Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Sep 5, 2024
Date Accepted: Nov 19, 2024
Awareness of Sexual Partner’s HIV Status Among Men Who Have Sex with Men in Zhejiang Province, China, a Large-Internet Cross-section Study
ABSTRACT
Background:
Men who have sex with men (MSM) constitute a significant proportion of HIV-infected individuals living with HIV. Over the past few years, China has implemented various strategies aimed at increasing the rate of HIV testing and reducing HIV transmission among MSM. Among these, the HIV serostatus disclosure approach has received particular attention.
Objective:
This study aimed to assess HIV serostatus disclosure and identify factors associated with awareness of sexual partners’ HIV status among MSM to provide a scientific basis for promoting HIV testing and reducing HIV transmission.
Methods:
A cross-sectional survey based on a large-scale internet survey was conducted among MSM in Zhejiang Province, China, between July and December 2023. MSM who were HIV-negative/unknown HIV status were recruited from the “Sunshine Test,” an Internet platform that uses location-based services to provide HIV prevention services. Participants were required to complete a questionnaire on demographic characteristics, sexual behavior, rush popper use, awareness of sexual partners’ HIV status, and knowledge of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). A multinomial regression model was used to identify the risk factors associated with awareness of sexual partners’ HIV status.
Results:
A total of 7629 MSM participated in the study, with 45.2% (3451) being aware, 35.4% (2701) being partly aware, and 19.4% (1477) being unaware of their sexual partner’s HIV status. The multinomial Logistic regression analysis revealed the following results: Compared to the unawareness of sexual partner’s HIV status group, participants who were students (adjusted odds ratio [aOR] = 1.43, 95% confidence interval [CI] 1.09-1.86), have a monthly income of more than US $1400 (aOR = 1.36, 95% CI: 1.03–1.80), perform insertive anal sex (aOR = 1.35, 95% CI: 1.12–1.63), have only male sex partner (aOR = 1.53, 95% CI: 1.28–1.82), have had one sex partner in the past 3 months (aOR = 2.36, 95% CI: 2.01–2.77), have used condom the past 3 months (aOR = 1.72, 95% CI: 1.33–2.22), frequently used rush poppers in the past 3 months (aOR = 2.27, 95% CI: 1.81–2.86), were aware of HIV PrEP (aOR = 2.04, 95% CI: 1.68–2.48), were aware of HIV PEP (aOR = 1.69, 95% CI: 1.39–2.06), use mail reagent self-testing (aOR = 1.19, 95% CI: 1.04–1.36), and have previously undergone HIV testing (aOR = 1.40, 95% CI: 1.16–1.69) were associated with increased odds of awareness of sexual partner’s HIV status.
Conclusions:
The awareness of sexual partners’ HIV status was low among HIV-negative/unknown MSM in China. We suggest strengthening targeted interventions through online platforms and gay applications to promote the disclosure of HIV serostatus and reduce HIV transmission among MSM.
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