Role of HIV Serostatus Communication on Frequent HIV Testing and Self-Testing Among Men Who Have Sex With Men Who Seek Sexual Partners on the Internet in Zhejiang, China: Cross-Sectional Study

Men who have sex with men (MSM) are increasingly using the internet to meet casual sexual partners. Those who do are at higher risk of sexually transmitted diseases. However, little is known about the rates and associations of frequent HIV testing and self-testing among such MSM. We aimed to examine HIV serostatus communication and perceptions regarding the HIV infection risk of internet-based partners, along with their associations with frequent HIV testing and self-testing. A cross-sectional study was conducted between May 2018 and April 2019 in Zhejiang Province, China. The study participants were assigned male at birth, were aged 18 years or older, had had casual sex with another male found through the internet in the last 6 months, and were HIV-negative. Information was obtained on HIV-testing behavior, along with demographic characteristics, HIV-related knowledge, internet-based behaviors, sexual behaviors with male partners, HIV serostatus communication, and perceptions regarding the HIV infection risk of internet-based partners. Uni- and multivariate logistic regression models were used to measure the associations of HIV testing and self-testing. The study recruited 281 individuals who had sought casual sexual partners through the internet during the previous 6 months. Of the participants, 61.9% (174/281) reported frequent HIV testing (twice or more frequently) and 50.9% (119/234; 47 with missing values) reported frequent HIV self-testing. MSM who always or usually communicated about the HIV serostatus of internet-based partners in the previous 6 months had 3.12 (95% CI 1.76-5.52) and 2.45 (95% CI 1.42-4.22) times higher odds of being frequently tested or self-tested for HIV, respectively, compared with those who communicated about this issue minimally or not at all. There remains a need to improve the frequency of HIV testing and self-testing among internet-based MSM. HIV serostatus communication should be improved within the context of social networking applications to promote frequent HIV testing among internet-based MSM, especially for those who communicated about this issue minimally or not at all.