An exploration of HIV testing, linkage-to-care and antiretroviral therapy initiation among Chinese men who have sex with men

Abstract

This dissertation researched on important epidemiologic and prevention intervention components of three crucial stages of the HIV care continuum, including HIV testing/diagnosis, linkage-to-care and antiretroviral therapy (ART) initiation. Specifically, I use propensity score adjustment to examine the intervention effect of prior repeat HIV testing to reduce HIV risk among HIV-negative men who have sex with men (MSM) in a cross-sectional study, and found higher prior HIV testing frequency was significantly associated with a reduced HIV risk; I conducted a qualitative study to assess determinants of linkage to and engagement in HIV care, and identified several key personal, structural and social barriers and facilitators for HIV utilization; I also evaluated sociodemographic, behavioral and clinical predictors of ART initiation among HIV-positive Chinese MSM, and found important intervention factors to enhance to ART use among HIV-infected Chinese MSM.

In sum, this dissertation explored novel perspectives of the HIV epidemics and HIV care utilization among Chinese MSM which had never been studied. The study findings provided implication for the design of future intervention programs, and rendered evidence to strengthen the current HIV prevention policy among Chinese MSM.