HIV prevention services and testing utilization behaviors among men who have sex with men at elevated risk for HIV in Chongqing, China.
OBJECTIVE
To investigate barriers and correlates of the use of HIV prevention services and HIV testing behaviors among men who have sex with men in Chongqing.


METHODS
Three consecutive cross-sectional surveys provided demographic, sexual behavior, HIV/syphilis infection, HIV prevention service, and testing behavior data.


RESULTS
Of 1239 participants, 15.4% were infected with HIV, incidence was 12.3 per 100 persons/year (95% CI: 9.2-15.3), 38% of the participants reported ever having unprotected insertive anal sex, 40% ever received free condom/lubricants in the past year, and 27.7% ever obtained free sexually transmitted infection examination/treatment in the past year. Multivariable logistic regression revealed that lower levels of HIV/AIDS related stigmatizing/discriminatory attitudes, full-time jobs, and sex debut with men at a younger age were independently associated with use of free condom/lubricants. Large social networks, higher incomes, and sexual debut with men at a younger age were associated with use of any HIV prevention and HIV testing services. Lower levels of stigmatizing/discriminatory attitudes were also associated with HIV testing. Fearing needles and being unaware of the venues for testing were top barriers for testing service utilization.


CONCLUSIONS
It is imperative to address HIV/AIDS related stigmatizing/discriminatory attitudes and other barriers while delivering intervention and testing services.
Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Dayong
0000-0001-9449-8484
D
Huang
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China.
Yifei
Y
Hu
Chongqing Center for Disease Control and Prevention, Chongqing 400042, China.
Guohui
G
Wu
Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Yujiang
Y
Jia
Chongqing Center for Disease Control and Prevention, Chongqing 400042, China.
Rongrong
R
Lu
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China.
Yan
Y
Xiao
San Francisco Department of Public Health, San Francisco, CA 94102, USA.
H F
HF
Raymond
San Francisco Department of Public Health, San Francisco, CA 94102, USA ; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94105, USA.
Willi
0000-0002-4148-5660
W
McFarland
State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206, China.
Yuhua
Y
Ruan
Shandong University School of Public Health, Jinan 250012, China.
Wei
0000-0002-8092-3280
W
Ma
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China.
Jiangping
J
Sun
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D017280:Condoms / Q000706:statistics & numerical data*; D004651:Employment / Q000706:statistics & numerical data; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D006293:Health Promotion / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D054526:Men's Health; D008875:Middle Aged; D010353:Patient Education as Topic; D012307:Risk Factors; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D047568:Unsafe Sex / Q000517:prevention & control* / Q000706:statistics & numerical data*; D014600:Utilization Review; D055815:Young Adult