title: Frequent HIV Testing: Impact on HIV Risk Among Chinese Men Who Have Sex with Men.
abstract: The HIV epidemic continues to expand among men who have sex with men (MSM) in China. The NIMH Project Accept/HPTN 043 trial suggested a borderline significant trend toward HIV incidence reduction among persons with higher testing rates.
  
  
  
  We assessed HIV testing histories and infection status among a community-based Beijing MSM. HIV serostatus was lab confirmed. We ascertained demographic/behavioral factors through questionnaire-based interviews. Associations of previous HIV testing with odds of current HIV infection were assessed, seeking improved like-with-like risk comparisons through multivariable logistic regression analysis with propensity score adjustment and restricted cubic spline modeling.
  
  
  
  Among 3588 participants, 12.7% were HIV infected; 70.8% reported having ever tested for HIV. Compared with MSM who never tested, those ever testing had a 41% reduction in the odds of being HIV positive [adjusted odds ratio (aOR): 0.59; 95% confidence interval (CI): 0.48 to 0.74. Higher HIV testing frequencies were associated with a decreasing trend in the odds of being infected with HIV vs. a referent group with no previous testing [>6 tests (aOR: 0.27; 95% CI: 0.18 to 0.41); 4-6 (aOR: 0.55; 95% CI: 0.39 to 0.78); 2-3 (aOR: 0.61; 95% CI: 0.45 to 0.82); P for trend <0.001]. The multivariable-adjusted model with restricted cubic spline of HIV testing frequency showed a higher frequency of previous HIV testing associated with lower odds of HIV infection, particularly among men with ≥10 lifetime male sexual partners.
  
  
  
  Using risk probability adjustments to enable less biased comparisons, frequent HIV testing was associated with a lower HIV odds among Chinese MSM.
authors.affiliation: *Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN; †Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN; ‡State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China; §Departments of Biomedical Informatics; ‖Biostatistics, Vanderbilt University School of Medicine, Nashville, TN; ¶Division of General Internal Medicine and Public Health, Vanderbilt University School of Medicine, Nashville, TN; #Beijing Municipal Center for Disease Control and Prevention, Beijing, China; and **Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.forename: Han-Zhu
authors.initials: HZ
authors.lastname: Qian
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Ruan
authors.forename: Pingsheng
authors.initials: P
authors.lastname: Wu
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
authors.forename: Yujiang
authors.initials: Y
authors.lastname: Jia
authors.forename: Lu
authors.initials: L
authors.lastname: Yin
authors.forename: Hongyan
authors.initials: H
authors.lastname: Lu
authors.forename: Xiong
authors.initials: X
authors.lastname: He
authors.forename: Yiming
authors.initials: Y
authors.lastname: Shao
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D057216:Propensity Score; D012307:Risk Factors; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners / Q000523:psychology*; D055815:Young Adult