Uptake of provider-initiated HIV and syphilis testing among Heterosexual STD Clinic attendees in Southern China: Results from a Cross-sectional Study

Background: Provider-initiated HIV and syphilis testing and counseling (PITC) services are important components of HIV and syphilis prevention programs. However, PITC guidelines have neither been formalized nor widely implemented in China. Limited studies conducted to identify the barriers to offering PITC services from sexually transmitted diseases (STD) clinic attendees’ perspective. We conducted a cross-sectional survey on heterosexual STD clinic attendees to evaluate this in China.Methods A cross-sectional survey was conducted in 2016 in Southern China. Participants completed a validated questionnaire including social-demographic information, reasons for not conducting HIV and syphilis testing, and HIV and STD infection history. In this study, we limited the participants as individuals who self-identified as heterosexual.Results A total of 1943 participants were recruited in this study. Among those participants, 60.6% (1177/1943) and 74.3% (1443/1943) conducted HIV testing and syphilis testing during the study, respectively. Of whom, 2.2% (26/1177) and 21.5% (310/1443) are found to be HIV-positive and syphilis-positive, respectively. The most common barrier to HIV and syphilis testing is a lack of awareness of HIV and syphilis infection. Condom use in the last sexual act, having paid sex during the last 6 months, and receiving HIV and STD related knowledge were positively associated with uptake of both HIV and syphilis testing.Conclusions This study highlights the need and importance of promoting provider-initiated HIV and syphilis testing and counseling services in China. Future studies on exploring innovative methods to improve the knowledge and awareness of HIV and syphilis infection among STD clinic attendees is warranted.