Background Syphilis self-testing may help expand syphilis testing among men who have sex with men (MSM). China has had rapid scale up of HIV self-testing pilots, creating an opportunity for integrating syphilis self-testing. However, there is a limited literature on optimizing implementation of syphilis self-testing. We organized an online survey of MSM in China to examine syphilis self-testing experience and its determinants among MSM in China

Methods A cross-sectional online survey was conducted in 2018. Participants completed a survey instrument including socio-demographic characteristics, sexual behaviors, syphilis self-testing, and HIV self-testing history. Eligible participants were born biologically male, aged 16 or over, and engaged in anal or oral sex with a man at least once during their lifetime. Multivariable logistic regression was conducted to identify correlates of syphilis self-testing.

Results Six hundred ninety-nine MSM from 89 cities in 21 provinces in China completed the study. 361 (51.7%) had ever tested for syphilis, of whom 174 (48.2%) had ever used syphilis self-testing. Among 174 who had self-tested, 90 (51.7%) reported that the self-test was their first syphilis test, 161 (92.5%) reported that they undertook syphilis self-testing together with HIV self-testing. After adjusting for covariates, syphilis self-testing was correlated with disclosure of sexual orientation (aOR: 1.90, 95%CI: 1.32–2.73), reporting two to five male sexual partners (aOR: 1.81, 95%CI: 1.04–3.16),, HIV self-testing (aOR: 39.90, 95%CI: 17.00–93.61), and never tested for syphilis in the hospital (aOR: 2.96, 95%CI: 1.86–4.72). Self-reported harms associated with syphilis self-testing were minimal.

Conclusions Scaling up syphilis self-testing could complement facility-based testing in China among MSM. Self-testing may increase first-time testing and has limited harms. Our findings suggest that syphilis self-testing could be integrated into HIV self-testing services.

Disclosure No significant relationships.