Oral Rapid Self-Testing Intention for HIV Sexual Health Among Young Men Who Have Sex with Men in Taiwan: A Theory-Driven Comparison of HIV Never-Testers and Ever-Testers.

According to national statistics, young men who have sex with men (YMSM) are at disproportionately higher risk for HIV infection in Taiwan, compared with older age groups, women, and heterosexual men. To improve HIV sexual health care, oral rapid self-testing for HIV (ORST) was recently introduced and became available in Taiwan on a limited scale. However, little is known about YMSM's intention to use ORST, and whether and how YMSM with different HIV testing experiences differ in their ORST intention. Accordingly, an anonymous online survey was conducted among YMSM in Taiwan (N = 2,063). Building upon the theory of planned behavior (TPB) and employing exploratory factor analysis, this study revealed a novel six-factor structure within the expanded TPB framework, highlighting ORST as a unique facilitating condition. Multivariate logistic regression was performed to examine the associations of TPB factors and items with ORST intention among HIV never-testers and ever-testers, demonstrating that significant TPB factors and items varied by HIV testing experience. Significant positive interactions were also identified among ORST ever-users (AORs = 2.10-2.45). HIV never-testers were more likely to report greater ORST intention when perceiving high control under such conditions as ORST not affecting their work/school schedule (AOR = 1.50) and wanting to have condomless anal sex (AOR = 1.60). HIV ever-testers were more likely to report greater ORST intention when holding positive attitudes toward ORST helping to avoid disclosing their HIV status (AOR = 1.38) and perceiving high control regarding ordering ORST kits online anonymously (AOR = 1.37). These findings provide insights that may guide future HIV sexual health-care initiatives tailored according to HIV testing experience for optimal effectiveness.