Do the same socio-demographic variables predict testing uptake and sero-status? HIV and syphilis among an observational sample of Chinese men who have sex with men in Shanghai, China

• Type of Material: Article
• Authors: Casey Xavier Hall, Northwestern University; Minh Luu, Emory University; Eric Nehl, Emory University; Na He, Fudan University; Tony Zheng, Shanghai Piaoxue Multicultural Medua Ltd; Regine Haardoerfer, Emory University; Frank Wong, Emory University
• Language: English
• Date: 2020-09-01
• Publisher: SAGE PUBLICATIONS LTD
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © The Author(s) 2020.
• Final Published Version (URL): http://dx.doi.org/10.1177/0956462420909733
• Title of Journal or Parent Work: INTERNATIONAL JOURNAL OF STD & AIDS
• Volume: 31
• Issue: 10
• Start Page: 939
• End Page: 949
• Grant/Funding Information: Preparation of this article was supported in part by grants from the National Institutes of Health (R01HD056956; PI: Wong) and the Emory Center for AIDS Research (P30 AI050409; Nehl and Wong). The content of this article is solely the responsibility of the authors and does not necessarily reflect the views of the funders.
• Keywords: WORKERS; Life Sciences & Biomedicine; men who have sex with men; HIV and syphilis testing; HIV; syphilis; Immunology; Sex work; China; Science & Technology; INFECTION; SURVEILLANCE; Infectious Diseases

Abstract

HIV and syphilis are pronounced among men who have sex with men (MSM) in China and often occur as co-infections, while testing remains low. Few studies examine common predictors across these outcomes. This observational venue-based sample of 546 MSM in Shanghai, China used a common set of psychosocial predictors to construct logistic models for the outcomes (HIV non-testing, syphilis non-testing, HIV sero-status, and syphilis sero-status). Fifty-seven (10.7%) participants tested positive for HIV, 126 (23.5%) for syphilis, and 33% of HIV-positive participants had a co-infection. Non-sex working MSM had consistently higher odds of HIV and syphilis non-testing (OR= 2.2, 95% CI 1.4–3.5, p < 0.001; OR = 2.4, 95, 95% CI 1.5–3.8, p < 0.001, respectively) compared to ‘money boy’ sex workers. Participants with a 0 score on HIV knowledge had 4.1 times (95% CI 1.4–12.5, p = 0.01) the odds of reporting HIV non-testing, 6.0 (95% CI 1.96–18.5, p < 0.01) times the odds of reporting non-testing for syphilis, and 8.44 times (95% CI 1.19–59.7, p = 0.03) the odds of testing positive for HIV, compared to a score of 8. The results highlighted the importance of integrating HIV/syphilis education and promoting testing for both HIV and syphilis among all sub-groups of MSM in China.