Missed opportunities for human immunodeficiency virus and syphilis testing among men who have sex with men in China: a cross-sectional study

Jason Ong, Hongyun Fu, Stephen Pan, M Kumi Smith, Dan Wu, Chongyi Wei, Bolin Cao, Wei Ma, Ligang Yang, Weiming Tang, Joseph Tucker

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


BACKGROUND: Men who have sex with men (MSM) are at high risk of human immunodeficiency virus (HIV)/syphilis. To inform strategies for dual testing, we describe patterns of HIV/syphilis testing, and examine factors associated with never testing for HIV/syphilis in China.

METHODS: An online survey (2016) was completed by MSM from 8 cities: men born biologically male, 16 years or older, and had sex with another man at least once during their lifetime. Demographic, sexual behavioral, and HIV/syphilis testing data were collected. Multivariable multinomial logistic regression identified characteristics associated with men who never tested for HIV/syphilis compared with men who ever tested for both infections.

RESULTS: Overall, 2105 men participated. Among them, 35.1% (738/2105) never tested for HIV/syphilis, and in those ever tested for HIV, only half (54.0%, 709/1312) had tested for syphilis. Relative to men who had ever tested for both infections, those with increased probability of never testing for HIV/syphilis include non-gay sexual identity (prevalence odds ratio [POR] 1.86; 95% confidence interval [CI], 1.45-2.37), not disclosed their sexuality/sexual history with men other than their regular partner (POR, 2.22; 95% CI, 1.75-2.78]) or with health professionals (POR, 11.11; 95% CI, 7.69-14.29), no condomless sex with casual partners in the last 3 months (POR, 1.89; 95% CI, 1.37-2.56), no community engagement in sexual health (POR, 15.16; 95% CI, 9.40-24.45), and mainly met partners offline (POR, 1.49; 95% CI, 1.16-1.92).

CONCLUSIONS: There are significant gaps in lifetime testing for HIV/syphilis among Chinese MSM. Strategies to target never testers and integrate syphilis testing within HIV testing services are urgently needed. Future opportunities include point-of-care dual test kits, and testing in China's expanding primary healthcare system.
Original languageEnglish (US)
Pages (from-to)382-386
Number of pages5
JournalSexually Transmitted Diseases
Issue number6
StatePublished - Jun 2018

Bibliographical note

Funding Information:
Conflicts of Interest: Funding has been received from the National Institutes of Health (NIAID 1R01AI114310-01), UNC-South China STD Research Training Center (FIC 1D43TW009532-01), UNC Center for AIDS Research (NIAID 5P30AI050410), UCSF Center for AIDS Research (NIAID P30 AI027763), NIMH (R00MH093201), UJMT Fogarty Fellowship (FIC R25TW0093), Australian National Health and Medical Research Council (APP1104781) and SESH Global (www.seshglobal. org). Administrative assistance from the Guangdong Provincial Center for Skin Diseases and STI Control. UNC Chapel Hill, and UNC Project-China in Guangzhou, China.

Publisher Copyright:
© Lippincott Williams & Wilkins.


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