with men

Rates of HIV testing are increasing among men who have sex with men (MSM) in Scotland and the UK. However, it remains vital to encourage MSM to test for HIV. The aim of the current study was to determine which factors discriminated among three groups of MSM: those tested for HIV within the previous year, those who had tested over one year previously, and those who had never tested. Cross-sectional data were collected using self-report, anonymous questionnaires from MSM frequenting gay venues in Glasgow, Scotland, during July 2010 (N = 822, response rate 62.6%). Those who identified themselves as HIV positive (n = 38), did not normally reside in Scotland (n = 88), and did not provide information on HIV testing (n = 13), were excluded (139 excluded, leaving N = 683). Around 57% (n = 391) had tested for HIV within the previous year, 23% (n = 155) had tested over one year previously and 20% (n = 137) had never tested. Compared with those tested within the previous year, those tested over one year previously and those never tested had greater fear of a positive-HIV test result, a weaker norm for HIV testing, and were more likely to have had no anal sex partners at all within the previous year. Those tested over one year previously were significantly older than both other groups (who were more likely to be under 25 years of age). Unprotected anal intercourse (UAI) did not discriminate among the HIV testing groups. The results highlight the need to promote HIV testing in Scotland among those under 25 years and over 45 years, those with high fear of testing, and those whose sexual behaviour puts them at risk. Interventions to increase HIV testing should promote positive norms and challenge the fear of a positive result.     

Online sex partner seeking and HIV testing frequency among young black sexual minority men

Abstract

Dating apps are a novel means of delivering HIV prevention messages. Young black sexual minority men (YBSMM) app users are at high risk for HIV and could benefit from frequent testing. Understanding testing behaviors among YBSMM is critical to inform tailored prevention interventions. We analyzed testing behaviors of 273 YBSMM, comparing typical testing frequency between app users and non-users using odds ratios. Overall, testing rates were high. App users were more likely than non-users to test at least every 12?months. App-using YBSMM exhibit high compliance with testing guidelines, which may indicate future successful uptake of biomedical preventions, such as Pre-Exposure Prophylaxis.     

Predictors of HIV testing among men who have sex with men: a focus on men living outside major urban centres in Canada

Men who have sex with men (MSM) represent almost half of new HIV infections in Canada each year. However, the vast majority of research on HIV testing among MSM has been conducted in major urban centres. The present study addressed this gap by investigating HIV testing behaviour and predictors of HIV testing among MSM living outside major urban centres, in the Interior of British Columbia. An anonymous online survey of 153 MSM assessed HIV testing behaviour and psychosocial factors that may impact HIV testing (internalized homophobia, disclosure to healthcare providers (HCPs) of same sex attraction, and gay community involvement). Almost one-quarter (24%) had never been tested and over one-third (35%) had not disclosed same sex attraction to HCPs. Internalized homophobia was associated with a lower likelihood of HIV testing, and this relationship was partially explained by the fact that those high in internalized homophobia were less likely to disclose same sex attraction to their HCPs. Neither formal nor informal involvement in the gay community was related to HIV testing, and both types of involvement were relatively low in our sample. Further research is needed to better understand the distinctive health issues facing MSM living outside major urban centres.     

HIV vulnerabilities and coercive sex at same-sex sexual debut among men who have sex with men in Beijing,China

Few studies have examined coercive sex and HIV vulnerabilities among men who have sex with men (MSM) in China. The present study seeks to compare individual characteristics between MSM who did and did not experience coercive sex at their MSM sexual debut and to identify HIV risk factors correlated with coercive sex at MSM sexual debut. In 2007, we recruited 167 MSM in Beijing, China by peer-referred social network sampling. Each participant then completed self-administered questionnaires regarding their sexual experiences and practices. Results show that 14% of participants reported coercive sex at MSM sexual debut, of whom 48% reported recent unprotected anal intercourse (UAI). Coercive sex at MSM sexual debut was significantly associated with UAI [adjusted odds ratio (AOR): 5.38, 95% confidence interval: 1.95–14.87] and lifetime number of male sex partners (AOR: 7.25, 95% CI: 2.39–22.01). Coercive sex is harming MSM in China and should be immediately addressed by researchers, public health officials, and MSM community stakeholders.     

男男性行为人群HIV感染者感染状态配对研究

该文综述了国外近年来在男男性行为人群(MSM)艾滋病病毒(HIV)感染者中,开展"感染状态配对"研究的相关文献,阐述了"感染状态配对"在降低HIV新发感染、促进咨询检测和性伴告知方面的积极意义,分析了在MSM HIV感染者中实施"感染状态配对"干预可能存在的问题,为在我国开展类似工作提供了参考信息。     

HIV testing and sexual risks among migrant men who have sex with men: findings from a large cross-sectional study in Beijing,China

Despite the exacerbating HIV transmission among migrant men who have sex with men (MSM) in China, few epidemiological studies explore their HIV testing/risk profiles. We sought to explore sociodemographic/behavioral correlates of HIV/syphilis and HIV testing among migrant MSM. A study was conducted among 3,588 HIV-uninfected MSM. Participants were recruited via short message services, peer referral, web-advertisement and community outreach. HIV/syphilis infections were lab-confirmed. Migrant MSM were more likely to be HIV-infected compared to local MSM. Among 2,699 migrant MSM, HIV testing was associated with older age, living longer in Beijing, having ≥10 lifetime male sexual partners (LMSPs), having insertive anal sex; while being unemployed/retired and having condomless receptive anal sex (CRAS) were associated with a lower odds of HIV testing. Being married, living longer in Beijing, ever testing for HIV and having sex with women were associated with lower HIV odds; while being unemployed/retired, having higher HIV perception, having ≥ 10 LMSPs and having CRAS were associated a higher HIV odds. Increased likelihood of syphilis was associated with older age, being employed, higher HIV perception, having ≥10 LMSPs and having CRAS. Our study provides implications for targeted interventions to tackle HIV/STI risks and improve HIV testing among migrant Chinese MSM.     

Accessing HIV testing and treatment among men who have sex with men in China: A qualitative study

Barriers to HIV testing and HIV care and treatment pose significant challenges to HIV prevention among men who have sex with men (MSM) in China. We carried out a qualitative study to identify barriers and facilitators to HIV testing and treatment among Chinese MSM. In 2012, seven focus group (FG) discussions were conducted with 49 MSM participants in Nanjing, China. Purposive sampling was used to recruit a diverse group of MSM participants. Semi-structured interviews were conducted to collect FG data. Major barriers to testing included gay- and HIV-related stigma and discrimination, relationship type and partner characteristics, low perception of risk or threat, HIV is incurable or equals death, concerns of confidentiality, unaware that testing is offered for free, and name-based testing. Key facilitators of testing included engaging in high-risk sex, sense of responsibility for partner, collectivism, testing as a part of standard/routine medical care, MSM-friendly medical personnel, increased acceptance of gay/bisexual men by the general public, legal recognition and protection of homosexuals, and home self-testing. Barriers to treatment included negative coping, nondisclosure to families, misconceptions of domestically produced antiretroviral drugs (ARVs) and the benefits of treatment, and costs associated with long-term treatment. Facilitators of treatment included sense of hopefulness that a cure would be found, the cultural value of longevity, peer social support and professional psychological counseling, affordable and specialized treatment and care, and reduced HIV-related stigma and discrimination. Finally, for both testing and treatment, more educational and promotional activities within MSM communities and among the general public are needed.     

Past year and prior incarceration and HIV transmission risk among HIV-positive men who have sex with men in the US*

Three quarters of new HIV infections in the US are among men who have sex with men (MSM). In other populations, incarceration is a social determinant of elevations in viral load and HIV-related substance use and sex risk behavior. There has been limited research on incarceration and these HIV transmission risk determinants in HIV-positive MSM. We used the Veterans Aging Cohort Study (VACS) 2011-2012 follow-up survey to measure associations between past year and prior (more than one year ago) incarceration and HIV viral load and substance use and sex risk behavior among HIV-positive MSM (N?=?532). Approximately 40% had ever been incarcerated, including 9% in the past year. In analyses adjusting for sociodemographic factors, past year and prior incarceration were strongly associated with detectable viral load (HIV-1 RNA >500 copies/mL) (past year adjusted odds ratio (AOR): 3.50 95% confidence interval (CI): 1.59, 7.71; prior AOR: 2.48 95% CI: 1.44, 4.29) and past 12 month injection drug use (AORs?>?6), multiple sex partnerships (AORs?>?1.8), and condomless sex in the context of substance use (AORs?>?3). Past year incarceration also was strongly associated with alcohol and non-injection drug use (AOR > 2.5). Less than one in five HIV-positive MSM recently released from incarceration took advantage of a jail/prison re-entry health care program available to veterans. We need to reach HIV-positive MSM leaving jails and prisons to improve linkage to care and clinical outcomes and reduce transmission risk upon release.     

MSM中HIV抗体阳性率及其影响因素分析

目的了解男男性行为人群（MSM）艾滋病病毒（HIV）的阳性检出率,探讨该人群感染HIV的影响因素。方法2012年1—12月,在武汉市动员MSM参加HIV抗体快速检测,并调查收集人口学和行为学信息,HIV抗体筛查阳性者接受确证检测。结果共有7123名符合条件的MSM参加了检测。分析表明,教育水平、现住址、过去3个月及最近1次肛交性行为安全套使用、找寻性伴地点、检测原因以及是否第1次参加HIV抗体检测,为影响MSM动员检测阳性发现的因素,差异均有统计学意义（P〈0．05）。其中,外地、过去3个月有时使用和最近1次没有使用安全套、在浴池找寻性伴、第1次参加检测和感觉不舒服而参加检测的MSM,HIV阳性检出的风险分别是参照组的1．830、3．082、3．530、2．762、1．943和6．141倍。结论需要综合考虑,调整动员检测模式,设计活动及分配资源,注重实际效果,从而最大限度发现地HIV阳性者。     

Feasibility of an internet-based HIV testing service: anonymous urine collection from men who have sex with men

A large proportion of people who are HIV positive do not know their serostatus because facility-based provider-initiated HIV testing and counseling, and voluntary counseling and testing, have not been efficiently implemented in China. Therefore, a new HIV testing strategy must be developed to improve testing services so that more HIV infections can be detected earlier. In this study, we established an anonymous internet-aided urine-based HIV testing service for men who have sex with men (MSM) from 1 April 2016 to 20 January 2017. In total, 3092 urine sample collection packs were distributed by grassroots organizations to MSM; 1977 (69.3%) packs were mailed back to the laboratory; and 1911 (96.7%) eligible samples were tested for HIV antibody. The rate of HIV antibody positivity was 7.1% (135/1901), excluding 10 previously-identified HIV infections. Of those tested, 65.4% (1243/1901) participants obtained their results from our website, 94 (69.6%) of 135 newly-identified urine HIV antibody-positive participants were contacted by CDC staff, and 61.7% (58/94) reported undergoing blood HIV antibody confirmation testing after learning of their urine HIV antibody test results. Of those who were tested for venous HIV antibody, 84.5% (49/58) reported being confirmed HIV antibody positive. Thirty-six of the newly diagnosed participants were successfully referred to a hospital to receive antiretroviral therapy. The rate of confirmed HIV antibody positivity was estimated to be 72.8–89.2 times of that of routine HIV antibody testing. In conclusion, this approach offers an alternative efficient HIV testing strategy to identify HIV positive persons in vulnerable populations.     

CDC-funded HIV testing,HIV positivity,and linkage to HIV medical care in non-health care settings among young men who have sex with men (YMSM) in the United States

In the United States, HIV infection disproportionately affects young gay, bisexual, and other men who have sex with men, aged 13–24 years (collectively referred to as YMSM), specifically black YMSM. Knowledge of HIV status is the first step for timely and essential prevention and treatment services. Because YMSM are disproportionately affected by HIV, the number of CDC-funded HIV testing events, overall and newly diagnosed HIV positivity, and linkage to HIV medical care among YMSM in non-health care settings were examined from 61 health department jurisdictions. Differences by age and race/ethnicity were analyzed. Additionally, trends in number of HIV testing events and newly diagnosed HIV positivity were examined from 2011 to 2015. In 2015, 42,184 testing events were conducted among YMSM in non-health care settings; this represents only 6% of tests in non-health care settings. Overall and newly diagnosed HIV positivity was 2.8% and 2.1%, respectively, with black/African–American YMSM being disproportionately affected (5.6% for overall; 4% for newly diagnosed); 71% of YMSM were linked within 90 days. The newly diagnosed HIV positivity among YMSM decreased from 2.8% in 2011 to 2.4% in 2015, and the number of newly diagnosed YMSM also decreased. Further targeted testing efforts among YMSM are needed to identify undiagnosed YMSM, specifically black YMSM.     

HIV risk and prevention among men who have sex with men in rural South Africa

Rural South African men who have sex with men (MSM) are likely to be underserved in terms of access to relevant healthcare and HIV prevention services. While research in urban and peri-urban MSM populations has identified a range of factors affecting HIV risk in South African MSM, very little research is available that examines HIV risk and prevention in rural MSM populations. This exploratory study begins to address this lack by assessing perceptions of HIV risk among MSM in rural Limpopo province. Using thematic analysis of interview and discussion data, two overarching global themes that encapsulated participants’ understandings of HIV risk and the HIV risk environment in their communities were developed. In the first theme, “community experience and the rural social environment”, factors affecting HIV risk within the broad risk environment were discussed. These included perceptions of traditional value systems and communities as homophobic; jealousy and competition between MSM; and the role of social media as a means of meeting other MSM. The second global theme, “HIV/AIDS knowledge, risk and experience”, focused on factors more immediately affecting HIV transmission risk. These included: high levels of knowledge of heterosexual HIV risk, but limited knowledge of MSM-specific risk; inconsistent condom and lubricant use; difficulties in negotiating condom and lubricant use due to uneven power dynamics in relationships; competition for sexual partners; multiple concurrent sexual partnerships; and transactional sex. These exploratory results suggest that rural South African MSM, like their urban and peri-urban counterparts, are at high risk of contracting HIV, and that there is a need for more in-depth research into the interactions between the rural context and the specific HIV risk knowledge and behaviours that affect HIV risk in this population.