Prevalence of HIV self-testing and associated factors among men who have sex with men in Chongqing, China: a cross-sectional study

Background HIV self-testing has been promoted globally as an effective complement to facility-based testing, particularly among men who have sex with men (MSM). However, evidence on HIV self-testing uptake and its determinants in western China remains limited. Objective To assess the prevalence of HIV self-testing and identify associated factors among MSM in Chongqing, China. Methods A cross-sectional study was conducted from March 2021 to March 2022 among MSM recruited using a snowball sampling strategy at CDC-based voluntary counseling and testing clinics in Chongqing. Participants completed an anonymous face-to-face questionnaire covering socio-demographic characteristics, HIV-related knowledge, sexual behaviors in the past 6 months, substance use, and HIV self-testing history. Multivariate logistic regression was used to identify factors associated with HIV self-testing. Results A total of 2,315 MSM were included. Overall, 16.2% (374/2,315) reported ever using HIV self-testing kits, with blood-based tests accounting for 97.6% of use. Higher educational attainment (high school/vocational school: OR = 2.56; college or above: OR = 3.60), having two or more sexual partners in the past 6 months ( OR = 11.85), and use of sexual stimulants ( OR = 3.49) were positively associated with HIV self-testing. Being married or cohabiting was negatively associated with HIV self-testing ( OR = 0.30). Conclusion HIV self-testing uptake among MSM in Chongqing remains low. Education level, marital status, sexual behavior, and stimulant use were key correlates. These findings underscore the need to integrate HIV self-testing into existing HIV prevention services, with targeted strategies for MSM with lower educational attainment and those in stable partnerships.