A new global research project is shedding light on HIV testing and PrEP engagement among sexual minority men, highlighting how relationship dynamics influence prevention behaviors. A recent study from China states that sexual minority men (SMM) in China continue to face a disproportionately high burden of HIV.
Researchers surveyed 1,379 sexually active sexual minority men using a geosocial networking app. The study explains that the purpose was to find the associations between relationship status and sexual agreements and HIV testing behaviors, PrEP willingness, and PrEP uptake. The findings showed that 36 percent, that is more than one-third of Chinese sexual minority men, were in a relationship, and among these men, 44 percent had a monogamous sexual agreement, and 24.6 percent were having an open relationship agreement.
The study also found that partnered Chinese SMM were more likely to have received a recent HIV test. This means they were more likely to have been tested than single men. The research also showed that bisexual men were less likely to have tested for HIV and less likely to have ever used PrEP as compared to gay men. How do these findings compare to what we see here in the United States? A 2024 viewpoint in The Lancet HIV states that Black men account for just 11% of PrEP prescriptions in the United States, even though national targets require roughly 50% PrEP coverage.
This is similar to what was seen in China, where bisexual men and men in open relationships showed lower prevention engagement. A major systematic review in the United States that included 42,870 Black MSM found PrEP awareness at 50.8% and PrEP uptake at only 15.5%. A study of Latinx sexual minority men in the United States revealed that cultural silence, religious expectations, misinformation, and stigma limit HIV testing and PrEP engagement. At the same time, the Chinese study also suggests the need for tailored interventions. Whether in China or here in our own communities, we need more awareness around HIV testing and PrEP behavior.
