JMIR Publications

ABSTRACT

Background:

To date, no randomized controlled trials have specifically addressed behaviour changes after HIV self-testing (HIVST) among transgender women (TGW).

Objective:

We evaluated the effects of HIVST on changes in HIV testing behaviour, frequency of condomless sex and partner numbers among TGW in China.

Methods:

Participants were recruited from two Chinese cities using both online and offline methods. TGW were randomly assigned to receive a HIVST intervention. Data from the prior three months were collected at three- and six-month intervals. The primary outcome was the mean change in the number of HIV tests among TGW during the six-month follow-up. An intention-to-treat analysis was conducted. The statistical analysis employed analysis of covariance and linear mixed-effects models.

Results:

From February to July 2021, 255 TGW were recruited, of which only 36.5% had a steady job and 27.1% earned less than 3000 CNY of income per month. They were randomly assigned to the intervention (n=127) and control (n=128) groups. At six months, the mean number of HIV tests was 2.14 (95% confidence interval (CI): 1.80 to 2.48) in the intervention group and 1.19 (0.99 to 1.40) in the control group (P<.001), with increases of 0.84 (95% CI: 0.54 to 1.14) and 0.11 (95% CI: –0.19 to 0.41) over six months, respectively. The net increase was 0.73 (95% CI: 0.31 to 1.15; P<.001), with a similar adjusted result. No significant differences in the frequency of condomless sex or partner numbers were observed between the two groups.

Conclusions:

HIVST is an effective strategy for enhancing regular HIV testing behaviour among TGW in China. This strategy should be combined with measures on addressing the financial vulnerability of the TGW community to reduce subsequent risk behaviours, including condomless sex. Clinical Trial: This trial was registered at chictr.org.cn (ChiCTR2000039766)