Generic placeholder image

Current HIV Research


ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Research Article

Post-lockdown Rebounding High-risk Behaviors and HIV Testing Among MSM in China in the Era of the COVID-19 Pandemic

Author(s): Jiahui Yang, Mengyao Yi, Han-Zhu Qian, Yuqing Chen, Qidi Zhou and Xianhong Li*

Volume 20, Issue 4, 2022

Published on: 23 August, 2022

Page: [287 - 295] Pages: 9

DOI: 10.2174/1570162X20666220613120735

Price: $65


Background: Lockdown measures for controlling the COVID-19 epidemic were enforced in China between January and May 2020. Previous studies showed a decrease in HIV high- Risk Behaviors (HRBs) and updated testing during the lockdown, but little is known about these behaviors during the post-lockdown period.

Objective: We conducted quantitative and qualitative assessments of HIV-related behaviors among MSM during the lockdown and post-lockdown periods in Changsha, south-central China.

Methods: Face-to-face structured interviews with open-ended questions were conducted using the TimeLine Follow Back (TLFB) method for collecting retrospective data on frequencies of HRBs and testing. McNemar’s Chi-square test and Wilcoxon signed-rank test were used to comparing frequencies of behaviors between lockdown (January-May 2020) and post-lockdown periods (June- October 2020). Content analysis was used to analyze qualitative data on the reasons for rebounding HRBs and testing.

Results: Of 159 MSM participants, 64% had at least one HRB during the post-lockdown period. Men had increased condomless sex (from 24% to 35%), multiple partners (23% to 35%), and substance abuse (16% to 27%) between the two study periods due to the negative emotions and increased use of social networks during the lockdown. HIV testing frequency also increased from 37% to 66% due to resuming routine testing services in the community-based organizations and increased HRBs among MSM during post-lockdown.

Conclusion: After lifting the lockdown measures, MSM had rebounding HRBs and uptake of testing. Effective preventive measures and healthcare services should be available to MSM after the lockdown measures are lifted.

Keywords: COVID-19, High-risk behaviors, HIV testing, Men who have sex with men (MSM), Timeline follow-back, lockdown.

UNAIDS data 2020. 2020. Available from: https://www.unaids. org/sites/default/files/media_asset/2020_aids-data-book_en.pdf (Accessed on 6 July 2020).
Zhang X, Wang N, Vermund SH, et al. Interventions to improve the HIV continuum of care in China. Curr HIV/AIDS Rep 2019; 16(6): 448-57.
[] [PMID: 31776975]
Baral S, Sifakis F, Cleghorn F, Beyrer C. Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries 2000-2006: A systematic review. PLoS Med 2007; 4(12): e339.
[] [PMID: 18052602]
Chawla N, Sarkar S. Defining “High-risk sexual behavior” in the context of substance use. J Psychosexual Health 2019; 1(1): 26-31.
Yang Z, Zhang S, Dong Z, Jin M, Han J. Prevalence of unprotected anal intercourse in men who have sex with men recruited online versus offline: A meta-analysis. BMC Public Health 2014; 14(1): 508.
[] [PMID: 24885058]
Mao YX, Xiao CC, Wang T, Li SY, Yan H. One-night-stand behavior and associated factors among young men who have sex with men in Wuhan, China. Zhonghua Liu Xing Bing Xue Za Zhi 2017; 38(6): 746-9.
[PMID: 28647975]
He L, Pan X, Wang N, et al. New types of drug use and risks of drug use among men who have sex with men: A cross-sectional study in Hangzhou, China. BMC Infect Dis 2018; 18(1): 182.
[] [PMID: 29665785]
Sun S, Whiteley L, Brown LK. HIV testing among chinese men who have sex with men: The roles of HIV knowledge, online social life, and sexual identity concerns. AIDS Behav 2020; 24(2): 437-49.
[] [PMID: 30924064]
Jiang H, Xie Y, Xiong Y, et al. HIV self-testing partially filled the HIV testing gap among men who have sex with men in China during the COVID-19 pandemic: Results from an online survey. J Int AIDS Soc 2021; 24(5): e25737.
[] [PMID: 34036750]
Booton RD, Fu G, MacGregor L, et al. Estimating the impact of disruptions due to COVID-19 on HIV transmission and control among men who have sex with men in China. medRxiv 2020.
Hyndman I, Nugent D, Whitlock GG, et al. COVID-19 restrictions and changing sexual behaviours in HIV-negative MSM at high risk of HIV infection in London, UK. Sex Transm Infect 2021.
Chow EPF, Hocking JS, Ong JJ, et al. Sexually transmitted infection diagnosis and access to a sexual health service before and after the national lockdown for COVID-19 in melbourne, Australia. Open Forum Infect Dis 2021; 8(1): aa536.
Weinhardt LS, Carey MP, Maisto SA, Carey KB, Cohen MM, Wickramasinghe SM. Reliability of the timeline follow-back sexual behavior interview. Ann Behav Med 1998; 20(1): 25-30.
[] [PMID: 9755348]
Robinson SM, Sobell LC, Sobell MB, Leo GI. Reliability of the Timeline Followback for cocaine, cannabis, and cigarette use. Psychol Addict Behav 2014; 28(1): 154-62.
[] [PMID: 23276315]
Hoeppner BB, Stout RL, Jackson KM, Barnett NP. How good is fine-grained Timeline Follow-back data? Comparing 30-day TLFB and repeated 7-day TLFB alcohol consumption reports on the person and daily level. Addict Behav 2010; 35(12): 1138-43.
[] [PMID: 20822852]
Martin-Willett R, Helmuth T, Abraha M, et al. Validation of a multisubstance online Timeline Followback assessment. Brain Behav 2020; 10(1): e01486.
[] [PMID: 31793226]
Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nurs Health Sci 2013; 15(3): 398-405.
[] [PMID: 23480423]
Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs 2008; 62(1): 107-15.
[] [PMID: 18352969]
Pampati S, Emrick K, Siegler AJ, et al. Changes in sexual behavior, PrEP adherence, and access to sexual health services due to the COVID-19 pandemic among a cohort of PrEP-using MSM in the South. medRxiv 2020.
Chen L, Chen W, Jiang T, Ni Z, Ma Q, Pan X. The characteristics and risk factors of web-based sexual behaviors among men who have sex with men in eastern china: Cross-sectional study. JMIR Public Health Surveill 2021; 7(9): e25360.
[] [PMID: 34473066]
Gonzales G, Loret de Mola E, Gavulic KA, McKay T, Purcell C. Mental health needs among lesbian, gay, bisexual, and transgender college students during the COVID-19 pandemic. J Adolesc Health 2020; 67(5): 645-8.
[] [PMID: 32933837]
Wang Y, Wang Z, Jia M, et al. Association between a syndemic of psychosocial problems and unprotected anal intercourse among men who have sex with men in Shanghai, China. BMC Infect Dis 2017; 17(1): 46.
[] [PMID: 28061819]
Ma Y. Advocating HIV testing, strengthening adolescent sexuality education. C. C J School Health 2018; 39(12): 1761-5.
Hollingshead BM, Dowsett GW, Bourne A. ‘It’s like getting an Uber for sex’: Social networking apps as spaces of risk and opportunity in the Philippines among men who have sex with men. Health Sociol Rev 2020; 29(3): 264-78.
[] [PMID: 33411604]
Chemnasiri T, Beane CR, Varangrat A, et al. Risk behaviors among young men who have sex with men in bangkok: A qualitative study to understand and contextualize high HIV incidence. J Homosex 2019; 66(4): 533-48.
[] [PMID: 29308991]
Yan X, Su H, Zhang B, Li Y, Zhang L, Jia Z. Adherence of HIV Self-Testing Among Men Who Have Sex With Men in China: Longitudinal Study. J Med Internet Res 2020; 22(9): e19627.
[] [PMID: 32940619]
Liu F, Qin Y, Meng S, et al. HIV self-testing among men who have sex with men in China: A qualitative implementation research study. J Virus Erad 2019; 5(4): 220-4.
[] [PMID: 31754445]
Lei Y, Zhang K, Xiao X, Tang C, Li X, Wang H. Sexual roles, risk sexual behaviours, and HIV prevalence among men who have sex with men seeking HIV testing in Changsha, China. Curr HIV Res 2018; 16(2): 174-81.
[] [PMID: 29992887]
Zhou J, Chen J, Goldsamt L, Wang H, Zhang C, Li X. HIV Testing and Associated Factors Among Men Who Have Sex with Men in Changsha, China. J Assoc Nurses AIDS Care: JANAC 2018; 29(6): 932-41.
[] [PMID: 29861317]
Zhang C, Li X, Koniak-Griffin D, Goldsamt LA, Zhou J. Effectiveness of self-testing kits availability on improving HIV testing frequency for chinese men who have sex with men and their sexual partners: A protocol for a multicenter randomised controlled trial. BMJ Open 2018; 8(12): e024423.
[] [PMID: 30552280]
Cortés AJ. On how role versatility boosts an STI. J Theor Biol 2018; 440: 66-9.
[] [PMID: 29273545]

Rights & Permissions Print Export Cite as
© 2024 Bentham Science Publishers | Privacy Policy