HIV Prevalence and Factors Influencing the Uptake of Voluntary HIV Counseling and Testing among Older Clients of Female Sex Workers in Liuzhou and Fuyang Cities, China, 2016-2017: A Cross-Sectional Study

OBJECTIVE: To compare the prevalence of HIV and associated factors for participating HIV voluntary counseling and testing (VCT) among older clients of female sex workers (CFSWs) in Liuzhou City and Fuyang City in China. METHODS: A cross-sectional study was conducted and the study employed 978 male CFSWs, aged 50 years and above from October 2016 to December 2017. All participants were required to complete a questionnaire and provide blood samples for HIV testing. Multivariate logistic regression analysis was used to analyze the influential factors of using VCT program and tested for HIV. RESULTS: The HIV infection prevalence rate was 1.2% and 0.5%, while 52.3% and 54.6% participants had ever utilized VCT service and tested for HIV in Liuzhou City and Fuyang City, respectively. The older CFSWs who ever heard of VCT program were more likely to uptake VCT program in both cities (OR(Liuzhou) = 2.224, OR(Fuyang) = 2.421). Participants, whose marital status was married or cohabiting (OR(Liuzhou) = 0.548, OR(Fuyang) = 0.495), who have stigma against individuals who are living with HIV/AIDS (OR(Liuzhou) = 0.273, OR(Fuyang) = 0.371), whose monthly income is more than 500 yuan (OR(Liuzhou) = 0.622, OR(Fuyang) = 0.600), and whose age is more than 60 years old (OR(Liuzhou) = 0.639, OR(Fuyang) = 0.554), were less likely to visit VCT clinics. Those who are worried about HIV-infected participants were more likely to utilize VCT services in Fuyang City (AOR = 1.838, 95%CI : 1.146‐2.948). CONCLUSION: Combine strategy will be needed to promote the utilization of VCT service, based on the socioeconomic characteristics of older male CFSWs in different cities of China.