title: Organizational characteristics of HIV/syphilis testing services for men who have sex with men in South China: a social entrepreneurship analysis and implications for creating sustainable service models.
abstract: BACKGROUND
  UNAIDS has called for greater HIV/syphilis testing worldwide just as local HIV/syphilis testing programs are cut or altered. New models are needed to make HIV/syphilis testing services sustainable while retaining their essential public health function. Social entrepreneurship, using business principles to promote a social cause, provides a framework to pilot programs that sustainably expand testing. Drawing on fieldwork in two South Chinese cities, we examined organizational and financial characteristics of current HIV/syphilis testing systems for men who have sex with men (MSM) in addition to new pilot programs focused on revenue-generation for sustainability.
  
  
  METHODS
  We undertook a qualitative study to explore organizational and financial characteristics of HIV/syphilis testing for MSM. Data were collected from men who have sex with men and policy stakeholders in Guangzhou and Hong Kong. Framework analysis was used to identify themes and then code the data.
  
  
  RESULTS
  Our qualitative research study included MSM and policy stakeholders (n = 84). HIV/syphilis testing services were implemented at a wide range of organizations which we grouped broadly as independent community-based organizations (CBOs), independent clinics, and hybrid CBO-clinic sites. From an organizational perspective, hybrid CBO-clinic sites offered the inclusive environment of an MSM CBO linked to the technical capacity and trained staff of a clinic. From a financial perspective, stakeholders expressed concern about the sustainability and effectiveness of sexual health services reliant on external funding. We identified four hybrid CBO-clinic organizations that launched pilot testing programs in order to generate revenue while expanding HIV testing.
  
  
  CONCLUSIONS
  Many MSM CBOs are searching for new organizational models to account for decreased external support. Hybrid CBO-clinic organizations create a strong foundation to increase HIV/syphilis testing using social entrepreneurship models in China.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tucker
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Muessig
authors.forename: Rosa
authors.initials: R
authors.lastname: Cui
authors.forename: Cedric H
authors.initials: CH
authors.lastname: Bien
authors.forename: Elaine J
authors.initials: EJ
authors.lastname: Lo
authors.forename: Ramon
authors.initials: R
authors.lastname: Lee
authors.forename: Kaidi
authors.initials: K
authors.lastname: Wang
authors.forename: Larry
authors.initials: L
authors.lastname: Han
authors.forename: Feng-Ying
authors.initials: FY
authors.lastname: Liu
authors.forename: Li-Gang
authors.initials: LG
authors.lastname: Yang
authors.forename: Bin
authors.initials: B
authors.lastname: Yang
authors.forename: Heidi
authors.initials: H
authors.lastname: Larson
authors.forename: Rosanna W
authors.initials: RW
authors.lastname: Peeling
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002681:China; D016520:Entrepreneurship / Q000191:economics / Q000458:organization & administration; D015658:HIV Infections / Q000175:diagnosis*; D006296:Health Services / Q000191:economics*; D006298:Health Services Administration; D018451:Homosexuality, Male; D006723:Hong Kong; D006801:Humans; D008297:Male; D008403:Mass Screening; D015397:Program Evaluation; D036301:Qualitative Research; D012725:Sexual Behavior; D013587:Syphilis / Q000175:diagnosis*; D055815:Young Adult