title: Accessing HIV testing and treatment among men who have sex with men in China: a qualitative study.
abstract: Barriers to HIV testing and HIV care and treatment pose significant challenges to HIV prevention among men who have sex with men (MSM) in China. We carried out a qualitative study to identify barriers and facilitators to HIV testing and treatment among Chinese MSM. In 2012, seven focus group (FG) discussions were conducted with 49 MSM participants in Nanjing, China. Purposive sampling was used to recruit a diverse group of MSM participants. Semi-structured interviews were conducted to collect FG data. Major barriers to testing included gay- and HIV-related stigma and discrimination, relationship type and partner characteristics, low perception of risk or threat, HIV is incurable or equals death, concerns of confidentiality, unaware that testing is offered for free, and name-based testing. Key facilitators of testing included engaging in high-risk sex, sense of responsibility for partner, collectivism, testing as a part of standard/routine medical care, MSM-friendly medical personnel, increased acceptance of gay/bisexual men by the general public, legal recognition and protection of homosexuals, and home self-testing. Barriers to treatment included negative coping, nondisclosure to families, misconceptions of domestically produced antiretroviral drugs (ARVs) and the benefits of treatment, and costs associated with long-term treatment. Facilitators of treatment included sense of hopefulness that a cure would be found, the cultural value of longevity, peer social support and professional psychological counseling, affordable and specialized treatment and care, and reduced HIV-related stigma and discrimination. Finally, for both testing and treatment, more educational and promotional activities within MSM communities and among the general public are needed.
authors.affiliation: a Behavioral and Community Health Sciences, Graduate School of Public Health , University of Pittsburgh , Pittsburgh , PA , USA.
authors.forename: Chongyi
authors.initials: C
authors.lastname: Wei
authors.forename: Hongjing
authors.initials: H
authors.lastname: Yan
authors.forename: Chuankun
authors.initials: C
authors.lastname: Yang
authors.forename: H Fisher
authors.initials: HF
authors.lastname: Raymond
authors.forename: Jianjun
authors.initials: J
authors.lastname: Li
authors.forename: Haitao
authors.initials: H
authors.lastname: Yang
authors.forename: Jinkou
authors.initials: J
authors.lastname: Zhao
authors.forename: Xiping
authors.initials: X
authors.lastname: Huan
authors.forename: Ron
authors.initials: R
authors.lastname: Stall
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001007:Anxiety; D044466:Asian People; D002681:China / Q000453:epidemiology; D004522:Educational Status; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010379:Peer Group; D036301:Qualitative Research; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012747:Sexual Partners / Q000523:psychology; D057545:Social Stigma; D012944:Social Support; D011795:Surveys and Questionnaires
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