China: Testing rates of chlamydia and gonorrhea, a study

Wu, Dan, et al. "Low chlamydia and gonorrhea testing rates among men who have sex with men in Guangdong and Shandong Provinces, China." Sexually transmitted diseases 46.4 (2019): 260-265.

Background: Although periodic chlamydia and gonorrhea testing is recommended for men who have sex with men (MSM), little is known about testing rates in China. This study examines chlamydia and gonorrhea testing rates and testing correlates among Chinese MSM.

Methods: An online survey of MSM was conducted in August 2017. Men 16 years or older who had ever had sex with a man were enrolled through a gay social networking mobile application. We asked men about their sexual behaviors, community engagement in sexual health, and previous testing for chlamydia, gonorrhea, and HIV. Multivariable logistic regressions were used to examine the association of testing with community engagement and recent HIV testing.

Results: Of 1031 men, 819 (79.5%) were younger than 30 years, and 263 (25.5%) reported condomless sex in the past 3 months. In total, 294 (28.5%) men tested for chlamydia, 315 (30.6%) men tested for gonorrhea, and 817 (79.2%) men tested for HIV. One hundred twenty-five (42.5%) men who received chlamydia testing and 134 (42.5%) men who received gonorrhea testing had substantial community engagement. Compared with men with no/minimal community engagement, men with substantial community engagement had greater odds of chlamydia testing (adjusted odds ratio [AOR], 2.8; 95% confidence interval [CI], 1.9-4.3) and gonorrhea testing (AOR, 2.9; 95% CI, 2.0-4.4). Men with recent HIV testing were more likely to have received chlamydia testing (AOR, 1.5; 95% CI, 1.1-2.0) and gonorrhea testing (AOR, 1.6; 95% CI, 1.2-2.1).

Conclusions: Chlamydia and gonorrhea testing levels are low among Chinese MSM. Integrating chlamydia and gonorrhea test promotion strategies into HIV prevention programs that engage MSM communities may help bridge the gap.

We also found that chlamydia/gonorrhea testing was significantly associated with substantial community engagement in sexual health. It is worth noting, however, that men with more community engagement and who have been tested are more likely to take the survey than their counterparts. Our test uptake rates are likely overestimates. This trend is consistent with previous literature showing improved HIV and syphilis testing uptake among individuals with higher community engagement. A recent quasi-experimental study in China also found that engaging MSM in STI testing programs significantly improved men's dual chlamydia/gonorrhea test uptake. There is currently a trend toward key population-led HIV prevention campaigns and strategies. Integrating chlamydia and gonorrhea test promotion strategies into HIV prevention programs that engage MSM communities may help increase testing rates.

Read the study via Sexually Transmitted Diseases