Sexualized Drug Use Linked to Higher HIV Testing Frequency Among Men Who Have Sex with Men in Three Chinese Cities...

Men who have sex with men (MSM) in China experience high HIV prevalence, yet little is known about the HIV testing behaviors of MSM among those who engage in sexualized drug use (SDU). Clarifying these patterns is essential for designing targeted HIV prevention interventions.

We analyzed baseline survey data from 1,800 MSM recruited in Chengdu, Suzhou, and Wuhan (2021-2022). Participants reported HIV testing history and SDU, including alcohol, rush/poppers, amphetamines, and other drugs (ketamine, marijuana, heroin, Ma Gu). Logistic regression estimated associations between SDU and HIV testing within 6 months, adjusting for demographics.

The mean age was 31.1 years; nearly half held a bachelor's degree or higher. Alcohol (68%) and rush/poppers (43%) were the most common substances used before or during sex, while amphetamines (1.8%) and other drugs (1.7%) were rarely used. Any drug use excluding alcohol was positively associated with recent HIV testing (adjusted OR = 1.35; 95% CI: 1.08-1.68). Rush/poppers use specifically was linked to higher odds of testing (adjusted OR = 1.32; 95% CI: 1.05-1.63).

SDU-particularly rush/poppers use-is prevalent among Chinese MSM and associated with greater HIV testing uptake. Tailored interventions that integrate substance use counseling with HIV testing promotion may help sustain high testing uptake and reduce transmission risk.