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RESEARCH ARTICLE
Contents Vol 22(3)

Using photovoice to explore HIV self-testing and secondary distribution of HIV self-testing among gay, bisexual and other men who have sex with men in China

Qianyun Wang https://orcid.org/0000-0002-8558-8565 A B C # , Ying Lu B # , Yuxin Ni B D # , Xumeng Yan B E , Rayner Kay Jin Tan https://orcid.org/0000-0002-9188-3368 B F , Dan Wu https://orcid.org/0000-0003-0415-5467 G , Joseph D. Tucker https://orcid.org/0000-0003-2804-1181 B H I , Jason J. Ong https://orcid.org/0000-0001-5784-7403 H J and Weiming Tang https://orcid.org/0000-0002-9026-707X A B *
+ Author Affiliations
- Author Affiliations

A Dermatology Hospital of Southern Medical University, Guangzhou, China.

B University of North Carolina at Chapel Hill Project-China, Guangzhou, China.

C Department of Social Welfare, University of California, Los Angeles, CA, USA.

D Department of Health Law, Policy, and Management, Boston University, Boston, MA, USA.

E Department of Community Health Sciences, University of California, Los Angeles, CA, USA.

F Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.

G Department of Social Medicine and Health Education, Nanjing Medical University, Nanjing, China.

H Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.

I Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

J Central Clinical School, Monash University, Melbourne, Vic, Australia.

* Correspondence to: Weiming_tang@med.unc.edu

# These authors contributed equally to this work

Handling Editor: Megan Lim

Sexual Health 22, SH24116 https://doi.org/10.1071/SH24116
Submitted: 9 June 2024  Accepted: 29 April 2025  Published: 22 May 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing

Abstract

Background

Human immunodeficiency virus self-testing (HIVST) has been globally recognized as a useful and reliable strategy to promote HIV testing, especially among marginalized populations. To improve the understanding of HIVST uptake of gay, bisexual and other men who have sex with men (GBMSM) in China, this study aims to qualitatively explore the HIVST uptake experiences among this population.

Methods

The study employed photovoice methodology, theoretically built on documentary photography and critical consciousness, to explore the experiences of HIVST and secondary distribution among GBMSM in China. Participants created photos and citations, and shared and discussed them in the group. Three focus groups and one follow-up interview were held virtually for each participant who self-identified as gay or bisexual and used a self-test kit before.

Results

This program recruited 22 participants from throughout China. The findings revealed that perceived discrimination based on sexual minority identity, and HIV-related stigma and fear affected participants’ decision to take HIVST and to pass HIVST kits on to others. Participants utilized HIVST on a routine basis, citing sexual health concerns, psychological comfort and a responsibility to their significant others as reasons for doing so. HIVST kit distribution within intimacy, and the significant role of GBMSM-led community-based organizations were found as characteristics of interactions between participants and those who they passed HIVST kit(s) on to.

Conclusion

In the study, images and narratives were acquired through empowering GBMSM, and promoting their community engagement to underline the necessity for measures and policies on promoting HIVST among this population. Findings also entailed the need to create a more inclusive society for sexual minorities and people living with HIV. Implications for promoting HIVST secondary distribution, and limitations and strengths of the pioneer photovoice study among GBMSM in China were also listed.

Keywords: China, digital public health, GBMSM, HIV self-testing, photovoice, qualitative research, secondary distribution, stigma and discrimination.

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