Abstract / Summary
Abstract Background Online self-sampling has emerged as a potential strategy to expand sexually transmitted infection (STI) screening, particularly for gonorrhea and chlamydia. However, evidence on its acceptability among men who have sex with men (MSM) remains limited. This study aimed to assess the acceptability of online self-sampling for gonorrhea and chlamydia and associated factors among MSM in China. Methods In 2024, a cross-sectional study was conducted among MSM in four cities in Guangdong Province, South China. Data were collected on sociodemographic characteristics, sexual behaviors and acceptability of online self-sampling. Univariate and multivariable logistic regression analyses were performed to identify associated factors. Results A total of 984 MSM were included, and 30.1% were willing to use online self-sampling. Among those unwilling to use online self-sampling, the main concerns were test accuracy and reliability (70.5%), data privacy (63.8%), and cost (60.5%). Multivariable logistic regression showed that prior HIV pre-exposure prophylaxis (PrEP) use was associated with higher acceptability (adjusted Odds Ratio (aOR): 3.46, 95% CI: 1.27–9.46), whereas more frequent sexual activity and engagement in commercial sex were associated with lower acceptability. Conclusions The acceptability of online self-sampling for gonorrhea and chlamydia among MSM in China was low. Improving health awareness, strengthening engagement with sexual health services, and enhancing user trust in online self-sampling services may help increase their acceptability among MSM.