Associations between self-test and pre- or post-exposure prophylaxis of HIV among men who have sex with men in China

Background This study aims to assess HIV self-testing (HIVST), pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) uptake and associations of three HIV prevention strategies among men who have sex with men (MSM) in China. Methods This study included two stages, baseline and follow-up, and was conducted in Harbin, the capital city of Heilongjiang province in North China. MSM were recruited online and by peer-referral. Data contained an online questionnaire and sampling blood for HIV tests. The research group generated a QR code linking to the survey, and participants were asked to scan this QR code with a cellphone to fill out the questionnaire. MSM at the baseline were imparted knowledge of PrEP, PEP and condom use. Results Between January 2018 and March 2019, the research team enrolled 773 MSM for baseline analysis, and 699 were HIV negative at baseline. For follow-up, 62% (430/699) participants were retained. At baseline, 11.6% (50/430) of the participants was aware of PrEP and 40.9% (176/430) of PEP; 0.7% (3/430) had ever taken PrEP and 3.3% (14/430) had taken PEP. At follow-up, 77.7% (334/430) reported awareness of PrEP and 54.0% (232/430) for PEP; Only 2.6% (11/430) initiated PrEP uptake and 3.0% (13/430) for PEP. Additionally, at follow-up, only 21 participants newly conducted HIVST. Results showed that being willing to pay for PrEP and PEP uptake was associated with conducting HIVST, and initiations of two HIV prevention methods, PrEP and PEP uptake, were significantly associated with each other. Conclusions Knowledge dissemination increased participant awareness and acceptance of PrEP and PEP effectively. Uptake of HIVST, PrEP, and PEP were low and associated with each other. It is promising to achieve high uptake by promoting HIVST, PrEP and PEP as one prevention package.