Jiun-Hau Huang

Background:

The statistics of the Taiwan Centers for Disease Control (CDC) have shown that young men who have sex with men (YMSM) are disproportionately affected by HIV. To help increase HIV testing behavior, oral rapid self-testing (ORST) for HIV has recently been introduced by Taiwan CDC and become available in Taiwan on a limited scale. However, little is known about intention to use HIV ORST and associated factors among YMSM in Taiwan.

Methods:

To systematically examine the HIV ORST intention, an anonymous online survey based on the Theory of Planned Behavior (TPB) was conducted between December 2017 and April 2018 among YMSM in Taiwan. Responses from 2,063 HIV-negative YMSM were included in the multivariate logistic regression analyses to explore the background characteristics and three TPB constructs—Attitude Toward the Behavior (ATB), Subjective Norm (SN), and Perceived Behavioral Control (PBC)—in relation to high HIV ORST intention.

Results:

In this study, 52.7% of YMSM were classified as having high HIV ORST intention and 16.5% had ever received HIV ORST. Further, YMSM with HIV ORST experience were more inclined to use HIV ORST (AOR=3.24). YMSM were also more likely to have high HIV ORST intention when perceiving relatively intermediate (AOR=1.43) and high (AOR=1.83) risk of HIV infection. As for TPB constructs, relatively positive ATB (AOR=2.75), supportive SN (AOR=1.70), and high PBC (AOR=3.59) were linked to high HIV ORST intention among these YMSM.

Conclusions:

On the basis of these findings, future prevention efforts could focus on enhancing HIV risk perception and facilitating positive changes in the three TPB constructs through theory-driven health education programs among YMSM in Taiwan. At policy level, ORST kits should also be made more accessible, available, and affordable to increase YMSM’s HIV ORST use intention.

Keywords: Oral rapid self-testing for HIV (HIV ORST); Young men who have sex with men (YMSM); Theory of Planned Behavior (TPB); HIV testing experience; Taiwan