BACKGROUND
The COVID-19 pandemic creates disruptions on HIV prevention and sexual health services for men who have sex with men (MSM).
OBJECTIVE
This study compared HIV testing utilization in three different reference periods (i.e., before COVID-19 outbreak, after the outbreak, and after the pandemic was under initial control). Factors associated with HIV testing utilization after COVID-19 outbreak were also investigated.
METHODS
Participants were Chinese-speaking MSM aged ≥18 years living in Shenzhen, China. Those self-reported as HIV positive were excluded. A total of 595 participants recruited through multiple sources completed a self-administered online survey during August to September 2020. HIV testing uptake between February and July 2020 was the dependent variable, and multivariate logistic regression models were fitted.
RESULTS
About half of the participants reported any HIV testing uptake between February and July 2020 (n=331, 55.6%). As compared to the time before COVID-19 outbreak (November 2019 to January 2020), HIV testing uptake was significantly lower during February and April 2020 (44.0% versus 61.0%, p<.001). However, HIV testing uptake did not increase significantly after the pandemic was under initial control (May to July 2020) (46.6% versus 44.0%, p=.21). After adjusting for significant background characteristics, factors associated with higher HIV testing uptake between February and July 2020 included: 1) HIV testing uptake prior to COVID-19 outbreak (AOR: 10.75, 95%CI: 7.22, 16.02, p<.001), 2) use of sexually transmitted infections (STI) testing (AOR: 7.02, 95%CI: 4.10, 12.02, p<.001), other HIV/STI prevention (AOR: 3.15, 95%CI: 2.16, 4.60, p<.001) and PrEP (AOR: 3.58, 95%CI: 1.54, 8.34, p=.002) between February and July 2020, 3) CAI with RP (AOR: 2.05, 95%CI: 1.34, 3.13, p=.001) and NRP (AOR: 2.49, 95%CI: 1.39, 4.47, p=.002), and SDU (AOR: 2.72, 95%CI: 1.50, 4.94, p=.001) between February and July 2020, 4) perceived risk of HIV infection at present was higher than the time before COVID-19 outbreak (AOR: 1.15, 95%CI: 1.01, 1.30, p=.03), 5) perceived COVID-19 preventive measures taken up by HIV testing service providers to be effective (AOR: 1.52, 95%CI: 1.29, 1.78, p<.001), and 6) perceived higher behavioral control to take up HIV testing after COVID-19 outbreak (AOR: 1.18, 95%CI: 1.00, 1.40, p=.048). Concerns about COVID-19 infection during HIV testing (AOR: 0.78, 95%CI: 0.68, 0.89, p<.001), avoiding crowed places (AOR: 0.68, 95%CI: 0.48, 0.98, p=0.04) and HIV testing service providers reduced their working hours (AOR: 0.59, 95%CI: 0.48, 0.98, p=0.046) were negatively associated with the dependent variable.
CONCLUSIONS
HIV testing utilization among Chinese MSM declined after COVID-19 outbreak and did not increase after the pandemic received initial control. Removing structural barriers to access HIV testing caused by COVID-19, modifying perceptions related to HIV testing, and making use of HIV self-testing might be useful strategies to improve HIV testing among MSM during the pandemic.