Application Of The Fourth-generation HIV Rapid Test Kit To Detect Acute HIV Infection Among MSM In Yunnan Province

Objectives:Exploring the feasibility of the fourth-generation rapid HIV tests kit to detect Acute HIV Infection(AHI),understand the awareness of the fourth-generation HIV rapid test kit among men who have sex with men(MSM)in Yunnan Province and the influencing factors.Analyzing the factors that affected the detection of AHI.This article is aimed to provide references for the further implementation of fourth-generation HIV rapid test kits testing MSM in Yunnan province.Methods:From January to December 2020,using the third-generation and the fourth-generation HIV rapid test kits to detected MSM.At the same time,recruited 402 MSM among them to conduct questionnaire.This questionnaire was partly modified on the basis of the Survey Questionnaire on the Health of Men Who Have Sex With Men which designed by Yunnan Provincial Center for Disease Control and Prevention.Content of the questionnaire mainly included general demographic characteristics,knowledge of AIDS,knowledge of AHI,Sexual situation,awareness of the fourth-generation HIV rapid test kit and willingness to use it.MSM who were diagnosed as AHI will receive questionnaire interview.And this interview were conducted around the high-risk behaviors pre-testing,sexual behaviors post-testing,Sexual partner mobilization test,and the situation of antiretroviral treatment(ART).The data of the questionnaire were collated by Epidata 3.1,and analyzed by SPSS21.Using chi-square test to analyzed single factor,and using Logistic regression analysis to analyzed multi-factors.Results:A total of 14,137 HIV tests and 402 questionnaires were completed.The effective rate of the questionnaire is 100%.The third-generation and fourth-generation HIV rapid test kit jointly diagnosed 231 HIV infection,and the fourth-generation HIV rapid test kit diagnosed 4 Acute HIV infection more than the third-generation HIV rapid test kit.Using the fourth-generation HIV rapid test kit to diagnose per HIV infection costs 20,45.35 yuan,and per acute HIV infection costs 1,20164.5 yuan,which only count the price of kit.There are 163(40.5%)MSM indicate that they knew about the fourth-generation HIV rapid test kit before this investigate,and 379(94.3%)MSM express that they are glad to use the fourth-generation HIV rapid test kit.Analysis the factors that affect the knowledge of the fourth-generation HIV rapid test kit includes:Location of investigation(χ2=23.079,P=0.002),education level(χ2=15.137,P=0.002),awareness of AIDS knowledge(χ2=4.150,P=0.042),infection risk(χ2=7.239,P=0.027),awareness of AHI(χ2=70.707,P<0.001),awareness of the earliest detection time after infection(χ2=23.926,P<0.001),the number of same-sex partners within six months(χ2=10.315,P=0.004),the occurrence of same-sex anal intercourse within six months(χ2=6.081,P=0.014),the occurrence of temporary anal intercourse within six months(χ2=8.255,P=0.004),the receiving of condom publicity and HIV/AIDS counseling and testing services(χ2=18.542,P<0.001),the receiving of peer education(χ2=28.998,P<0.001),HIV testing(χ2=13.418,P<0.001)and regular HIV testing(χ2=26.086,P<0.001).The significant factors of multivariate analysis included:Location of investigation(OR=3.917,95%CI:1.532-10.012;OR=0.327,95%CI:0.128～0.831;OR=0.197,95%CI:0.053～0.732),education level(OR=6.256,95%CI:1.236～31.668),awareness of AHI(OR=6.650,95%CI:3.732～11.849),the occurrence of temporary same-sex anal intercourse within six months(OR=2.155,95%CI:1.247～3.725),the receiving of peer education((OR=6.810,95%CI:2.646～17.526),regular HIV testing(OR=2.986,95%CI:1.610～5.537).The awareness rate of AIDS related knowledge is 96.5%;and there are 125(31.1%)MSM say they knew the acute HIV infection,and 97 MSM of them know the acute HIV infected people has the highly transmissibility;112 MSM can accurately judge that it is need 10 days to detect HIV infection after high-risk behavior.Conclusions:After high-risk sex,The fourth-generation HIV rapid test kit can can detect Acute HIV infections that cannot be detected by the third-generation HIV rapid test kit,it has positive significance to stop the spread of AIDS,At the same time,MSM and social organization staff in Yunnan Province have a high willingness to use/undertake it,so it is feasible to use The fourth-generation HIV rapid test kit diagnose Acute HIV infection among MSM in Yunnan Province.At present,MSM in Yunnan Province have a low level of knowledge about the fourth-generation HIV rapid test kit and Acute HIV infection,and rather than the third-generation HIV rapid test kit,the cost of HIV infected detection is high,which limits the application of fourth-generation HIV rapid test kit use in HIV mass screening.