Untested and undiagnosed: barriers to HIV testing among men who have sex with men, Beijing, China
Identifieur interne : 003F82 ( Istex/Corpus ); précédent : 003F81; suivant : 003F83Untested and undiagnosed: barriers to HIV testing among men who have sex with men, Beijing, China
Auteurs : Xuefeng Li ; Hongyan Lu ; H F Raymond ; Yanming Sun ; Yujiang Jia ; Xiong He ; Song Fan ; Yiming Shao ; Willi Mcfarland ; Yan Xiao ; Yuhua RuanSource :
- Sexually Transmitted Infections [ 1368-4973 ] ; 2012-04.
English descriptors
- KwdEn :
- Anal, Antiretroviral therapy, Appropriate counselling, Beijing, Beijing center, Casual partner, Demographic characteristics, Disease control, Epidemiology, Epidemiology table, Francisco department, Health insurance, High level, Independent predictors, Infection, Marital status, Mmwr morb, National center, Negative attitudes, Odds ratio, Preferred role, Prevalence, Prevention approaches, Prevention paradigms, Prevention tools, Previous test, Public health, Regression analyses, Scale point, Serostatus, Serostatus awareness, Sexual orientation, Social networks, Stigmatised attitudes, Testing history, Testing site, Transm, Undiagnosed, Undiagnosed infection, Unprotected, Unprotected anal, Unprotected anal intercourse, Vanderbilt university, Vanderbilt university school, Viral load suppression.
- Teeft :
- Anal, Antiretroviral therapy, Appropriate counselling, Beijing, Beijing center, Casual partner, Demographic characteristics, Disease control, Epidemiology, Epidemiology table, Francisco department, Health insurance, High level, Independent predictors, Infection, Marital status, Mmwr morb, National center, Negative attitudes, Odds ratio, Preferred role, Prevalence, Prevention approaches, Prevention paradigms, Prevention tools, Previous test, Public health, Regression analyses, Scale point, Serostatus, Serostatus awareness, Sexual orientation, Social networks, Stigmatised attitudes, Testing history, Testing site, Transm, Undiagnosed, Undiagnosed infection, Unprotected, Unprotected anal, Unprotected anal intercourse, Vanderbilt university, Vanderbilt university school, Viral load suppression.
Abstract
Objectives Undiagnosed HIV presents great potential for the spread of infection. The authors identify the prevalence and correlates of never testing and being unaware of HIV infection in Beijing men who have sex with men (MSM). Methods Cross-sectional biological and behavioural survey using respondent-driven sampling; 500 MSM were included. Results HIV prevalence was 7.2% with 86.1% unaware of their infection; 33.2% had never tested. Never testing was associated with lower educational (adjusted odds ratio (AOR) 1.6, 95% CI (CI) 1.1 to 2.5), living in Beijing for ≤3 years (AOR 1.5, 95% CI 1.0 to 2.3), unprotected anal intercourse with most recent male partner (AOR 1.6, 95% CI 1.0 to 2.4), being unaware of the most recent male partner's HIV status (AOR 3.6, 95% CI 2.1 to 6.1) and holding stigmatised attitudes towards persons with HIV (AOR 1.1 per scale point, 95% CI 1.0 to 1.1). Predictors of having undiagnosed HIV infection were being married (AOR 2.4, 95% CI 1.0 to 5.4), living in Beijing for ≤3 years (AOR 3.6, 95% CI 1.5 to 8.4), being unaware of the most recent male partner's HIV status (AOR 6.8, 95% CI 0.9 to 51.6) and holding negative attitudes towards safe sex (AOR 1.1 per scale point, 95% CI 1.0 to 1.1). Conclusions Recent attention has focused on HIV prevention interventions that depend upon knowing one's serostatus, including viral load suppression, prevention with positives, pre-exposure prophylaxis and seroadaptation. Until the low level of testing and resulting high level of undiagnosed HIV infection are addressed, these tools are not likely to be effective for MSM in China.
Url:
DOI: 10.1136/sextrans-2011-050248
Links to Exploration step
ISTEX:C3404C164D60AA3CA2D8F3626B03EDE838EA21F7Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Untested and undiagnosed: barriers to HIV testing among men who have sex with men, Beijing, China</title><author><name sortKey="Li, Xuefeng" sort="Li, Xuefeng" uniqKey="Li X" first="Xuefeng" last="Li">Xuefeng Li</name><affiliation><mods:affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Lu, Hongyan" sort="Lu, Hongyan" uniqKey="Lu H" first="Hongyan" last="Lu">Hongyan Lu</name><affiliation><mods:affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Raymond, H F" sort="Raymond, H F" uniqKey="Raymond H" first="H F" last="Raymond">H F Raymond</name><affiliation><mods:affiliation>San Francisco Department of Public Health, San Francisco, California, USA</mods:affiliation></affiliation></author><author><name sortKey="Sun, Yanming" sort="Sun, Yanming" uniqKey="Sun Y" first="Yanming" last="Sun">Yanming Sun</name><affiliation><mods:affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Jia, Yujiang" sort="Jia, Yujiang" uniqKey="Jia Y" first="Yujiang" last="Jia">Yujiang Jia</name><affiliation><mods:affiliation>Institute for Global Health, Vanderbilt University School of Medicine, Nashville, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, USA</mods:affiliation></affiliation></author><author><name sortKey="He, Xiong" sort="He, Xiong" uniqKey="He X" first="Xiong" last="He">Xiong He</name><affiliation><mods:affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Fan, Song" sort="Fan, Song" uniqKey="Fan S" first="Song" last="Fan">Song Fan</name><affiliation><mods:affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Shao, Yiming" sort="Shao, Yiming" uniqKey="Shao Y" first="Yiming" last="Shao">Yiming Shao</name><affiliation><mods:affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Mcfarland, Willi" sort="Mcfarland, Willi" uniqKey="Mcfarland W" first="Willi" last="Mcfarland">Willi Mcfarland</name><affiliation><mods:affiliation>San Francisco Department of Public Health, San Francisco, California, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Institute for Global Health, Vanderbilt University School of Medicine, Nashville, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: willi_mcfarland@hotmail.com</mods:affiliation></affiliation></author><author><name sortKey="Xiao, Yan" sort="Xiao, Yan" uniqKey="Xiao Y" first="Yan" last="Xiao">Yan Xiao</name><affiliation><mods:affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Ruan, Yuhua" sort="Ruan, Yuhua" uniqKey="Ruan Y" first="Yuhua" last="Ruan">Yuhua Ruan</name><affiliation><mods:affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. 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R. China</mods:affiliation></affiliation></author><author><name sortKey="Lu, Hongyan" sort="Lu, Hongyan" uniqKey="Lu H" first="Hongyan" last="Lu">Hongyan Lu</name><affiliation><mods:affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Raymond, H F" sort="Raymond, H F" uniqKey="Raymond H" first="H F" last="Raymond">H F Raymond</name><affiliation><mods:affiliation>San Francisco Department of Public Health, San Francisco, California, USA</mods:affiliation></affiliation></author><author><name sortKey="Sun, Yanming" sort="Sun, Yanming" uniqKey="Sun Y" first="Yanming" last="Sun">Yanming Sun</name><affiliation><mods:affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Jia, Yujiang" sort="Jia, Yujiang" uniqKey="Jia Y" first="Yujiang" last="Jia">Yujiang Jia</name><affiliation><mods:affiliation>Institute for Global Health, Vanderbilt University School of Medicine, Nashville, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, USA</mods:affiliation></affiliation></author><author><name sortKey="He, Xiong" sort="He, Xiong" uniqKey="He X" first="Xiong" last="He">Xiong He</name><affiliation><mods:affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Fan, Song" sort="Fan, Song" uniqKey="Fan S" first="Song" last="Fan">Song Fan</name><affiliation><mods:affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Shao, Yiming" sort="Shao, Yiming" uniqKey="Shao Y" first="Yiming" last="Shao">Yiming Shao</name><affiliation><mods:affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Mcfarland, Willi" sort="Mcfarland, Willi" uniqKey="Mcfarland W" first="Willi" last="Mcfarland">Willi Mcfarland</name><affiliation><mods:affiliation>San Francisco Department of Public Health, San Francisco, California, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Institute for Global Health, Vanderbilt University School of Medicine, Nashville, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: willi_mcfarland@hotmail.com</mods:affiliation></affiliation></author><author><name sortKey="Xiao, Yan" sort="Xiao, Yan" uniqKey="Xiao Y" first="Yan" last="Xiao">Yan Xiao</name><affiliation><mods:affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</mods:affiliation></affiliation></author><author><name sortKey="Ruan, Yuhua" sort="Ruan, Yuhua" uniqKey="Ruan Y" first="Yuhua" last="Ruan">Yuhua Ruan</name><affiliation><mods:affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Sexually Transmitted Infections</title><title level="j" type="abbrev">Sex Transm Infect</title><idno type="ISSN">1368-4973</idno><idno type="eISSN">1472-3263</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-04">2012-04</date><biblScope unit="volume">88</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="187">187</biblScope></imprint><idno type="ISSN">1368-4973</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1368-4973</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anal</term><term>Antiretroviral therapy</term><term>Appropriate counselling</term><term>Beijing</term><term>Beijing center</term><term>Casual partner</term><term>Demographic characteristics</term><term>Disease control</term><term>Epidemiology</term><term>Epidemiology table</term><term>Francisco department</term><term>Health insurance</term><term>High level</term><term>Independent predictors</term><term>Infection</term><term>Marital status</term><term>Mmwr morb</term><term>National center</term><term>Negative attitudes</term><term>Odds ratio</term><term>Preferred role</term><term>Prevalence</term><term>Prevention approaches</term><term>Prevention paradigms</term><term>Prevention tools</term><term>Previous test</term><term>Public health</term><term>Regression analyses</term><term>Scale point</term><term>Serostatus</term><term>Serostatus awareness</term><term>Sexual orientation</term><term>Social networks</term><term>Stigmatised attitudes</term><term>Testing history</term><term>Testing site</term><term>Transm</term><term>Undiagnosed</term><term>Undiagnosed infection</term><term>Unprotected</term><term>Unprotected anal</term><term>Unprotected anal intercourse</term><term>Vanderbilt university</term><term>Vanderbilt university school</term><term>Viral load suppression</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Anal</term><term>Antiretroviral therapy</term><term>Appropriate counselling</term><term>Beijing</term><term>Beijing center</term><term>Casual partner</term><term>Demographic characteristics</term><term>Disease control</term><term>Epidemiology</term><term>Epidemiology table</term><term>Francisco department</term><term>Health insurance</term><term>High level</term><term>Independent predictors</term><term>Infection</term><term>Marital status</term><term>Mmwr morb</term><term>National center</term><term>Negative attitudes</term><term>Odds ratio</term><term>Preferred role</term><term>Prevalence</term><term>Prevention approaches</term><term>Prevention paradigms</term><term>Prevention tools</term><term>Previous test</term><term>Public health</term><term>Regression analyses</term><term>Scale point</term><term>Serostatus</term><term>Serostatus awareness</term><term>Sexual orientation</term><term>Social networks</term><term>Stigmatised attitudes</term><term>Testing history</term><term>Testing site</term><term>Transm</term><term>Undiagnosed</term><term>Undiagnosed infection</term><term>Unprotected</term><term>Unprotected anal</term><term>Unprotected anal intercourse</term><term>Vanderbilt university</term><term>Vanderbilt university school</term><term>Viral load suppression</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objectives Undiagnosed HIV presents great potential for the spread of infection. The authors identify the prevalence and correlates of never testing and being unaware of HIV infection in Beijing men who have sex with men (MSM). Methods Cross-sectional biological and behavioural survey using respondent-driven sampling; 500 MSM were included. Results HIV prevalence was 7.2% with 86.1% unaware of their infection; 33.2% had never tested. Never testing was associated with lower educational (adjusted odds ratio (AOR) 1.6, 95% CI (CI) 1.1 to 2.5), living in Beijing for ≤3 years (AOR 1.5, 95% CI 1.0 to 2.3), unprotected anal intercourse with most recent male partner (AOR 1.6, 95% CI 1.0 to 2.4), being unaware of the most recent male partner's HIV status (AOR 3.6, 95% CI 2.1 to 6.1) and holding stigmatised attitudes towards persons with HIV (AOR 1.1 per scale point, 95% CI 1.0 to 1.1). Predictors of having undiagnosed HIV infection were being married (AOR 2.4, 95% CI 1.0 to 5.4), living in Beijing for ≤3 years (AOR 3.6, 95% CI 1.5 to 8.4), being unaware of the most recent male partner's HIV status (AOR 6.8, 95% CI 0.9 to 51.6) and holding negative attitudes towards safe sex (AOR 1.1 per scale point, 95% CI 1.0 to 1.1). Conclusions Recent attention has focused on HIV prevention interventions that depend upon knowing one's serostatus, including viral load suppression, prevention with positives, pre-exposure prophylaxis and seroadaptation. Until the low level of testing and resulting high level of undiagnosed HIV infection are addressed, these tools are not likely to be effective for MSM in China.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>beijing</json:string><json:string>undiagnosed</json:string><json:string>serostatus</json:string><json:string>transm</json:string><json:string>anal</json:string><json:string>epidemiology</json:string><json:string>scale point</json:string><json:string>negative attitudes</json:string><json:string>unprotected anal intercourse</json:string><json:string>odds ratio</json:string><json:string>epidemiology table</json:string><json:string>stigmatised attitudes</json:string><json:string>viral load suppression</json:string><json:string>undiagnosed infection</json:string><json:string>disease control</json:string><json:string>testing site</json:string><json:string>testing history</json:string><json:string>unprotected</json:string><json:string>mmwr morb</json:string><json:string>beijing center</json:string><json:string>high level</json:string><json:string>prevention paradigms</json:string><json:string>francisco department</json:string><json:string>public health</json:string><json:string>prevention approaches</json:string><json:string>serostatus awareness</json:string><json:string>prevention tools</json:string><json:string>vanderbilt university school</json:string><json:string>national center</json:string><json:string>health insurance</json:string><json:string>sexual orientation</json:string><json:string>preferred role</json:string><json:string>casual partner</json:string><json:string>previous test</json:string><json:string>social networks</json:string><json:string>demographic characteristics</json:string><json:string>marital status</json:string><json:string>unprotected anal</json:string><json:string>appropriate counselling</json:string><json:string>vanderbilt university</json:string><json:string>regression analyses</json:string><json:string>independent predictors</json:string><json:string>antiretroviral therapy</json:string><json:string>infection</json:string><json:string>prevalence</json:string></teeft></keywords><author><json:item><name>Xuefeng Li</name><affiliations><json:string>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</json:string></affiliations></json:item><json:item><name>Hongyan Lu</name><affiliations><json:string>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</json:string></affiliations></json:item><json:item><name>H F Raymond</name><affiliations><json:string>San Francisco Department of Public Health, San Francisco, California, USA</json:string></affiliations></json:item><json:item><name>Yanming Sun</name><affiliations><json:string>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</json:string></affiliations></json:item><json:item><name>Yujiang Jia</name><affiliations><json:string>Institute for Global Health, Vanderbilt University School of Medicine, Nashville, USA</json:string><json:string>Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, USA</json:string></affiliations></json:item><json:item><name>Xiong He</name><affiliations><json:string>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</json:string></affiliations></json:item><json:item><name>Song Fan</name><affiliations><json:string>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</json:string></affiliations></json:item><json:item><name>Yiming Shao</name><affiliations><json:string>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</json:string></affiliations></json:item><json:item><name>Willi McFarland</name><affiliations><json:string>San Francisco Department of Public Health, San Francisco, California, USA</json:string><json:string>Institute for Global Health, Vanderbilt University School of Medicine, Nashville, USA</json:string><json:string>E-mail: willi_mcfarland@hotmail.com</json:string></affiliations></json:item><json:item><name>Yan Xiao</name><affiliations><json:string>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</json:string></affiliations></json:item><json:item><name>Yuhua Ruan</name><affiliations><json:string>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>HIV</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>gay men</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>men who have sex with men</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>China</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>HIV testing</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>undiagnosed HIV infection</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>epidemiology</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>street youth</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>homosexual</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>sexual behaviour</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>risk behaviours</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>AIDS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>HSV-2</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>epidemiology (general)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>public health</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>CHINA</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>STD control</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>trials</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>STD</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>HCV</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>risk factors</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>viral</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>HBV</value></json:item></subject><articleId><json:string>sextrans-2011-050248</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Objectives Undiagnosed HIV presents great potential for the spread of infection. The authors identify the prevalence and correlates of never testing and being unaware of HIV infection in Beijing men who have sex with men (MSM). Methods Cross-sectional biological and behavioural survey using respondent-driven sampling; 500 MSM were included. Results HIV prevalence was 7.2% with 86.1% unaware of their infection; 33.2% had never tested. Never testing was associated with lower educational (adjusted odds ratio (AOR) 1.6, 95% CI (CI) 1.1 to 2.5), living in Beijing for ≤3 years (AOR 1.5, 95% CI 1.0 to 2.3), unprotected anal intercourse with most recent male partner (AOR 1.6, 95% CI 1.0 to 2.4), being unaware of the most recent male partner's HIV status (AOR 3.6, 95% CI 2.1 to 6.1) and holding stigmatised attitudes towards persons with HIV (AOR 1.1 per scale point, 95% CI 1.0 to 1.1). Predictors of having undiagnosed HIV infection were being married (AOR 2.4, 95% CI 1.0 to 5.4), living in Beijing for ≤3 years (AOR 3.6, 95% CI 1.5 to 8.4), being unaware of the most recent male partner's HIV status (AOR 6.8, 95% CI 0.9 to 51.6) and holding negative attitudes towards safe sex (AOR 1.1 per scale point, 95% CI 1.0 to 1.1). Conclusions Recent attention has focused on HIV prevention interventions that depend upon knowing one's serostatus, including viral load suppression, prevention with positives, pre-exposure prophylaxis and seroadaptation. Until the low level of testing and resulting high level of undiagnosed HIV infection are addressed, these tools are not likely to be effective for MSM in China.</abstract><qualityIndicators><score>7.986</score><pdfVersion>1.4</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>23</keywordCount><abstractCharCount>1612</abstractCharCount><pdfWordCount>4486</pdfWordCount><pdfCharCount>29064</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>260</abstractWordCount></qualityIndicators><title>Untested and undiagnosed: barriers to HIV testing among men who have sex with men, Beijing, China</title><pmid><json:string>22158932</json:string></pmid><genre><json:string>research-article</json:string></genre><host><title>Sexually Transmitted Infections</title><language><json:string>unknown</json:string></language><issn><json:string>1368-4973</json:string></issn><eissn><json:string>1472-3263</json:string></eissn><publisherId><json:string>sti</json:string></publisherId><volume>88</volume><issue>3</issue><pages><first>187</first></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>infectious diseases</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>public health & health services</json:string><json:string>public health</json:string></scienceMetrix><inist><json:string>sciences appliquees, technologies et medecines</json:string><json:string>sciences biologiques et medicales</json:string><json:string>sciences medicales</json:string></inist></categories><publicationDate>2012</publicationDate><copyrightDate>2011</copyrightDate><doi><json:string>10.1136/sextrans-2011-050248</json:string></doi><id>C3404C164D60AA3CA2D8F3626B03EDE838EA21F7</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/C3404C164D60AA3CA2D8F3626B03EDE838EA21F7/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/C3404C164D60AA3CA2D8F3626B03EDE838EA21F7/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/C3404C164D60AA3CA2D8F3626B03EDE838EA21F7/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Untested and undiagnosed: barriers to HIV testing among men who have sex with men, Beijing, China</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://publisher-list.data.istex.fr">BMJ Publishing Group Ltd</publisher><availability><licence><p>© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</p></availability><date>2011-12-08</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Untested and undiagnosed: barriers to HIV testing among men who have sex with men, Beijing, China</title><author xml:id="author-0000"><persName><forename type="first">Xuefeng</forename><surname>Li</surname></persName><affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Hongyan</forename><surname>Lu</surname></persName><affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</affiliation></author><author xml:id="author-0002"><persName><forename type="first">H F</forename><surname>Raymond</surname></persName><affiliation>San Francisco Department of Public Health, San Francisco, California, USA</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Yanming</forename><surname>Sun</surname></persName><affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Yujiang</forename><surname>Jia</surname></persName><affiliation>Institute for Global Health, Vanderbilt University School of Medicine, Nashville, USA</affiliation><affiliation>Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, USA</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Xiong</forename><surname>He</surname></persName><affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</affiliation></author><author xml:id="author-0006"><persName><forename type="first">Song</forename><surname>Fan</surname></persName><affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</affiliation></author><author xml:id="author-0007"><persName><forename type="first">Yiming</forename><surname>Shao</surname></persName><affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</affiliation></author><author xml:id="author-0008" corresp="yes"><persName><forename type="first">Willi</forename><surname>McFarland</surname></persName><email>willi_mcfarland@hotmail.com</email><affiliation>San Francisco Department of Public Health, San Francisco, California, USA</affiliation><affiliation>Institute for Global Health, Vanderbilt University School of Medicine, Nashville, USA</affiliation></author><author xml:id="author-0009"><persName><forename type="first">Yan</forename><surname>Xiao</surname></persName><affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</affiliation></author><author xml:id="author-0010"><persName><forename type="first">Yuhua</forename><surname>Ruan</surname></persName><affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</affiliation></author><idno type="istex">C3404C164D60AA3CA2D8F3626B03EDE838EA21F7</idno><idno type="ark">ark:/67375/NVC-TP4VGNPT-B</idno><idno type="DOI">10.1136/sextrans-2011-050248</idno><idno type="href">sextrans-88-187.pdf</idno><idno type="article-id">sextrans-2011-050248</idno><idno type="PMID">22158932</idno><idno type="local">sextrans;88/3/187</idno></analytic><monogr><title level="j">Sexually Transmitted Infections</title><title level="j" type="abbrev">Sex Transm Infect</title><idno type="pISSN">1368-4973</idno><idno type="eISSN">1472-3263</idno><idno type="publisher-id">sti</idno><idno type="PublisherID-hwp">sextrans</idno><idno type="PublisherID-nlm-ta">Sex Transm Infect</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-04"></date><biblScope unit="volume">88</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="187">187</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011-12-08</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Objectives Undiagnosed HIV presents great potential for the spread of infection. The authors identify the prevalence and correlates of never testing and being unaware of HIV infection in Beijing men who have sex with men (MSM). Methods Cross-sectional biological and behavioural survey using respondent-driven sampling; 500 MSM were included. Results HIV prevalence was 7.2% with 86.1% unaware of their infection; 33.2% had never tested. Never testing was associated with lower educational (adjusted odds ratio (AOR) 1.6, 95% CI (CI) 1.1 to 2.5), living in Beijing for ≤3 years (AOR 1.5, 95% CI 1.0 to 2.3), unprotected anal intercourse with most recent male partner (AOR 1.6, 95% CI 1.0 to 2.4), being unaware of the most recent male partner's HIV status (AOR 3.6, 95% CI 2.1 to 6.1) and holding stigmatised attitudes towards persons with HIV (AOR 1.1 per scale point, 95% CI 1.0 to 1.1). Predictors of having undiagnosed HIV infection were being married (AOR 2.4, 95% CI 1.0 to 5.4), living in Beijing for ≤3 years (AOR 3.6, 95% CI 1.5 to 8.4), being unaware of the most recent male partner's HIV status (AOR 6.8, 95% CI 0.9 to 51.6) and holding negative attitudes towards safe sex (AOR 1.1 per scale point, 95% CI 1.0 to 1.1). Conclusions Recent attention has focused on HIV prevention interventions that depend upon knowing one's serostatus, including viral load suppression, prevention with positives, pre-exposure prophylaxis and seroadaptation. Until the low level of testing and resulting high level of undiagnosed HIV infection are addressed, these tools are not likely to be effective for MSM in China.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>HIV</term></item><item><term>gay men</term></item><item><term>men who have sex with men</term></item><item><term>China</term></item><item><term>HIV testing</term></item><item><term>undiagnosed HIV infection</term></item><item><term>epidemiology</term></item><item><term>street youth</term></item><item><term>homosexual</term></item><item><term>sexual behaviour</term></item><item><term>risk behaviours</term></item><item><term>AIDS</term></item><item><term>HSV-2</term></item><item><term>epidemiology (general)</term></item><item><term>public health</term></item><item><term>CHINA</term></item><item><term>STD control</term></item><item><term>trials</term></item><item><term>STD</term></item><item><term>HCV</term></item><item><term>risk factors</term></item><item><term>viral</term></item><item><term>HBV</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2011-12-08">Created</change><change when="2012-04">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/C3404C164D60AA3CA2D8F3626B03EDE838EA21F7/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">sextrans</journal-id><journal-id journal-id-type="nlm-ta">Sex Transm Infect</journal-id><journal-id journal-id-type="publisher-id">sti</journal-id><journal-title>Sexually Transmitted Infections</journal-title><abbrev-journal-title abbrev-type="publisher">Sex Transm Infect</abbrev-journal-title><abbrev-journal-title>Sex Transm Infect</abbrev-journal-title><issn pub-type="ppub">1368-4973</issn><issn pub-type="epub">1472-3263</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">sextrans-2011-050248</article-id><article-id pub-id-type="doi">10.1136/sextrans-2011-050248</article-id><article-id pub-id-type="other">sextrans;88/3/187</article-id><article-id pub-id-type="other">sextrans;sextrans-2011-050248</article-id><article-id pub-id-type="pmid">22158932</article-id><article-id pub-id-type="other">187</article-id><article-id pub-id-type="other">sextrans-2011-050248</article-id><article-categories><subj-group subj-group-type="heading"><subject>Epidemiology</subject></subj-group><series-title>Original article</series-title></article-categories><title-group><article-title>Untested and undiagnosed: barriers to HIV testing among men who have sex with men, Beijing, China</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Li</surname><given-names>Xuefeng</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Lu</surname><given-names>Hongyan</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Raymond</surname><given-names>H F</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Sun</surname><given-names>Yanming</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Jia</surname><given-names>Yujiang</given-names></name><xref ref-type="aff" rid="aff4">4</xref><xref ref-type="aff" rid="aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>He</surname><given-names>Xiong</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Fan</surname><given-names>Song</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Shao</surname><given-names>Yiming</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>McFarland</surname><given-names>Willi</given-names></name><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Xiao</surname><given-names>Yan</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Ruan</surname><given-names>Yuhua</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib></contrib-group><aff id="aff1"><label>1</label>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</aff><aff id="aff2"><label>2</label>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</aff><aff id="aff3"><label>3</label>San Francisco Department of Public Health, San Francisco, California, USA</aff><aff id="aff4"><label>4</label>Institute for Global Health, Vanderbilt University School of Medicine, Nashville, USA</aff><aff id="aff5"><label>5</label>Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, USA</aff><author-notes><corresp><label>Correspondence to</label> Dr Willi McFarland, San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102-6033, USA; <email>willi_mcfarland@hotmail.com</email></corresp></author-notes><pub-date pub-type="epub-original"><day>8</day><month>12</month><year>2011</year></pub-date><pub-date pub-type="ppub"><month>4</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>8</day><month>12</month><year>2011</year></pub-date><volume>88</volume><volume-id pub-id-type="other">88</volume-id><volume-id pub-id-type="other">88</volume-id><issue>3</issue><issue-id pub-id-type="other">sextrans;88/3</issue-id><issue-id pub-id-type="other">3</issue-id><issue-id pub-id-type="other">88/3</issue-id><fpage>187</fpage><history><date date-type="accepted"><day>9</day><month>11</month><year>2011</year></date></history><permissions><copyright-statement>© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</copyright-statement><copyright-year>2012</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="sextrans-88-187.pdf"></self-uri><abstract><sec><title>Objectives</title><p>Undiagnosed HIV presents great potential for the spread of infection. The authors identify the prevalence and correlates of never testing and being unaware of HIV infection in Beijing men who have sex with men (MSM).</p></sec><sec><title>Methods</title><p>Cross-sectional biological and behavioural survey using respondent-driven sampling; 500 MSM were included.</p></sec><sec><title>Results</title><p>HIV prevalence was 7.2% with 86.1% unaware of their infection; 33.2% had never tested. Never testing was associated with lower educational (adjusted odds ratio (AOR) 1.6, 95% CI (CI) 1.1 to 2.5), living in Beijing for ≤3 years (AOR 1.5, 95% CI 1.0 to 2.3), unprotected anal intercourse with most recent male partner (AOR 1.6, 95% CI 1.0 to 2.4), being unaware of the most recent male partner's HIV status (AOR 3.6, 95% CI 2.1 to 6.1) and holding stigmatised attitudes towards persons with HIV (AOR 1.1 per scale point, 95% CI 1.0 to 1.1). Predictors of having undiagnosed HIV infection were being married (AOR 2.4, 95% CI 1.0 to 5.4), living in Beijing for ≤3 years (AOR 3.6, 95% CI 1.5 to 8.4), being unaware of the most recent male partner's HIV status (AOR 6.8, 95% CI 0.9 to 51.6) and holding negative attitudes towards safe sex (AOR 1.1 per scale point, 95% CI 1.0 to 1.1).</p></sec><sec><title>Conclusions</title><p>Recent attention has focused on HIV prevention interventions that depend upon knowing one's serostatus, including viral load suppression, prevention with positives, pre-exposure prophylaxis and seroadaptation. Until the low level of testing and resulting high level of undiagnosed HIV infection are addressed, these tools are not likely to be effective for MSM in China.</p></sec></abstract><kwd-group><kwd>HIV</kwd><kwd>gay men</kwd><kwd>men who have sex with men</kwd><kwd>China</kwd><kwd>HIV testing</kwd><kwd>undiagnosed HIV infection</kwd><kwd>epidemiology</kwd><kwd>street youth</kwd><kwd>homosexual</kwd><kwd>sexual behaviour</kwd><kwd>risk behaviours</kwd><kwd>AIDS</kwd><kwd>HSV-2</kwd><kwd>epidemiology (general)</kwd><kwd>public health</kwd><kwd>CHINA</kwd><kwd>STD control</kwd><kwd>trials</kwd><kwd>STD</kwd><kwd>HCV</kwd><kwd>risk factors</kwd><kwd>viral</kwd><kwd>HBV</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Untested and undiagnosed: barriers to HIV testing among men who have sex with men, Beijing, China</title><partName>Original article</partName></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Untested and undiagnosed: barriers to HIV testing among men who have sex with men, Beijing, China</title><partName>Original article</partName></titleInfo><name type="personal"><namePart type="given">Xuefeng</namePart><namePart type="family">Li</namePart><affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hongyan</namePart><namePart type="family">Lu</namePart><affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H F</namePart><namePart type="family">Raymond</namePart><affiliation>San Francisco Department of Public Health, San Francisco, California, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yanming</namePart><namePart type="family">Sun</namePart><affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yujiang</namePart><namePart type="family">Jia</namePart><affiliation>Institute for Global Health, Vanderbilt University School of Medicine, Nashville, USA</affiliation><affiliation>Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Xiong</namePart><namePart type="family">He</namePart><affiliation>Beijing Center for Disease Control and Prevention, Beijing, P. R. China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Song</namePart><namePart type="family">Fan</namePart><affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yiming</namePart><namePart type="family">Shao</namePart><affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">Willi</namePart><namePart type="family">McFarland</namePart><affiliation>San Francisco Department of Public Health, San Francisco, California, USA</affiliation><affiliation>Institute for Global Health, Vanderbilt University School of Medicine, Nashville, USA</affiliation><affiliation>E-mail: willi_mcfarland@hotmail.com</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yan</namePart><namePart type="family">Xiao</namePart><affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yuhua</namePart><namePart type="family">Ruan</namePart><affiliation>State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P. R. China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2012-04</dateIssued><dateCreated encoding="w3cdtf">2011-12-08</dateCreated><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract>Objectives Undiagnosed HIV presents great potential for the spread of infection. The authors identify the prevalence and correlates of never testing and being unaware of HIV infection in Beijing men who have sex with men (MSM). Methods Cross-sectional biological and behavioural survey using respondent-driven sampling; 500 MSM were included. Results HIV prevalence was 7.2% with 86.1% unaware of their infection; 33.2% had never tested. Never testing was associated with lower educational (adjusted odds ratio (AOR) 1.6, 95% CI (CI) 1.1 to 2.5), living in Beijing for ≤3 years (AOR 1.5, 95% CI 1.0 to 2.3), unprotected anal intercourse with most recent male partner (AOR 1.6, 95% CI 1.0 to 2.4), being unaware of the most recent male partner's HIV status (AOR 3.6, 95% CI 2.1 to 6.1) and holding stigmatised attitudes towards persons with HIV (AOR 1.1 per scale point, 95% CI 1.0 to 1.1). Predictors of having undiagnosed HIV infection were being married (AOR 2.4, 95% CI 1.0 to 5.4), living in Beijing for ≤3 years (AOR 3.6, 95% CI 1.5 to 8.4), being unaware of the most recent male partner's HIV status (AOR 6.8, 95% CI 0.9 to 51.6) and holding negative attitudes towards safe sex (AOR 1.1 per scale point, 95% CI 1.0 to 1.1). Conclusions Recent attention has focused on HIV prevention interventions that depend upon knowing one's serostatus, including viral load suppression, prevention with positives, pre-exposure prophylaxis and seroadaptation. Until the low level of testing and resulting high level of undiagnosed HIV infection are addressed, these tools are not likely to be effective for MSM in China.</abstract><subject><genre>keywords</genre><topic>HIV</topic><topic>gay men</topic><topic>men who have sex with men</topic><topic>China</topic><topic>HIV testing</topic><topic>undiagnosed HIV infection</topic><topic>epidemiology</topic><topic>street youth</topic><topic>homosexual</topic><topic>sexual behaviour</topic><topic>risk behaviours</topic><topic>AIDS</topic><topic>HSV-2</topic><topic>epidemiology (general)</topic><topic>public health</topic><topic>CHINA</topic><topic>STD control</topic><topic>trials</topic><topic>STD</topic><topic>HCV</topic><topic>risk factors</topic><topic>viral</topic><topic>HBV</topic></subject><relatedItem type="host"><titleInfo><title>Sexually Transmitted Infections</title></titleInfo><titleInfo type="abbreviated"><title>Sex Transm Infect</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">1368-4973</identifier><identifier type="eISSN">1472-3263</identifier><identifier type="PublisherID">sti</identifier><identifier type="PublisherID-hwp">sextrans</identifier><identifier type="PublisherID-nlm-ta">Sex Transm Infect</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>88</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>187</start></extent></part></relatedItem><identifier type="istex">C3404C164D60AA3CA2D8F3626B03EDE838EA21F7</identifier><identifier type="ark">ark:/67375/NVC-TP4VGNPT-B</identifier><identifier type="DOI">10.1136/sextrans-2011-050248</identifier><identifier type="href">sextrans-88-187.pdf</identifier><identifier type="ArticleID">sextrans-2011-050248</identifier><identifier type="PMID">22158932</identifier><identifier type="local">sextrans;88/3/187</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2012, Published by the BMJ Publishing Group Limited. 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