title: Qualitative Assessment of Barriers and Facilitators of Access to HIV Testing Among Men Who Have Sex with Men in China.
abstract: Diagnosis of HIV is the entry point into the continuum of HIV care; a well-recognized necessary condition for the ultimate prevention of onward transmission. In China, HIV testing rates among men who have sex with men (MSM) are low compared to other high risk subgroups, yet experiences with HIV testing among MSM in China are not well understood. To address this gap and prepare for intervention development to promote HIV testing and rapid linkage to treatment, six focus groups (FGs) were conducted with MSM in Beijing (40 HIV-positive MSM participated in one of four FGs and 20 HIV-negative or status unknown MSM participated in one of two FGs). Major themes reported as challenges to HIV testing included stigma and discrimination related to HIV and homosexuality, limited HIV knowledge, inconvenient clinic times, not knowing where to get a free test, fear of positive diagnosis or nosocomial infection, perceived low service quality, and concerns/doubts about HIV services. Key facilitators included compensation, peer support, professionalism, comfortable testing locations, rapid testing, referral and support after diagnosis, heightened sense of risk through engagement in high-risk behaviors, sense of responsibility to protect self, family and partner support, and publicity via social media. Themes and recommendations were generally consistent across HIV-positive and negative/status unknown groups, although examples of enacted stigma were more prevalent in the HIV-positive groups. Findings from our study provide policy suggestions for how to bolster current HIV prevention intervention efforts to enhance 'test-and-treat' strategies for Chinese MSM.
authors.affiliation: 1 Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: 4 Xicheng District Center for Disease Control and Prevention , Beijing, China .
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Sun
authors.affiliation: 1 Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine , Nashville, Tennessee.|2 Department of Medicine (Division of Epidemiology), Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Han-Zhu
authors.initials: HZ
authors.lastname: Qian
authors.affiliation: 1 Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Lu
authors.initials: L
authors.lastname: Yin
authors.affiliation: 4 Xicheng District Center for Disease Control and Prevention , Beijing, China .
authors.forename: Zheng
authors.initials: Z
authors.lastname: Yan
authors.affiliation: 5 Chaoyang District Center for Disease Control and Prevention , Beijing, China .
authors.forename: Lijuan
authors.initials: L
authors.lastname: Wang
authors.affiliation: 5 Chaoyang District Center for Disease Control and Prevention , Beijing, China .
authors.forename: Shulin
authors.initials: S
authors.lastname: Jiang
authors.affiliation: 6 Beijing City Center for Disease Control and Prevention , Beijing, China .
authors.forename: Hongyan
authors.initials: H
authors.lastname: Lu
authors.affiliation: 7 State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing, China .|8 Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Beijing, China .
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Ruan
authors.affiliation: 7 State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing, China .|8 Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Beijing, China .
authors.forename: Yiming
authors.initials: Y
authors.lastname: Shao
authors.affiliation: 1 Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine , Nashville, Tennessee.|3 Department of Pediatrics (Division of Infectious Diseases), Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
authors.affiliation: 9 Department of Health Behavior and Health Education, University of Michigan , Ann Arbor, Michigan.
authors.forename: K Rivet
authors.initials: KR
authors.lastname: Amico
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D003376:Counseling; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D018451:Homosexuality, Male; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D015995:Prevalence; D036301:Qualitative Research; D012309:Risk-Taking; D012747:Sexual Partners; D057545:Social Stigma; D012959:Socioeconomic Factors