Prevalence of and factors associated with behavioral intention to take up home-based HIV self-testing among male clients of female sex workers in China - an application of the Theory of Planned Behavior

HIV self-testing (HIVST) is a useful means to increase coverage of HIV testing but under-utilized by male clients of female sex workers (MCFSW) in China. This study investigated the prevalence of and factors associated with behavioral intention to take up HIVST in the next year among MCFSW in Hong Kong, China. We recruited Chinse-speaking adult men who had patronized at least one female sex worker in the past six months. A total of 303 MCFSW completed a self-administered questionnaire. Univariate and multivariable ordinal logistic regression models were fit. Only 23.8% of participants indicated that they probably/definitely would take up HIVST in the next year. The multivariable ordinal logistic regression model showed that positive attitudes towards HIVST (adjusted odds ratios (aOR): 1.24, 95%CI: 1.13, 1.37), perceived HIVST uptake is completely under one's control (perceived behavioral control) (aOR: 1.44, 95%CI: 1.08, 1.92), and perceived higher risk of HIV infection (aOR: 1.32, 95%CI: 1.01, 1.76) were associated with higher intention to take up HIVST in the next year. The prevalence of behavioral intention to use HIVST was low among MCFSW in Hong Kong. Perceptions based on the Theory of Planned Behavior and perceived risk of HIV infection were associated with behavioral intention to use HIVST.