Abstract / Summary
Aim: This study aimed to explore the association between HIV testing trajectories, sexual behavior characteristics and HIV exposure prevention prophylaxis use, to provide a basis for developing more precise HIV prevention strategies.
Study design: This analysis utilized pseudonymized data from a three-arm, open-label randomized controlled trial (RCT) conducted in Guangxi, China, between 2021 and 2023.
Methods: This prospective cohort study enrolled 327 participants from southern China. Longitudinal data-including HIV testing, sexual risk behaviors, and prophylaxis use (PrEP/PEP)-were collected at baseline and quarterly for one year. Group-based trajectory modeling (GBTM) was used to identify behavioral patterns, and person-years (PY) of follow-up were calculated to estimate incidence densities of PrEP/PEP use and STI occurrence.
Results: A total of 76.45% of men who have sex with men (MSM) received HIV testing less frequently than once every three months, and HIV self-testing (HIVST) was not significantly associated with increased rates of HIV testing (HT). In the HT model, MSM who underwent middle-frequency HT were less likely to report having fewer temporary sexual partners (OR 0.120, 95% CI 0.017-0.85, P = 0.034) and regular sexual partners (OR 0.502, 95% CI 0.267-0.943, P = 0.032). The use of PrEP increased with higher HT frequency, demonstrating a 3.39-fold (95% CI: 1.377-8.843, P = 0.008) increase in the middle frequency group and a 7.335-fold (95% CI: 2.505-21.475, P < 0.001) increase in the high frequency group compared to the low frequency group. PEP use also increased with higher HT frequency, showing a 6.129-fold (95% CI: 1.921-19.553, P = 0.002) increase in the high frequency group compared to the low frequency group.
Conclusions: While frequent HIV testing demonstrates significant associations with increased sexual partner numbers, its role in facilitating consistent use of HIV exposure prevention prophylaxis remains clinically valuable.