Anticipated HIV stigma among HIV negative men who have sex with men in China: a cross-sectional study

BACKGROUND: Anticipated HIV stigma, i.e., the expectation of adverse experiences from one’s seroconversion, is associated with both negative psychological and behavioral outcomes. We know little about anticipated HIV stigma’s relationship with emerging technologies, such as HIV self-testing (HIVST) and online sex-seeking platforms, that have become popular among populations that are disproportionately affected by HIV/AIDS. This study examined correlates of anticipated HIV stigma among Chinese men who have sex with men (MSM). METHODS: In July 2016, MSM, who were ≥ 16 years old and self-reported as HIV negative or unknown, were recruited from a gay mobile phone application in China. Information regarding socio-demographics, sexual behaviors, sexual health service utilization, and anticipated HIV stigma were collected. Anticipated HIV stigma (i.e., negative attitude toward future stigmatization of HIV seroconversion by others) was measured as the mean score from a 7-item Likert-scale ranging from 1 (low) to 4 (high). Generalized linear models were conducted to examine the factors associated with the anticipated HIV stigma scores. RESULTS: Overall, 2006 men completed the survey. Most men completed high school (1308/2006, 65.2%) and had an annual personal income of ≤9200 USD (1431/2006, 71.3%). The mean anticipated HIV stigma score for the participants was 2.98 ± 0.64. Using social media to seek sexual partners was associated with higher anticipated HIV stigma (Adjusted β = 0.11, 95% confidence interval (CI): 0.05 to 0.17, p = 0.001). HIV self-testing (Adjusted β = − 0.07, 95%CI: − 0.13 to − 0.01, p = 0.02) and having disclosed one’s sexual orientation to a healthcare provider (Adjusted β = − 0.16, 95%CI: − 0.22 to − 0.96, p < 0.001) were associated with lower anticipated HIV stigma. CONCLUSION: Our data suggested that anticipated HIV stigma is still common among Chinese MSM not living with HIV. Tailored anti-HIV stigma campaigns on social media are especially needed, and the promotion of HIVST may be a promising approach.