Influencing Factors Of HIV Testing Among Men Who Have Sex With Men In Shenzhen City And The Exploratory Study Of Window Phase

Objective To understand the status of HIV testing and explore the possible factors of influencing HIV testing for men who have sex with men(MSM)in Shenzhen city,and to explore the feasibility of HIV DNA and TNA testing for HIV acute/early infection screening and shorten the window phase in this population,and provide scientific basis for further research on targeted strategies for expanding detection.Methods Three methods,including time-place sampling,peer-propelled sampling and voluntary consultation testing were used to conduct questionnaire survey and blood sampling for serological testing of MSM in this city.The survey mainly included information on sexual behavior and HIV testing.HIV DNA and TNA testing were performed on the samples of MSM population with negative results of routine screening by simple random sampling,and the actual infection status of the samples was determined according to the results of Western Blot or two nucleic acid results after follow-up.SPSS 25.0 was used for statistical analysis,and frequency and composition ratio were used for statistical description of related characteristics.Using Logistic regression to analyze related factors of HIV detection and infection.The consistency test of HIV DNA/TNA and HIV infection status was conducted by SPSS statistical software.Results1.In the last 1 year,61.5%(861/1400)MSM had been tested for HIV antibody.Multivariate analysis of HIV test in the last 1 year showed that college degree or above(AOR:1.96),frequently used condoms in homosexual anal intercourse(AOR:2.69),regularly used gay dating apps(AOR:1.37),received HIV counseling or testing services(AOR:4.48),received lubricant dispensing services(AOR:1.49),identified a person infected with HIV(AOR:2.11)were factors contributing to HIV testing in persons infected with HIV.Having anal or genital symptoms(AOR:0.63)was a hindrance to HIV testing.2.15.1%(212/1400)MSM surveyed had been self-tested for HIV.Multivariate analysis showed: college degree or above(AOR: 2.52),frequent(>50%)use of condoms during homosexual anal intercourse(AOR: 1.57),use of Rush(AOR: 2.42),knew someone infected with HIV(AOR: 1.64)were contributing factors to HIV self-testing.Living in this city for 1 year(AOR:0.65)and receiving lubricant distribution service(AOR:0.57)were obstacles to HIV self-testing.3.7.4%(104/1400)of MSM surveyed tested positive for HIV.Multivariate analysis results showed that consistent use of condoms(AOR: 0.43),use of Rush(AOR: 2.04),had anal or genital symptoms(AOR: 2.04),and HIV self-testing(AOR: 2.47)were risk factors for HIV infection.College degree or above(AOR: 0.52),HIV awareness(AOR: 0.55),HIV testing in the last 1 year(AOR: 0.49),testing in a peer volunteer organization(AOR: 0.35)were protective factors for HIV infection.4.Among the 489 MSM samples with HIV antibody negative initial screening,485 were found to be uninfected and 4 were found to be infected.HIV DNA was successfully detected in 3 cases and one case was missed,the sensitivity and specificity of this test were 75%(3/4),99.8%(484/485),respectively,and the Kappa value was 0.748(P<0.001).HIV TNA was detected successfully without missing detection,the sensitivity and specificity of this detection are 100%(4/4),99.8%(484/485),respectively,and the kappa value was 0.888(P<0.001).Conclusions1.The HIV testing rate of MSM population in this city is low in the past year,so it is necessary to strengthen the implementation of HIV testing expansion policy,especially for the MSM with lower education level,having symptoms of anal or genital damage,and never using condom.2.The proportion of taking self-testing is low,so the publicity and promotion of self-testing should be strengthened,especially for MSM who have lived in this city for more than 1 year.3.The positive rate of HIV testing among MSM in this city is slightly high,so it is necessary to strengthen testing and intervention for MSM,and expand the coverage of prevention services,especially for MSM with lower education level,non-persistent use of condoms,use of Rush,anal or genital-related symptoms and self-testing.4.In this study,HIV DNA and TNA tests could detect HIV-infected persons who are screened negative for antibodies.It is recommended that it be included in the local MSM population screening program to further shorten the HIV detection window period and improve detection rate.