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Original research
Factors predicting first-time hepatitis C virus testing uptake among men who have sex with men in China: an observational prospective cohort study
  1. Zixin Wang1,2,
  2. Phoenix K H Mo1,
  3. Yuan Fang3,
  4. Mary Ip1,
  5. Joseph T F Lau1
  1. 1 Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
  2. 2 Shenzhen Research Institute, Chinese University of Hong Kong, Shenzhen, China
  3. 3 Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, China
  1. Correspondence to Dr Zixin Wang, Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; wangzx{at}


Objectives Men who have sex with men (MSM) are at high risk of hepatitis C virus (HCV). This study investigated predictors of first-time HCV testing uptake during a 6-month period among a sample of MSM in Hong Kong.

Methods Participants were 351 Chinese-speaking MSM who had never received HCV testing. Participants completed two telephone surveys 6 months apart. At baseline, participants reported on sociodemographics, sexual behaviours, risk perception, depressive symptoms and anxiety symptoms. Illness representations, which refers to how people think about HCV, was measured by the Brief Illness Perception Questionnaire (BIPQ) at baseline. The BIPQ assessed identity (identifying symptoms of HCV), timeline (whether HCV is acute/chronic), consequences (severity of HCV), personal control and treatment control (whether HCV is under volitional control), concern, emotions (anger, guilt or shame) and coherence (overall comprehensibility of HCV). Six months later, participants reported on HCV testing uptake. Logistic regression was used to analyse the associations between baseline predictors and HCV testing uptake.

Results Most participants were aged ≤30 years (55.0%) and had attained college education or above (85.2%). Among 242 participants (68.9%) who completed the month 6 follow-up, 12.4% had tested for HCV during the follow-up period. After adjustment for HIV testing and chemsex in the last year, participants who perceived more severe consequences of HCV reported higher HCV testing uptake (adjusted ORs (AOR): 2.22, 95% CI: 1.65 to 3.00). Belief that treatment can control HCV (AOR: 1.75, 95% CI: 1.35 to 2.26) and having negative emotions related to HCV (AOR: 1.59, 95% CI: 1.25 to 2.03) were also positively associated with HCV testing uptake.

Conclusions Targeted health promotion efforts are needed to increase HCV testing among MSM in Hong Kong. Healthcare workers engaged in HCV-related programming should consider modifying the illness representations of HCV. Integrating HCV and HIV testing services may also be beneficial.

  • hepatitis C
  • testing
  • gay men
  • predictors
  • China

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  • Handling editor Joseph D Tucker

  • Contributors ZW and JTFL designed the study and wrote the protocol. ZW designed the questionnaire and analytical plan, analysed and interpreted the data. MI supervised the data collection process. ZW, PKHM, YF and JTFL wrote the manuscript. PKHM and ZW revised the manuscript critically and finalised the paper. All authors contributed to and approved the final manuscript.

  • Funding This study was supported by the Beat Drugs Fund, Narcotics Division, Security Bureau of Hong Kong SAR, China (Ref# 160051).

  • Disclaimer The funder had no role in study design, collection, analysis or interpretation of the data, writing the manuscript or the decision to submit the paper for publication.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethics approval was obtained from the Survey and Behavioral Research Ethics Committee of the Chinese University of Hong Kong (Ref# 160051).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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