National Survey on HIV Self-Testing Among Chinese Youth: ~13% Have Tried It, Over 80% Perceive No Infection Risk

On the eve of the 37th World AIDS Day, an online survey targeting users of HIV self-test kits, with young students as the primary demographic, was completed across 33 provinces, municipalities, and autonomous regions in China. A total of 1,607 valid questionnaires were collected, among which 85.56% of respondents were aged 18–24 years, and 83.37% were college students. The data clearly illustrate the behavioral preferences and cognitive gaps regarding HIV testing among the surveyed population. For instance, “51.87% of rapid HIV test kits were purchased through e-commerce platforms, with users placing the highest value on their timeliness and privacy protection advantages.”

This survey was hosted by the China Health Promotion Foundation’s “Family Health Guardian and Science Popularization Public Welfare Program,” with public welfare support from JD Health and Wondfo Biotech, and received endorsement from relevant experts. The survey aimed to understand the testing purposes, preferences, and experiences of users of HIV self-test kits, as well as the current level of awareness of core HIV knowledge, thereby providing evidence to optimize HIV health education, testing counseling, and psychological intervention strategies.

Among the 1,607 respondents, approximately 13.25% (213 individuals) had previously used HIV rapid test kits. When asked about the reasons for not using them, 81.42% of respondents stated that they “did not perceive themselves to be at risk of HIV infection,” while only 3.59% reported having already undergone testing at hospitals or other institutions.

Regarding the advantages of HIV rapid test strips, respondents most strongly endorsed the following three aspects: “rapid results within 15 minutes” (33.64%), “privacy protection” (29.91%), and “convenience of testing anytime, anywhere” (26.17%). In terms of acquisition or purchase channels, e-commerce platforms ranked first (51.87%), followed by on-campus student clubs or non-profit organizations (17.76%). Off-campus community working groups or non-profit organizations, as well as physical pharmacies or medical device stores, each accounted for 7.48%, reflecting the diversity of access methods for rapid test strips.

In terms of testing purposes, the primary reason was “routine periodic testing” (33.64%), followed by “seeking testing after engaging in high-risk behaviors” (23.36%). Notably, 14.02%–26.64% of respondents reported having 2–4 sexual partners. Currently, sexual transmission is the main route of HIV spread in China; therefore, promoting self-protection during sexual activity should become a core component of HIV health education.

HIV rapid test strips primarily screen for HIV infection by detecting HIV antibodies in blood, oral mucosal transudate (commonly referred to as “saliva”), or urine, with results generally available within 10–30 minutes.

Surveys indicate that blood testing remains the most prevalent method, accounting for 77.57%, followed by saliva (25.23%) and urine (13.08%). In terms of satisfaction, urine testing achieved the highest proportion of “very satisfied” responses (79.31%), followed by saliva testing (46.3%), while blood testing recorded only 36.53%. When selecting a testing method for next time, users showed a preference for continuing with their most recent approach, primarily citing ease of operation, non-invasiveness and painlessness, and perceived higher accuracy as the main reasons.

Sales data from JD Health indicates that blood test strips account for over 80% of the transaction volume. Notably, the proportion of consumers opting for multi-disease combined testing has seen significant growth, rising from 10% in 2019 to 20% in 2024. This survey further reveals that 43.46% of respondents have purchased rapid testing products for HPV, syphilis, and other sexually transmitted diseases, underscoring the growing importance of multi-disease co-testing in meeting user demand.

Although 64.49% of users considered rapid diagnostic test strips “accurate,” there was significant divergence in opinions on whether the results equated to a confirmed diagnosis. Specifically, 35.05% believed they were equivalent to a confirmed diagnosis, 29.91% were uncertain, and another 35.05% explicitly disagreed. Nevertheless, a high proportion of users expressed willingness to seek confirmatory testing at professional institutions after screening, with those responding “very willing” and “willing” totaling 73.83%, while only 13.77% indicated they were unwilling.

Meanwhile, 54.67% of users reported experiencing anxiety or panic during testing. This psychological burden primarily stemmed from uncertainty about the risk of infection (49.57%), concerns about the consequences of infection (48.72%), and worries that the window period might lead to inaccurate test results (39.32%).

Experts specifically emphasize that “early testing, early detection, and early treatment” are crucial measures to help individuals with HIV control disease progression, maintain good health, and achieve a normal life expectancy. It is important to note that results from rapid HIV test strips are not definitive diagnoses and should be considered for reference only. If a test strip yields a positive result, individuals should promptly visit a center for disease control and prevention or a hospital for retesting and confirmatory testing to obtain a final diagnosis.