Syphilis self-testing: A nationwide pragmatic study among men who have sex with men in china

Cheng Wang, Weibin Cheng, Changchang Li, Weiming Tang, Jason J. Ong, M. Kumi Smith, Hongyun Fu, Michael Marks, Juan Nie, Heping Zheng, Joseph D. Tucker, Bin Yang

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Background. Syphilis self-testing may help expand syphilis testing among men who have sex with men (MSM). China has rapidly scaled up human immunodeficiency virus (HIV) self-testing, creating an opportunity for integrated syphilis self-testing. However, there is a limited literature on implementing syphilis self-testing. Methods. A cross-sectional online survey was conducted among Chinese MSM in 2018. Participants completed a survey instrument including sociodemographic characteristics, sexual behaviors, syphilis self-testing, and HIV self-testing history. Multivariable logistic regression was conducted to identify correlates of syphilis self-testing. We also recorded potential harms associated with syphilis self-testing. Results. Six hundred ninety-nine MSM from 89 cities in 21 provinces in China completed the study. A total of 361/699 (51.7%) men tested for syphilis, of whom 174/699 (24.9%) men used syphilis self-testing. Among 174 who had self-tested, 90 (51.7%) reported that the self-test was their first syphilis test and 161 (92.5%) reported that they undertook syphilis self-testing together with HIV self-testing. After adjusting for covariates, syphilis self-testing was correlated with disclosure of sexual orientation to family or friends (adjusted odds ratio [aOR], 1.90; 95% confidence interval [CI], 1.32-2.73), reporting 2-5 male sexual partners (aOR, 1.81; 95% CI, 1.04-3.16), HIV self-testing (aOR, 39.90; 95% CI, 17.00-93.61), and never tested for syphilis in the hospital (aOR, 2.96; 95% CI, 1.86-4.72). Self-reported harms associated with syphilis self-testing were minimal. Conclusions. Scaling up syphilis self-testing could complement facility-based testing in China among MSM. Self-testing may increase first-time testing and has limited harms. Our findings suggest that syphilis self-testing could be integrated into HIV selftesting services.

Original languageEnglish (US)
Pages (from-to)2178-2186
Number of pages9
JournalClinical Infectious Diseases
Issue number10
StatePublished - May 6 2020

Bibliographical note

Funding Information:
Financial support. This work was supported by the Dermatology Hospital of Southern Medical University and the National Institutes of Health (grant numbers NICHD UG3HD096929 and NIAID K24AI143471).

Publisher Copyright:
© The Author(s) 2019.


  • MSM
  • Men who have sex with men
  • Self-testing
  • Syphilis


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