JMIR Publications

ABSTRACT

Background:

Routinely HIV testing accompanied with PrEP usage requires innovative supports in real-world settings.

Objective:

To determine HIV self-testing (HIVST) use and partner distribution among MSM using PrEP in a demonstration project in China, 2018-2019.

Methods:

In four major cities of China, we prospectively followed MSM from the CROPrEP project, which provides daily or on-demand PrEP for 12 months, to assess the usage and secondary distribution of HIVST at quarterly follow-ups. Half of the PrEP users were randomized to receive two HIVST per month, in addition to the quarterly facility-based HIV testing. We evaluated the feasibility of providing HIVST to PrEP users.

Results:

We recruited 939 MSM and randomized 471 to receive HIVST, including 235 (49.9%) daily and 236 (50.1%) on-demand PrEP users. At baseline, the median age was 29 years old and 390 (82.0%) of men had at least a college education, and 119 (25.3%) had never used facility-based HIV testing before. Three months after PrEP initiation, 341 (74.5%) men had used the HIVST provided and found it very easy to use. Among this group, 180/341 (52.8%) had distributed it to other MSM and 132/256 (51.6%) used it with sexual partners at the onset of sex. Participants on daily-PrEP were more likely to use HIVST (aHR =1.3, 95% CI: 1.0-1.6) and distribute HIVST kits (aHR=1.3, 95% CI: 1.1-1.7) compared to men using on-demand PrEP.

Conclusions:

MSM who are using PrEP had a high rate of usage and secondary distribution of HIVST, especially among those on daily PrEP. Assuming that fourth-generation HIVST kits are available, HIVST may be able to replace some of the facility-based HIV testings. Clinical Trial: CROPrEP, ChiCTR-IIN-17013762