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

- Men who have sex with men (MSM) are at high risk of HIV transmission.
- HIV voluntary counseling and testing (VCT) is important in case detection and prevention.
- Only 13% of the never-testers intended to participate in VCT in the next six months.
- Most of the never-testers are in the pre-contemplation stage of change (TTM) with respect to VCT.
- Strategies tailored to this specific SOC are needed to promote VCT among MSM.

ObjectiveWe investigated the prevalence and associated factors of men who have sex with men (MSM) and had never participated in Human Immunodeficiency Virus (HIV) voluntary counseling and testing (VCT) but intended to do so in the next six months.MethodAn anonymous cross-sectional survey interviewed 577 MSM in Hong Kong, China, face-to-face or through an electronic questionnaire.ResultsWe identified 245 MSM who had never participated in VCT (never-testers), among whom 12.7% intended to do so in the next six months. Factors associated positively with high behavioral intention were: 1) perceived necessity to participate in HIV test regularly (multivariate odds ratios (ORm) = 4.54, 95% confidence interval (CI): 1.30-15.83), 2) perception that > 20% of the local MSM had participated in VCT (ORm = 17.86, 95% CI: 1.89-169.08) and 3) perceived higher chance to have sex with people living with HIV (PLWH) in the next six months (ORm = 2.92, 95% CI: 1.08-7.93). Negatively associated factors were: local residency (ORm = 0.06, 95% CI: 0.01-0.34) and perceived higher chance of having unprotected anal intercourse (UAI) in the next six months (ORm = 0.27, 95% CI: 0.09-0.84). In addition, no interaction term between the independent variable and UAI status was found to be statistically significant.ConclusionMany sampled never-testers had low intention to take up VCT and were in the pre-contemplation stage of the Transtheoretical Model. Stage-matched promotions are warranted.