Low Chlamydia and Gonorrhea Testing Rates Among Men Who Have Sex With Men in Guangdong and Shandong Provinces, China

Background Although periodic chlamydia and gonorrhea testing is recommended for men who have sex with men (MSM), little is known about testing rates in China. This study examines chlamydia and gonorrhea testing rates and testing correlates among Chinese MSM. Methods An online survey of MSM was conducted in August 2017. Men 16 years or older who had ever had sex with a man were enrolled through a gay social networking mobile application. We asked men about their sexual behaviors, community engagement in sexual health, and previous testing for chlamydia, gonorrhea, and HIV. Multivariable logistic regressions were used to examine the association of testing with community engagement and recent HIV testing. Results Of 1031 men, 819 (79.5%) were younger than 30 years, and 263 (25.5%) reported condomless sex in the past 3 months. In total, 294 (28.5%) men tested for chlamydia, 315 (30.6%) men tested for gonorrhea, and 817 (79.2%) men tested for HIV. One hundred twenty-five (42.5%) men who received chlamydia testing and 134 (42.5%) men who received gonorrhea testing had substantial community engagement. Compared with men with no/minimal community engagement, men with substantial community engagement had greater odds of chlamydia testing (adjusted odds ratio [AOR], 2.8; 95% confidence interval [CI], 1.9–4.3) and gonorrhea testing (AOR, 2.9; 95% CI, 2.0–4.4). Men with recent HIV testing were more likely to have received chlamydia testing (AOR, 1.5; 95% CI, 1.1–2.0) and gonorrhea testing (AOR, 1.6; 95% CI, 1.2–2.1). Conclusions Chlamydia and gonorrhea testing levels are low among Chinese MSM. Integrating chlamydia and gonorrhea test promotion strategies into HIV prevention programs that engage MSM communities may help bridge the gap.

[1]  Larry Han,et al.  Pay-it-forward strategy to enhance uptake of dual gonorrhea and chlamydia testing among men who have sex with men in China: a pragmatic, quasi-experimental study. , 2019, The Lancet. Infectious diseases.

[2]  Hongyun Fu,et al.  Missed Opportunities for Human Immunodeficiency Virus and Syphilis Testing Among Men Who Have Sex With Men in China: A Cross-Sectional Study , 2017, Sexually transmitted diseases.

[3]  M. Unemo,et al.  Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action , 2017, PLoS medicine.

[4]  Larry Han,et al.  Community engagement in sexual health and uptake of HIV testing and syphilis testing among MSM in China: a cross-sectional online survey. , 2017, Journal of the International AIDS Society.

[5]  M. Aalsma,et al.  Differences in risk behaviours, HIV/STI testing and HIV/STI prevalence between men who have sex with men and men who have sex with both men and women in China , 2016, International journal of STD & AIDS.

[6]  J. Tucker,et al.  Providing HIV-related services in China for men who have sex with men , 2016, Bulletin of the World Health Organization.

[7]  B. Mustanski,et al.  A Data-Driven Simulation of HIV Spread Among Young Men Who Have Sex With Men: Role of Age and Race Mixing and STIs , 2015, Journal of acquired immune deficiency syndromes.

[8]  M. Zhang,et al.  The Increased Effectiveness of HIV Preventive Intervention among Men Who Have Sex with Men and of Follow-Up Care for People Living with HIV after ‘Task-Shifting’ to Community-Based Organizations: A ‘Cash on Service Delivery’ Model in China , 2014, PloS one.

[9]  M. Unemo,et al.  Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future , 2014, Clinical Microbiology Reviews.

[10]  W. Mcfarland,et al.  A peer-led, community-based rapid HIV testing intervention among untested men who have sex with men in China: an operational model for expansion of HIV testing and linkage to care , 2014, Sexually Transmitted Infections.

[11]  R. Kirkcaldy,et al.  Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men--STD Surveillance Network, United States, 2010-2012. , 2014, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[12]  K. Gamarel,et al.  The impact of anticipated HIV stigma on delays in HIV testing behaviors: findings from a community-based sample of men who have sex with men and transgender women in New York City. , 2013, AIDS patient care and STDs.

[13]  H. J. Vriend,et al.  Modelling the impact of chlamydia screening on the transmission of HIV among men who have sex with men , 2013, BMC Infectious Diseases.

[14]  C. Kent,et al.  The Cost-Effectiveness of Screening Men Who Have Sex With Men for Rectal Chlamydial and Gonococcal Infection to Prevent HIV Infection , 2013, Sexually transmitted diseases.

[15]  C. Hoebe,et al.  The value of testing multiple anatomic sites for gonorrhoea and chlamydia in sexually transmitted infection centres in the Netherlands, 2006–2010 , 2012, International journal of STD & AIDS.

[16]  R. Peeling,et al.  The epidemic of sexually transmitted infections in China: implications for control and future perspectives , 2011, BMC medicine.

[17]  David P. Wilson,et al.  What is the potential for bisexual men in China to act as a bridge of HIV transmission to the female population? Behavioural evidence from a systematic review and meta-analysis , 2011, BMC infectious diseases.

[18]  Myron S. Cohen,et al.  A Twin Response to Twin Epidemics: Integrated HIV/Syphilis Testing at STI Clinics in South China , 2011, Journal of acquired immune deficiency syndromes.

[19]  J. Lau,et al.  Psychological factors in association with uptake of voluntary counselling and testing for HIV among men who have sex with men in Hong Kong. , 2011, Public health.

[20]  Xiangsheng Chen.  One stone to kill two birds. , 2009, Bulletin of the World Health Organization.

[21]  Catherine A McLean,et al.  Gonococcal, Chlamydia, and Syphilis Infection Positivity Among MSM Attending a Large Primary Care Clinic, Boston, 2003 to 2004 , 2009, Sexually transmitted diseases.

[22]  L. Johnson,et al.  The Effect of Genital Tract Infections on HIV-1 Shedding in the Genital Tract: A Systematic Review and Meta-Analysis , 2008, Sexually transmitted diseases.

[23]  Bei-chuan Zhang,et al.  MSM and HIV/AIDS in China , 2005, Cell Research.

[24]  P. Vernazza,et al.  Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1 , 1997, The Lancet.

[25]  J. Wasserheit,et al.  Epidemiological Synergy: Interrelationships between Human Immunodeficiency Virus Infection and Other Sexually Transmitted Diseases , 1992, Sexually transmitted diseases.