Frequent HIV Testing: Impact on HIV Risk among Chinese Men Who Have Sex with Men

BACKGROUND:

The HIV epidemic continues to expand among men who have sex with men (MSM) in China. The NIMH Project Accept/HPTN 043 trial suggested a borderline significant trend towards HIV incidence reduction among persons with higher testing rates.

METHODS:

We assessed HIV testing histories and infection status among a community-based Beijing MSM. HIV serostatus was lab-confirmed. We ascertained demographic/behavioral factors via questionnaire-based interviews. Associations of prior HIV testing with odds of current HIV infection were assessed, seeking improved like-with-like risk comparisons through multivariable logistic regression analysis with propensity score adjustment and restricted cubic spline modeling.

RESULTS:

Among 3,588 participants, 12.7% were HIV-infected; 70.8 % reported having ever tested for HIV. Compared to MSM who never tested, those ever testing had a 41% reduction in the odds of being HIV-positive. Higher HIV testing frequencies were associated with a decreasing trend in the odds of being infected with HIV vs. a referent group with no prior testing (>6 tests [aOR: 0.27; 95%CI: 0.18, 0.41]; 4-6 [aOR: 0.55; 95%CI: 0.39, 0.78]; 2-3 [aOR: 0.61; 95%CI: 0.45, 0.82]). The multivariable adjusted model with restricted cubic spline of HIV testing frequency showed a higher frequency of prior HIV testing associated with lower odds of HIV infection, particularly among men with ≥10 lifetime male sexual partners.

CONCLUSIONS:

Using risk probability adjustments to enable less biased comparisons, frequent HIV testing was associated with a lower HIV odds among Chinese MSM.

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By:  Liu Y1, Qian HZ, Ruan Y, Wu P, Osborn CY, Jia Y, Yin L, Lu H, He X, Shao Y, Vermund SH.

• 1Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
• 2 Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
• 3 State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
• 4 Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
• 5 Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
• 6 Division of General Internal Medicine & Public Health, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
• 7 Beijing Municipal Center for Disease Control and Prevention, Beijing, China
• 8 Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA. 
• J Acquir Immune Defic Syndr. 2016 Mar 19. 

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