{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T02:47:47Z","timestamp":1778035667715,"version":"3.51.4"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The Coronavirus Diseases 2019 (COVID-19) directly affects HIV prevention and sexual health services utilization among men who have sex with men (MSM). This study investigated changes in human immunodeficiency virus (HIV) testing utilization among MSM before and after the COVID-19 pandemic received initial control in Shenzhen, China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a sub-analysis of a prospective observational cohort study conducted among MSM in Shenzhen, China between August 2020 and May 2021. Participants were recruited through outreaching in gay venues, online recruitment, and peer referral. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. This study was based on 412 MSM who reported to be HIV-negative\/unknown sero-status at baseline, 297 (72.1%) of them completed the follow-up online survey. Multilevel logistic regression models (level 1: sources of recruitment; level 2: individual participants) were fitted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>When comparing follow-up data with baseline data, a significant increase was observed in the uptake of any type of HIV testing (77.9% at Month 6 vs. 59.2% at baseline, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). After adjusting for age group, education level, current employment status and monthly personal income, two predisposing factors were associated with higher uptake of HIV testing during the follow-up period. They were: (1) condomless anal intercourse with male non-regular male sex partners at follow-up only (AOR: 5.29, 95%CI: 1.27, 22.01) and (2) sanitizing before and after sex at baseline (AOR: 1.26, 95%CI: 1.02, 1.47). Regarding enabling factors, utilization of HIV testing (AOR: 3.90, 95%CI: 2.27, 6.69) and STI testing (AOR: 2.43, 95%CI: 1.20, 4.93) 6 months prior to the baseline survey was associated with higher uptake of HIV testing during the follow-up period. Having the experience that HIV testing service providers reduced service hours during the follow-up period was also positively associated with the dependent variable (AOR: 3.45, 95%CI: 1.26, 9.41).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HIV testing utilization among MSM might rebound to the level before the COVID-19 outbreak after the pandemic received initial control in China. This study offered a comprehensive overview to identify potential reasons that can influence the uptake of HIV testing among Chinese MSM.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.842121","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T06:01:52Z","timestamp":1654754512000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Changes in HIV Testing Utilization Among Chinese Men Who Have Sex With Men During the COVID-19 Pandemic in Shenzhen, China: An Observational Prospective Cohort Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Kechun","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul Shing-fong","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"He","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongbiao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaqi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofeng","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zixin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1186\/s12879-019-4559-1","article-title":"The prevalence of HIV among MSM in China: a large-scale systematic analysis","volume":"19","author":"Dong","year":"2019","journal-title":"BMC Infect Dis."},{"key":"B2","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1071\/SH16001","article-title":"incidence and associated risk factors in men who have sex with men in Mainland China: an updated systematic review and meta-analysis","volume":"13","author":"Zhang","year":"2016","journal-title":"Sex Health."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e52124","DOI":"10.1371\/journal.pone.0052124","article-title":"Should associations between HIV-related risk perceptions and behaviors or intentions be positive or negative?","volume":"7","author":"Tsui","year":"2012","journal-title":"PLoS ONE."},{"key":"B4","doi-asserted-by":"publisher","first-page":"S181","DOI":"10.1007\/s10461-013-0434-z","article-title":"Social environmental factors and condom use among female injection drug users who are sex workers in China","volume":"18","author":"Gu","year":"2014","journal-title":"AIDS Behav."},{"key":"B5","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1071\/SH11108","article-title":"Prevalence and associated factors of condom use during commercial sex by female sex workers who were or were not injecting drug users in China","volume":"9","author":"Lau","year":"2012","journal-title":"Sex Health."},{"key":"B6","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1016\/j.jana.2018.05.003","article-title":"Testing and associated factors among men who have sex with men in Changsha, China","volume":"29","author":"Zhou","year":"2018","journal-title":"J Assoc Nurses AIDS Care."},{"key":"B7","unstructured":"Coronavirus Disease (COVID-2019) Situation Reports"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e182","DOI":"10.1101\/2020.10.16.20213959","article-title":"HIV testing by public health centers and municipalities and new HIV cases during the COVID-19 pandemic in Japan","volume":"87","author":"Ejima","year":"2021","journal-title":"J Acquir Immune Defic Syndr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e114","DOI":"10.1097\/QAI.0000000000002604","article-title":"Testing and diagnoses during the COVID-19 pandemic in Melbourne, Australia","volume":"86","author":"Chow","year":"2021","journal-title":"J Acquir Immune Defic Syndr."},{"key":"B10","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1007\/s10461-020-02969-0","article-title":"Economic, mental health, HIV prevention and HIV treatment impacts of COVID-19 and the COVID-19 response on a global sample of cisgender gay men and other men who have sex with men","volume":"25","author":"Santos","year":"2021","journal-title":"AIDS Behav."},{"key":"B11","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.1007\/s10461-020-02894-2","article-title":"Characterizing the impact of COVID-19 on men who have sex with men across the United States in April, 2020","volume":"24","author":"Sanchez","year":"2020","journal-title":"AIDS Behav."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e25697","DOI":"10.1002\/jia2.25697","article-title":"The impact of disruptions due to COVID-19 on HIV transmission and control among men who have sex with men in China","volume":"24","author":"Booton","year":"2021","journal-title":"J Int AIDS Soc."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e25737","DOI":"10.1002\/jia2.25737","article-title":"HIV self-testing partially filled the HIV testing gap among men who have sex with men in China during the COVID-19 pandemic: results from an online survey","volume":"24","author":"Jiang","year":"2021","journal-title":"J Int AIDS Soc."},{"key":"B14","volume-title":"Health Promotion Planning: An Educational and Ecological Approach. 3rd ed.","author":"Green","year":"1999"},{"key":"B15","doi-asserted-by":"publisher","first-page":"3006","DOI":"10.1007\/s10461-020-02935-w","article-title":"\u201cEverything is a mess\u201d: how COVID-19 is impacting engagement with HIV testing services in rural southwestern Uganda","volume":"24","author":"Ponticiello","year":"2020","journal-title":"AIDS Behav."},{"key":"B16","doi-asserted-by":"publisher","first-page":"3010","DOI":"10.1007\/s10461-020-02938-7","article-title":"Impact of the COVID-19 pandemic on HIV testing and assisted partner notification services, western kenya","volume":"24","author":"Lagat","year":"2020","journal-title":"AIDS Behav."},{"key":"B17","doi-asserted-by":"publisher","first-page":"3014","DOI":"10.1007\/s10461-020-02939-6","article-title":"COVID-19 lockdowns: impact on facility-based HIV testing and the case for the scaling up of home-based testing services in Sub-Saharan Africa","volume":"24","author":"Mhango","year":"2020","journal-title":"AIDS Behav."},{"key":"B18","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1016\/j.ijid.2021.04.005","article-title":"An exploratory study of factors associated with difficulties in accessing HIV services during COVID-19 among Chinese gay and bisexual men in Hong Kong","volume":"106","author":"Suen","year":"2021","journal-title":"Int J Infect Dis."},{"key":"B19","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1186\/s12879-020-05024-4","article-title":"Uptake and willingness to use PrEP among Chinese gay, bisexual and other men who have sex with men with experience of sexualized drug use in the past year","volume":"20","author":"Wang","year":"2020","journal-title":"BMC Infect Dis."},{"key":"B20","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s10461-005-1682-3","article-title":"Post-circuit blues: motivations and consequences of crystal meth use among gay men in Miami","volume":"9","author":"Kurtz","year":"2005","journal-title":"AIDS Behav."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e17894","DOI":"10.2196\/17894","article-title":"Influence of social media on sexualized drug use and Chemsex among Chinese men who have sex with men: observational prospective cohort study","volume":"22","author":"Wang","year":"2020","journal-title":"J Med Internet Res."},{"key":"B22","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1186\/s12879-018-3454-5","article-title":"The interaction between HIV testing social norms and self-efficacy on HIV testing among Chinese men who have sex with men: results from an online cross-sectional study","volume":"18","author":"Zhao","year":"2018","journal-title":"BMC Infect Dis."},{"key":"B23","doi-asserted-by":"publisher","first-page":"831456","DOI":"10.3389\/fpubh.2022.831456","article-title":"Changes in compliance with personal preventive measures and mental health status among Chinese factory workers during the COVID-19 pandemic: an observational prospective cohort study","volume":"10","author":"Yuan","year":"2022","journal-title":"Front Public Health."},{"key":"B24","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1080\/09540121.2017.1338659","article-title":"Behavioral intention to take up different types of HIV testing among men who have sex with men who were never-testers in Hong Kong","volume":"30","author":"Wang","year":"2018","journal-title":"AIDS Care."},{"key":"B25","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1007\/s10461-017-1887-2","article-title":"Randomized controlled trial evaluating efficacy of promoting a home-based HIV self-testing with online counseling on increasing HIV testing among men who have sex with men","volume":"22","author":"Wang","year":"2018","journal-title":"AIDS Behav."},{"key":"B26","doi-asserted-by":"publisher","first-page":"3582","DOI":"10.3390\/ijerph18073582","article-title":"Factors predicting uptake of sexually transmitted infections testing among men who have sex with men who are \u201cpre-exposure prophylaxis tourists\u201d-an observational prospective cohort study","volume":"18","author":"Wang","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B27","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1186\/s12879-018-3044-6","article-title":"Intimate relationship characteristics as determinants of HIV risk among men who have sex with regular male sex partners: a cross-sectional study in Guangzhou, China","volume":"18","author":"He","year":"2018","journal-title":"BMC Infect Dis."},{"key":"B28","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1186\/s12879-018-3360-x","article-title":"cross-sectional study of the relationship between sexual compulsivity and unprotected anal intercourse among men who have sex with men in shanghai, China","volume":"18","author":"Wang","year":"2018","journal-title":"BMC Infect Dis."},{"key":"B29","doi-asserted-by":"publisher","first-page":"838973","DOI":"10.3389\/fmed.2022.838973","article-title":"Factors predicting COVID-19 vaccination uptake among men who have sex with men in China: an observational prospective cohort study","volume":"9","author":"Zhang","year":"2022","journal-title":"Front Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1071\/SH20088","article-title":"Factors associated with past HIV testing among men who have sex with men attending university in China: a cross-sectional study","volume":"18","author":"Ye","year":"2021","journal-title":"Sex Health."},{"key":"B31","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1016\/j.ypmed.2013.09.005","article-title":"Prevalence and associated factors of intention to participate in HIV voluntary counseling and testing for the first time among men who have sex with men in Hong Kong, China","volume":"57","author":"Lau","year":"2013","journal-title":"Prev Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1186\/s12889-020-08705-6","article-title":"Association between social capital and mental health among older people living with HIV: the Sichuan older HIV-infected cohort study (SOHICS)","volume":"20","author":"Han","year":"2020","journal-title":"BMC Public Health."},{"key":"B33","doi-asserted-by":"publisher","first-page":"e22457","DOI":"10.2196\/22457","article-title":"Self-reported compliance with personal preventive measures among Chinese factory workers at the beginning of work resumption following the COVID-19 outbreak: cross-sectional survey study","volume":"22","author":"Pan","year":"2020","journal-title":"J Med Internet Res."},{"key":"B34","doi-asserted-by":"publisher","first-page":"e24673","DOI":"10.2196\/24673","article-title":"Behavioral intention to receive a COVID-19 vaccination among Chinese factory workers: cross-sectional online survey","volume":"23","author":"Zhang","year":"2021","journal-title":"J Med Internet Res"},{"key":"B35","doi-asserted-by":"publisher","first-page":"e028933","DOI":"10.1136\/bmjopen-2019-028933","article-title":"Relationship between gay app use and HIV testing among men who have sex with men in Shenzhen, China: a serial cross-sectional study","volume":"9","author":"Wei","year":"2019","journal-title":"BMJ Open."},{"key":"B36","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1097\/QAI.0000000000001001","article-title":"Frequent HIV testing: impact on HIV risk among Chinese men who have sex with men","volume":"72","author":"Liu","year":"2016","journal-title":"J Acquir Immune Defic Syndr."},{"key":"B37","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1080\/17441692.2015.1134612","article-title":"HIV test uptake among MSM in China: implications for enhanced HIV test promotion campaigns among key populations","volume":"12","author":"Han","year":"2017","journal-title":"Glob Public Health."},{"key":"B38","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1097\/QAI.0000000000000278","article-title":"HIV self-testing among online MSM in China: implications for expanding HIV testing among key populations","volume":"67","author":"Han","year":"2014","journal-title":"J Acquir Immune Defic Syndr."},{"key":"B39","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1186\/s40249-017-0326-y","article-title":"Uptake of HIV Self-testing among men who have sex with men in Beijing, China: a cross-sectional study","volume":"30","author":"Ren","year":"2017","journal-title":"Biomed Environ Sci."},{"key":"B40","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12981-021-00339-x","article-title":"Prevalence and associated factors of HIV self-testing among men who have sex with men in Ningbo, China: a cross-sectional study","volume":"18","author":"Hong","year":"2021","journal-title":"AIDS Res Ther."},{"key":"B41","doi-asserted-by":"publisher","first-page":"S76","DOI":"10.1016\/S0140-6736(16)32003-7","article-title":"HIV self-testing among high-risk men who have sex with men in China: a cross-sectional study","volume":"388","author":"Qin","year":"2016","journal-title":"Lancet."},{"key":"B42","doi-asserted-by":"publisher","first-page":"e611","DOI":"10.1016\/S2352-3018(18)30244-3","article-title":"Opportunities and challenges for HIV self-testing in China","volume":"5","author":"Tang","year":"2018","journal-title":"Lancet HIV."},{"key":"B43","doi-asserted-by":"publisher","first-page":"2942","DOI":"10.1007\/s10461-020-02845-x","article-title":"A scoping review of employment and HIV","volume":"24","author":"Maulsby","year":"2020","journal-title":"AIDS Behav."},{"key":"B44","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1136\/sti.2010.042903","article-title":"The incidence of syphilis, HIV and HCV and associated factors in a cohort of men who have sex with men in Nanjing, China","volume":"87","author":"Hao","year":"2011","journal-title":"Sex Transm Infect."},{"key":"B45","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.drugpo.2018.11.014","article-title":"Chemsex behaviours among men who have sex with men: A systematic review of the literature","volume":"63","author":"Maxwell","year":"2019","journal-title":"Int J Drug Policy."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1827","DOI":"10.1016\/j.jsxm.2020.07.085","article-title":"COVID-19 and the changes in the sexual behavior of men who have sex with men: results of an online survey","volume":"17","author":"Shilo","year":"2020","journal-title":"J Sex Med."},{"key":"B47","first-page":"8","article-title":"Sexual behavior during the Covid-19 pandemic: it's telecounseling time! Innov Clin Neurosci","volume":"18","author":"Calabr\u00f2","year":"2021"},{"key":"B48","doi-asserted-by":"publisher","first-page":"15","DOI":"10.3390\/ijerph18020729","article-title":"Effectiveness of a novel HIV self-testing service with online real-time counseling support (HIVST-Online) in increasing HIV testing rate and repeated HIV testing among men who have sex with men in Hong Kong: results of a pilot implementation project","volume":"18","author":"Chan","year":"2021","journal-title":"Int J Environ Res Public Health."},{"key":"B49","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1177\/0956462420953012","article-title":"Factors associated with regular HIV testing behavior of MSM in China: a cross-sectional survey informed by theory of triadic influence","volume":"31","author":"Zhao","year":"2020","journal-title":"Int J STD AIDS."},{"key":"B50","doi-asserted-by":"publisher","first-page":"e75","DOI":"10.2105\/AJPH.2014.302322","article-title":"The role of stigma and medical mistrust in the routine health care engagement of black men who have sex with men","volume":"105","author":"Eaton","year":"2015","journal-title":"Am J Public Health."},{"key":"B51","doi-asserted-by":"publisher","first-page":"e0117376","DOI":"10.1371\/journal.pone.0117376","article-title":"Perceived empathy of service providers mediates the association between perceived discrimination and behavioral intention to take up HIV antibody testing again among men who have sex with men","volume":"10","author":"Gu","year":"2015","journal-title":"PLoS ONE."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.842121\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T06:01:56Z","timestamp":1654754516000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.842121\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,9]]},"references-count":51,"alternative-id":["10.3389\/fmed.2022.842121"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.842121","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,9]]},"article-number":"842121"}}