Which Chinese men who have sex with men miss out on HIV testing?

Objectives: To describe socio-demographic, behavioural and other characteristics associated with HIV testing behaviour among men who have sex with men (MSM) in Jinan, China. Methods: A cross-sectional survey was conducted among MSM (N=500) in Jinan in 2008 using respondent-driven sampling - a method used worldwide to reach hidden high-risk populations. Bivariate and multivariate analyses, adjusted for the sampling method, were conducted to identify correlates of not having an HIV test. Results: Overall, 80.7% (95% CI 75.0% to 85.0%) of MSM in Jinan have not had an HIV test in the past 12 months. In the multivariate analyses, having not visited the local Centers for Disease Control and Prevention's website (AOR 5.59, 95% CI 2.62 to 11.95), being over the age of 35 years (AOR 3.77, 95% CI 1.19 to 11.93) and self-identified as bisexual or unsure (AOR 3.85, 95% CI 2.16 to 6.85) are significantly associated with having not had an HIV test. In addition, married men are slightly less likely to have not been tested compared to single men (AOR 0.38, 95% CI 0.17 to 0.85). Those who report meeting their sex partners at high-risk venues are two times more likely to have not had an HIV test (AOR 2.02, 95% CI 0.97 to 4.21). Conclusions: Targeted, culturally appropriate and innovative interventions to increase HIV testing uptake should be a top priority for HIV prevention among MSM in China.