Reasons for boosting HIV testing and association with risky sexual behaviors in MSM population: evidence from China

Abstract

Background: A regular human immunodeficiency virus (HIV) testing with a safe sexual behavior is an important preventive strategy in the control of HIV especially among men who have sex with men (MSM), who are in risk of HIV infection. Therefore, we aim to explore the reasons boosting HIV testing among MSM and the risky sexual behaviors behind. Methods: An institutional based investigationwas conducted to collect data from MSM in January and December 2022in Zhejiang Coastal Public Welfare Center which is a non-government organization (NGO). The risky sexual behaviors included commercial sexual behaviors, unprotected sexual behaviors, multiple sexual partners, drug using and using sexual stimulant. The reasons for boosting MSM to have HIV testing included prevention before/after exposure, regular habit testing high risk post testing, peer driven testing, publicity and education testing and others. The factors influencing the unprotected sex, multiple sexual partners, using drugs and sexual stimulants of MSM were explored based on multivariate logistic regression. Results:In total, 7266 MSM were incorporated in the analysis. The most important reason for boosting MSM to have an HIV testing were their regular habit testing(51.73%) followed by high risk post test (15.99%), publicity and education testing(12.72%). The population who had high risk post HIV test had the highest percentage of unprotected sex(78.83%), commercial sex(0.84%), using drugs(4.22%) and sexual stimulant(42.0%), multiple sexual partners(30.98%) and symptoms or diagnosis of sexual transmitted diseases (6.11%) compared with MSM with other HIV testing reasons respectively. Compared with the reasons for HIV testing of prevention before/after exposure, people with high-risk post testing had a higher probability of having unprotected sex (P<0.001, OR=5.804) and multiple sexual partners (P=0.041, OR=1.476). Publicity and education testing had a lower probability of having unprotected sex (P<0.001, OR=0.432) and multiple sexual partners (P=0.006, OR=0.575). Conclusions: Reasons for boosting HIV testing among MSM were different with different risky sexual behaviors, and the rate of having risky sexual behaviors among MSM with regular HIV testing habits was lower. However, most MSM have not developed the habit of regular HIV testing. Therefore, improving the HIV testing among MSM is still important to reduce the transmission of HIV.