Syphilis self-testing: a nationwide pragmatic study among men who have sex with men in China WoS Publication

author list

  • Wang, Cheng; Cheng, Weibin; Li, Changchang; Tang, Weiming; Ong, Jason J; Smith, M Kumi; Fu, Hongyun; Marks, Michael; Nie, Juan; Zheng, Heping; Tucker, Joseph D; Yang, Bin


  • Abstract Background Syphilis self-testing may help expand syphilis testing among men who have sex with men (MSM). China has rapidly scaled up HIV self-testing, creating an opportunity for integrated syphilis self-testing. However, there is a limited literature on implementing syphilis self-testing. Methods A cross-sectional online survey was conducted among Chinese MSM in 2018. Participants completed a survey instrument including socio-demographic characteristics, sexual behaviors, syphilis self-testing, and HIV self-testing history. Multivariable logistic regression was conducted to identify correlates of syphilis self-testing. We also recorded potential harms associated with syphilis self-testing. Results Six hundred ninety-nine MSM from 89 cities in 21 provinces in China completed the study. A total of 361/699 (51.7%) men tested for syphilis, of whom 174/699 (24.9%) men used syphilis self-testing. Among 174 who had self-tested, 90 (51.7%) reported that the self-test was their first syphilis test, and 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 to family or friends (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.


  • Wang, Cheng
  • Cheng, Michael
  • Li, Changchang
  • Tang, Weiming
  • Ong, Jason J
  • Smith, M Kumi
  • Fu, Hongyun
  • Cheng, Michael
  • Nie, Juan
  • Zheng, Heping
  • Tucker, Joseph D
  • Yang, Bin

publication date

  • 2019

published in