Cheng Wang, PhD, 1,2 Yajie Wang, MD,1,2 Joseph D. Tucker, PhD,3,4,5 Mingzhou Xiong, MD,1,2 Hongyun Fu, PhD, 6 M. Kumi Smith, PhD, 7 Weiming Tang, PhD, 1,2,3 Jason J. Ong, PhD, 4,8 Heping Zheng, PhD,1,2 Bin Yang, PhD,1,2,§

1. Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, China

2. Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, Guangdong, China

3. University of North Carolina Project-China, Guangzhou, Guangdong, China

4. Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK

5. Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA

6. Division of Community Health and Research, Eastern Virginia Medical School, Norfolk, Virginia, USA

7. Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, USA

8. Central Clinical School, Monash University, Victoria, Melbourne, Australia

Introduction: Self-testing for HIV and syphilis may help improve test uptake among female sex workers. China has implemented many HIV and syphilis self-testing programs among men who have sex with men, creating an opportunity to promote HIV and syphilis self-testing among female sex workers. However, there have been few studies examining HIV or syphilis self-testing among female sex workers.


Methods: A venue-based cross-sectional study was conducted among Chinese female sex workers in 2019. Participants completed a survey including social-demographic characteristics, sexual behaviors, and HIV and syphilis self-testing history. Multivariable logistic regression was conducted to identify correlates of self-testing. We also recorded potential harms associated with self-testing.


Results: One thousand four hundred and forty-three Chinese female sex workers were recruited. A total of 1072/1287 (83.3%) and 928/1287 (72.1%) had ever tested for HIV and syphilis, respectively. 103/1287 (8.0%) and 76/1287(6.0%) had ever self-tested for HIV and syphilis, respectively. More than half reported that the self-test was their first test (HIV: 59.2%, 61/103; syphilis: 57.9%, 44/76), around one-fifth reported self-testing results influenced the price of sex (HIV: 21.4%, 22/103; syphilis: 18.4%, 14/76). After adjusting for covariates, HIV and syphilis self-testing were both associated with receiving anal sex in the past month (HIV: aOR: 2.2, 95%CI: 1.4-3.5; syphilis: aOR: 2.6, 95%CI: 1.5-4.3), using a drug before or during sex (HIV: aOR: 2.8, 95%CI: 1.8-4.5; syphilis: aOR: 3.8, 95%CI: 2.3-6.4), tested for other STIs in the past 6 months (HIV: aOR: 3.4, 95%CI: 2.1-5.5; syphilis: aOR: 3.4, 95%CI: 1.9-6.0), ever tested in the hospital (HIV: aOR: 3.4, 95%CI: 2.0-5.6; syphilis: aOR: 5.1, 95%CI: 2.5-10.4), and ever tested in the community (HIV: aOR: 1.5, 95%CI: 1.2-1.9; syphilis: aOR: 1.7, 95%CI: 1.3-2.2). Low frequency of violence related to self-testing was reported.


Conclusions: Self-testing for HIV and syphilis could expand overall testing uptake, increase testing frequency, and has minimal potential harms among female sex workers. HIV and syphilis self-testing should be incorporated among Chinese female sex workers as a complement to facility-based testing services.

34 IUSTI Congress - European Congres on Sexually transmitted Infections and HIV/AIDS
Bucharest, September 3-5,