Willingness And Its Correlations Of Promoting HIV Testing Of Sexual Partners By Self-testing Kits Among HIV-positive MSM In Guangzhou

Objectives: To understand partner notification and its correlations according to sexual partner types among HIV-positive MSM in Guangzhou.To understand the willingness to promote HIV testing of sexual partners by HIV self-testing(HIVST)kits and its correlations among HIV-positive MSM in Guangzhou.To explore the feasibility of promoting HIV testing of sexual partners by self-testing kits among HIV-positive MSM in Guangzhou.Methods: In April 2016 to December 2016,this study was conducted among HIV-positive MSM in Guangzhou.Guangzhou Center for Health Care was the main survey field,which was established for MSM by Guangzhou Center for Disease Control and Prevention,GZTZ.org and Lingnan Health Center.An electronic-questionnaire was conducted by respondent to collect demographic characteristics,sexual behaviors,social discrimination,partner notification,understanding and usage of HIVST kits and the willingness to promote HIV testing of sexual partners by HIVST kits.Then HIVST kits were distributed to ones who were glad to bring them to theirs partners.The usages and results of HIVST of partners were collected after three months.SAS 9.3 software was used to analyze the data with descriptive statistics,chi-square tests,Fisher exact probability tests and Logistic regression analyses.Results:1.The recruitment and demographics: In total,340 HIV-positive MSM were recruited in this study,the median age of which was 28 years old.Of the 340 participants,65.9%(224/340)achieved junior college or university degree.87.7%(298/340)of them self-identified as homosexual,and 9.1%(31/340)were married and had spouse.45.3%(154/340)of them were diagnosed as HIV infection at least two years.2.Sexual behaviors in the past six months: In the past six months,58.8%(200/340)of them had regular partners and 43.5%(148/340)of them had casual partners.During having anal intercourse with anal partner,regular partner and casual partner,70.0%(177/253),75.0%(150/200)and 69.6%(103/148)were consecutive in using condoms respectively.In the past six months,53.2%(181/340)of them used rush popper,Vacant Capsules or Viagra,and 9.4%(32/340)of them attended gay venues.3.Different types of Partner notification and its correlations: There were38.7%(12/31),67.5%(135/200)and 45.3%(67/148)of the participants engaged in spouse notification,regular partner notification and casual partner notification in the past six months,respectively,while only 16.9%(25/148)of participants who had casual partners notified all the casual partners of their HIV serostatus.Multivariate Logistic regression analyses indicated that participants having single regular partner(a OR=2.77,95%CI:1.46~5.24),knowing HIV-infected individuals have partner notification obligation(a OR=6.74,95%CI:3.33~13.65),having a lower degree feel of social discrimination against people living with HIV/AIDS(PLWHA)(a OR=4.69,95%CI:1.39~15.80)and having discussed the need to notify partners with an HIV medical-care provider(a OR=3.32,95%CI:1.59~6.93)were more likely to notify regular partners of their HIV serostatus,while participants knowing HIV-infected individuals have partner notification obligation(a OR=4.69,95%CI:2.19~10.06)and having discussed the need to notify partners with an HIV medical-care provider(a OR=4.09,95%CI:1.71~9.78)were more likely to notify casual partners of their HIV serostatus.4.Willingness to promote partners' HIV testing by HIVST: Among 340 participants,76.8%(261/340)of them said they were glad to recommend HIVST kits to partners.There were 77.4%(24/31),81.5%(145/178)and 70.3%(104/148),respectively,saying that they were glad to recommend HIVST kits to spouses,regular partners and casual partners.Surprisingly,85.1%(74/87)of HIV-positive MSM who had no sexual partner in the past six months were glad to recommend HIVST kits to forepassed or future partners.Participants having no partner(a OR=5.58,95%CI:1.70~15.88),having regular partners only(a OR=4.70,95%CI:1.59~13.32)and having both regular and casual partners(a OR=3.95,95%CI:1.23~8.90)were gladder to recommend HIVST kits to partners,when compared with those having regular partners only in the past six months.5.correlations of willingness to promote partners' HIV testing by HIVST:Multivariate Logistic regression analyses indicated that participants who were diagnosed as HIV infection less than six months(a OR=3.50,95%CI:1.09~11.28),who engaged in partner notification in the past six months(a OR=2.37,95%CI:1.06~5.29),who had used HIVST(a OR=2.84,95%CI:1.02~7.92)and whose friends or partners had used HIVST(a OR=2.72,95%CI:1.16~6.38)were gladder to recommend HIVST kits to regular partners,while participants who were diagnosed as HIV infection less than six months(a OR=3.80,95%CI:1.31~11.01),who engaged in partner notification in the past six months(a OR=2.93,95%CI:1.32~6.46)and who thought HIVST is no worse than VCT(a OR=6.56,95%CI:1.36~31.61)were gladder to recommend HIVST kits to casual partners.6.HIVST kits application and partners' usage actually: Actually,seven participants applied for HIVST kits to recommend them to partners.Three partners of the seven participants used HIVST kits and fed back testing results to us,and one of the three was HIV-positive and then diagnosed as HIV infection.During bringing HIVST kits to partners,no one reported he was forced to get a HIV test and no one reported his HIV serostatus was disclosed reluctantly.Conclusion:1.Risky sexual behaviors like condomless anal intercourse,multiple sexual partners and substance abuse are active among HIV-positive MSM in Guangzhou.HIV-positive MSM attending gay venues should be drawn great attention.2.The prevalence of regular partner notification is higher than that of casual partner notification,the whole prevalence of partner notification is low among HIV-positive MSM in Guangzhou.3.HIVST is approved by HIV-positive MSM in Guangzhou.The willingness to promote partners' HIV testing by HIVST is strong.Partner notification plays a key role in this model.The model of promoting partners' HIV testing by HIVST among HIV-positive MSM is feasible preliminarily.4.The actual effects of promoting partners' HIV testing by HIVST among HIV-positive MSM needs to be further study.