Using Photovoice to explore HIV self-testing and secondary distribution of HIV self-testing among gay, bisexual and other men who have sex with men in China

Abstract

AbstractBackgroundHuman immunodeficiency virus self-testing (HIVST) has been globally recognized as a useful and reliable strategy to promote HIV testing, especially among marginalized populations. In order to improve the understanding of HIVST uptake of the test users, notably gay, bisexual and other men who have sex with men (GBMSM) in China, this study aims to qualitatively explore the HIVST uptake experiences among this population.MethodsThe study employed Photovoice methodology, theoretically built on documentary photography and critical consciousness, to explore the experiences of HIVST and secondary distribution among GBMSM in China. Participants created photos and citations and shared and discussed them in the group. Three focus groups and one follow-up interview were held virtually for each participant who were self-identified as gay or bisexual and used a self-test kit before.ResultsThis program recruited 22 participants from all throughout China. The findings revealed that systemic discrimination based on gay identification and AIDS-phobia both inside and outside the gay community, affected participants’ decision to take HIVST and to pass HIVST kits on to others. Participants utilized HIVST on a routine basis, citing sexual health concerns, psychological comfort, and a responsibility to their significant others as reasons for doing so.HIVST kitdistribution within intimacy,andthe significant role of gay-led community-based organizationswere found as characteristics of interactions between participants and those who they passed HIVST kit(s) on to. There were observed both facilitators and barriers to HIVST uptake and/or secondary distribution in this demographic.ConclusionIn the study, images and narratives were acquired through empowering GBMSM and promoting their community engagement to underline the necessity for measures and policies on promoting HIVST among this population. Findings also entailed the need to create a more inclusive society for sexual minorities and people living with HIV. Implications for promoting HIVST secondary distribution and limitations and strengths of the pioneer photovoice study among GBMSM in China were also listed.