Effectiveness of self-testing kits availability on improving HIV testing frequency for chinese men who have sex with men and their sexual partners: a protocol for a multicenter randomised controlled trial

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Abstract

Introduction

HIV epidemic is increasing among men who have sex with men (MSM) in China, yet HIV testing uptake remains low. As an emerging approach, HIV self-testing (HIVST) has the potential to promote HIV testing coverage and frequency in this population. However, evidence of the effectiveness on implementation of HIVST among Chinese MSM and their sexual partners is scarce.

Methods and analysis

The randomised controlled trial will be performed in Changsha, Changde, Shaoyang and Yiyang, Hunan province, China, recruiting 184 recent testers (men who had at least one HIV test within the past 2 years) and 26 non-recent testers (men who did not have HIV tests within 2 years or never had an HIV test). Eligible men will be randomly divided 1:1 into two groups: intervention (with free HIVST kits plus site-based HIV testing services) and control (site-based HIV testing services only). Participants in the intervention group will be provided with two free finger-prick-based HIVST kits, and can apply for two to four kits every 3 months for 1 year.

Participants in both groups will complete questionnaires via WeChat at five separate times: baseline, third, sixth, ninth and twelfth month. The primary outcome is the mean number of HIV tests for MSM over the 12-month study period. The secondary outcome is the mean number of HIV tests for sexual partners of MSM over the 12-month study period. The tertiary outcomes are the self-reported proportion of consistent condom usage for anal sex, and the numbers of sexual partners during the 12-month study period.

Ethics and dissemination

The study has been approved by the Institutional Review Board of Behavioural and Nursing Research in Xiangya School of Nursing of Central South University, China (2018002). Study results will be disseminated through conferences and academic journals.

Trial registration number

ChiCTR1800015584; Pre-results.

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Most cited references 12

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

Jianjun Li, Chuankun Yang, Hongjing Yan … (2013)

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.

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HIV epidemiology and responses among men who have sex with men and transgender individuals in China: a scoping review

Songyuan Tang, Weiming Tang, Kathrine Meyers … (2016)

Background Despite global efforts to control HIV among key populations, new infections among men who have sex with men (MSM) and transgender (TG) individuals are still increasing. The increasing HIV epidemic among MSM/TG in China indicates that more effective services are urgently needed. However, policymakers and program managers must have a clear understanding of MSM/TG sexual health in China to improve service delivery. To meet this need, we undertook a scoping review to summarize HIV epidemiology and responses among MSM and TG individuals in China. Methods We searched MEDLINE, EMBASE and the Cochrane Library for recent studies on MSM/TG HIV epidemiology and responses. We also included supplemental articles, grey literature, government reports, policy documents, and best practice guidelines. Results Overall, HIV prevalence among Chinese MSM was approximately 8 % in 2015 with a higher prevalence observed in Southwest China. TG are not captured in national HIV, STD, or other sexual health surveillance systems. There is limited data sharing between the public health authorities and community-based organizations (CBOs). Like other low and middle income countries, China is challenged by low rates of HIV testing, linkage, and retention. Several pilot interventions have been shown to be effective to increase HIV testing among MSM and TG individuals, but have not been widely scaled up. Data from two randomized controlled trials suggests that crowdsourcing contests can increase HIV testing, creating demand for services while engaging communities. Conclusion Improving HIV surveillance and expanding HIV interventions for Chinese MSM and TG individuals are essential. Further implementation research is needed to ensure high-quality HIV services for MSM and TG individuals in China. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1904-5) contains supplementary material, which is available to authorized users.

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Using Grindr, a Smartphone Social-Networking Application, to Increase HIV Self-Testing Among Black and Latino Men Who Have Sex With Men in Los Angeles, 2014.

Emily Huang, Robert W Marlin, Sean D Young … (2016)

In Los Angeles County, about 25% of men who have sex with men (MSM) are HIV-positive but unaware of their status. An advertisement publicizing free HIV self-tests was placed on Grindr, a smartphone social-networking application, from April 17 to May 29, 2014. Users were linked to http://freehivselftests.weebly.com/ to choose a self-test delivery method: U.S. mail, a Walgreens voucher, or from a vending machine. Black or Latino MSM ≥ 18 years old were invited to take a testing experiences survey. During the campaign, the website received 11,939 unique visitors (average: 284 per day) and 334 self-test requests. Among 57 survey respondents, 55 (97%) reported that using the self-test was easy; two persons reported testing HIV positive and both sought medical care. Social networking application self-testing promotion resulted in a large number of self-test requests and has high potential to reach untested high-risk populations who will link to care if they test positive.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2018

Publication date (Electronic): 14 December 2018

Volume: 8

Issue: 12

Electronic Location Identifier: e024423

Affiliations

[1 ] Xiangya Nursing School of Central South University , Changsha, China

[2 ] School of Nursing of University of California at Los Angeles , Los Angeles, California, USA

[3 ] New York University Rory Meyers College of Nursing , New York, New York, USA

Author notes

[Correspondence to ] Dr Xianhong Li; xianhong_li228@ 123456hotmail.com

Author information

Ci Zhang http://orcid.org/0000-0002-1031-9803

Article

Publisher ID: bmjopen-2018-024423

DOI: 10.1136/bmjopen-2018-024423

PMC ID: 6303590

PubMed ID: 30552280

SO-VID: ec69b713-a3e8-4b63-896f-f68bf21b19b3

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 26 May 2018

Date revision received : 29 August 2018

Date accepted : 12 October 2018

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ScienceOpen disciplines: Medicine

Keywords: hiv,men who have sex with men (msm),hiv self-testing (hivst),sexual partner testing,hiv testing frequency

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ScienceOpen disciplines: Medicine

Keywords: hiv, men who have sex with men (msm), hiv self-testing (hivst), sexual partner testing, hiv testing frequency

Effectiveness of self-testing kits availability on improving HIV testing frequency for chinese men who have sex with men and their sexual partners: a protocol for a multicenter randomised controlled trial

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Introduction

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Ethics and dissemination

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HIV Self-Testing

Most cited references 12

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

HIV epidemiology and responses among men who have sex with men and transgender individuals in China: a scoping review

Using Grindr, a Smartphone Social-Networking Application, to Increase HIV Self-Testing Among Black and Latino Men Who Have Sex With Men in Los Angeles, 2014.

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