(P235) The impact of COVID-19 on Sexual and HIV testing behaviors among MSM tested for HIV in China: A Serial Trend Analysis

Abstract

Background: HIV testing remains the most important means to engage key populations like men who have sex with men (MSM) in HIV care. This study aimed to assess the impact of the COVID-19 pandemic on sexual and HIV testing behaviors among MSM in Guangdong to inform the adaptation of current HIV programs.

Methods: We retrospectively analyzed data from annual online surveys that assessed sexual and HIV testing behaviors among MSM in Guangdong from 2018 to 2022. Only individuals >16 years, self-identified as male, reported sex with another man in the last 12 months, and resided in Guangdong were eligible. Information collected included age, education level, number of sexual partners, and venue of last HIV test. A trend test was used to assess the changes in sexual and HIV testing behaviors over time, and logistic regression were used to identify the factors associated with HIV testing uptake. Data was categorized as: 'before Covid-19' for 2018-2019, ‘during Covid-19’ for 2020 and 'After Covid-19' for 2021-2022.

Results: Overall, data from 1693 participants were included in this study (average age 29±4.55). Most participants earned >746 USD monthly (57.9%) and had a college or above level of education (69.3%). We observed an increasing trend MSM with >2 stable (χ²_trend=93.25, P< 0.001) and casual (χ²_trend=54.76, P< 0.001) male sexual partners in the past six months, engaged in condomless sex (χ²_trend=7.60, P=0.015), and had last HIV test at a facility (χ²_trend=59.90, P< 0.001) [Table 1]. MSM ≥25years (OR=0.72, 95%CI: 0.53-0.99) had lower odds of HIV testing uptake after the Covid-19 pandemic. MSM with college or above education(OR = 2.22, 95%CI: 1.65-2.97), had >2 stable male sexual partners (OR = 2.80, 95%CI:1.485-5.2), engaged in condomless sex(OR =1.3, 95%CI:1.02-1.81) and last tested for HIV at a facility (OR =2.31, 95%CI:1.69-3.17) had higher odds of HIV testing uptake after the pandemic.

Conclusions: Sexual risk behaviors and HIV testing habits among MSM in China have evolved after the COVID-19 pandemic. The number of MSM with more than two stable and casual sexual partners has increased, but condom use is still low. Hence, policymakers need to expand HIV prevention strategies, like condoms and PrEP use promotion.