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Sex Transm Infect. 2019 Jun;95(4):251-253. doi: 10.1136/sextrans-2018-053527. Epub 2018 Aug 20.

Bridging the HIV-syphilis testing gap: dual testing among men who have sex with men living in China.

Ong JJ1,2,3, Liao M4, Lee A2, Fu H2,5, Pan SW2,6,7, Tang W2,6, Wei C8, Dan W2,6, Yang B2,9, Yang L9, Wang C9, Tucker JD10,2,6.

Author information

Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China.
Central Clinical School, Monash University, Melbourne, Australia.
Shandong Centre for Disease Control and Prevention, Jinan, China.
Eastern Virginia Medical School, Norfolk, Virginia, USA.
University of North Carolina, Chapel Hill, North Carolina, USA.
Department of Public Health, Xi'an Jiaotong-Liverpool University, Suzhou, China.
School of Public Health, Rutgers University, New Brunswick, New Jersey, USA.
Southern Medical University Dermatology Hospital, Guangzhou, China.
Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK



The WHO recommends dual testing for HIV and syphilis among key populations, including men who have sex with men (MSM). We assessed the proportion of men who had dual tested and reasons for not dual testing.


In 2017, an online survey of MSM was conducted in eight cities from two provinces in China. Data on sociodemographics and sexual behaviours were collected. Descriptive analysis was used to examine the experience of dual testing. Multivariable logistic regression identified characteristics associated with men who had dual tested.


Among 802 men who had ever tested for HIV, 297 dual tested (37%, 95% CI 34 to 40). Men dual tested in a variety of settings: public hospital (35%), voluntary counselling and testing sites (28%), self-testing at home (18%), community-based organisation (8%), community health centre (7%), other (3%) or private hospital (1%). Greater odds for dual testing was found in men who had disclosed their sexuality to a healthcare provider (adjusted OR (AOR) 1.81, 95% CI 1.27 to 2.59, p=0.001), and who had substantial (AOR 2.71, 95% CI 1.67 to 4.41, p<0.001) or moderate community engagement in sexual health (AOR 2.30, 95% CI 1.49 to 3.57, p<0.001), compared with those with no community engagement. The most common reasons for not dual testing were no knowledge that they could be dual tested (34%), did not ask the doctor to be dual tested (25%) and did not believe they were at risk for syphilis (19%).


Chinese MSM are dual testing through a variety of test sites, including home self-testing. However, the overall dual testing rate remains low despite recent efforts to integrate HIV and syphilis testing.


China; HIV; dual test; men who have sex with men; syphilis

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