title: HIV and syphilis testing preferences among men who have sex with men in South China: a qualitative analysis to inform sexual health services.
abstract: BACKGROUND
  Health services for men who have sex with men (MSM) are inadequate in many areas around the world. HIV and syphilis test uptake remain suboptimal among MSM in China and many other regions. To inform the development of more comprehensive sexually transmitted disease (STD) testing programs among MSM, we collected descriptive data on MSM testing practices and preferences.
  
  
  METHODS
  MSM in two large urban Chinese cities were recruited through community-based organizations and clinics to participate in semi-structured interviews. We purposively sampled MSM across a range of sociodemographic characteristics and testing history, and assessed preferences for HIV and syphilis testing in the context of facilitators and barriers to testing and previous testing experiences. Each interview transcript was coded and thematically analyzed using Atlas.ti 7.0.
  
  
  RESULTS
  35 MSM were interviewed. Confidentiality and privacy were the most important factors influencing participants' decisions about whether and where to get tested. Men preferred rapid testing (results available within 30 minutes) compared to conventional tests where results take several hours or days to return. Participants described concerns about quality and accuracy of rapid tests offered in non-clinical settings such as community-based organizations. Men preferred testing service providers who were MSM-friendly, non-discriminatory, and medically trained. Preferred service center environments included: convenient but discrete location, MSM-friendly atmosphere, and clean/standard medical facilities.
  
  
  CONCLUSIONS
  Our data highlight the need for HIV/syphilis testing services that are confidential and inclusive of MSM. Rapid testing in decentralized (i.e. peripheral health facilities and community-level, non-clinical venues) settings provides an opportunity to reach individuals who have not been tested before, but must be accompanied by quality assurance systems and technical competence. Implementation research could further evaluate HIV/syphilis testing programs responsive to MSM preferences.
  
  
  OBJECTIVE
  A qualitative study of MSM in South China found that men preferred rapid STD testing at MSM-focused test centers, but were concerned about test quality assurance and confidentiality.
authors: University of North Carolina-Project China, Guangzhou, China; Mount Sinai School of Medicine, New York, United States of America.
authors: Cedric H
authors: CH
authors: Bien
authors: University of North Carolina-Project China, Guangzhou, China; Gillings School of Global Public Health, University of North Carolina, Chapel Hill, United States of America.
authors: Kathryn E
authors: KE
authors: Muessig
authors: Harvard Medical School, Boston, United States of America.
authors: Ramon
authors: R
authors: Lee
authors: Gillings School of Global Public Health, University of North Carolina, Chapel Hill, United States of America.
authors: Elaine J
authors: EJ
authors: Lo
authors: Guangdong Provincial STD Control Center, Guangzhou, China.
authors: Li Gang
authors: LG
authors: Yang
authors: Guangdong Provincial STD Control Center, Guangzhou, China.
authors: Bin
authors: B
authors: Yang
authors: London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors: Rosanna W
authors: RW
authors: Peeling
authors: University of North Carolina-Project China, Guangzhou, China; London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Medicine, University of North Carolina, Chapel Hill, United States of America.
authors: Joseph D
authors: JD
authors: Tucker
mesh_terms: D000293:Adolescent; D000328:Adult; D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards*; D015658:HIV Infections / Q000175:diagnosis* / Q000821:virology; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D034121:Reproductive Health Services; D013587:Syphilis / Q000175:diagnosis*; D055815:Young Adult