Returning for HIV Test Results: A Systematic Review of Barriers and Facilitators
BACKGROUND The majority of people living with HIV/AIDS in China are unaware of their serostatus, and increasing the utilization of HIV testing may help to control the epidemic. METHODS This longitudinal study was conducted among female sex workers (FSWs) in 2 cities in Yunnan Province, China. Participants were surveyed in face-to-face interviews and tested for HIV and STDs. Factors associated with HIV-testing history and HIV-test follow-up were analyzed. RESULTS Of the 1642 study participants, 291 (17.7%) had been previously tested and 868 (52.9%) returned for post-test follow-up. Factors associated with having a previous HIV test included attending the Kaiyuan study (aOR: 4.9, 95% CI: 2.3-10.1), ≥ 9 years of schooling (aOR: 10.9, 95% CI: 2.6-45.5), <5 clients in the recent week (aOR: 1.7, 95% CI: 1.2-2.3), having a regular sexual partner (aOR: 1.9, 95% CI: 1.4-2.5), illegal drug use history (aOR: 2.2, 95% CI: 1.5-3.1), pelvic pain in the past 12 months (aOR: 1.9, 95% CI: 1.1-3.6), HIV-seropositivity (aOR: 1.8, 95% CI: 1.2-2.8), and high perception of HIV risk (aOR: 1.5, 95% CI: 1.1-2.2). FSWs who had ≥ 9 years of schooling (aOR: 1.4, 95% CI: 1.1-1.9), had <5 clients in the recent week (aOR: 1.3, 95% CI: 1.1-1.6), or were from another province (aOR: 1.9, 95% CI: 1.4-2.5) or city (aOR: 1.4, 95% CI: 1.1-1.8) were more likely to follow-up. CONCLUSIONS The low HIV-testing history and follow-up rates found in this is study is a significant public health problem as many high-risk individuals are not aware of their serostatus. Immediate action needs to be taken to increase the utilization of HIV testing services and notify people of their HIV status.