JMIR Publications

ABSTRACT

Background:

HIV self-testing (HIVST) holds great promise for expanding HIV testing. Yet, large scale data on HIVST behavior is scant. Millions of HIVST kits were sold through e-commerce platforms each year.

Objective:

This study aimed to analyze spatiotemporal distribution of the HIVST kit purchasing population (HIVSTKPP) in China.

Methods:

Deidentified transaction data were retrieved from a leading e-commerce platform in China. Bayesian spatiotemporal analysis was performed to locate hot spots with HIVSTKPP rates. Spatial autocorrelation analysis and space-time cluster analysis were conducted to identify clusters of HIVSTKPP

Results:

Between 1 January 2016 and 31 December 2019, a total of 2.18 million anonyms in China placed 4.15 million orders and purchased 4.51 million HIVST kits online. In each year, the observed monthly HIVSTKPP peaked in December, the month of the World AIDS Day. HIVSTKPP rates per 100,000 population significantly increased from 20.62 in 2016 to 64.82 in 2019. Hot spots were mainly located in municipalities, provincial capitals, and large cities, while high-high clusters and high-demand clusters were predominantly detected in cities along the southeast coast. We found positive correlations between a region’s number of HIV testing facilities, urbanization ratio, and GDP per capita and the HIVSTKPP.

Conclusions:

Our study identified key areas in larger demands for HIVST for public health policymakers to re-allocate resources and optimize the HIV care continuum. Further research combining spatiotemporal patterns of HIVST with HIV surveillance data is urgently needed to identify potential gaps in current HIV-monitoring practices.