Significant TPB factors and items associated with oral rapid self-testing intention varied by HIV testing experience among young men who have sex with men in Taiwan, with distinct predictors identified for never-testers versus ever-testers.
An anonymous online survey of YMSM in Taiwan revealed a novel six-factor structure within an expanded Theory of Planned Behavior (TPB) framework for oral rapid self-testing (ORST) intention.
ORST ever-users showed significant positive interactions with ORST intention.
HIV never-testers were more likely to report greater ORST intention when perceiving high behavioral control related to scheduling and sexual behavior.
HIV ever-testers were more likely to report greater ORST intention when holding positive attitudes toward privacy and anonymity.
YMSM in Taiwan face disproportionately higher risk for HIV infection compared with older age groups, women, and heterosexual men.
Significant TPB factors and items associated with ORST intention differed between HIV never-testers and HIV ever-testers.
This research surveyed over 2,000 young gay and bisexual men in Taiwan to understand what factors influence their willingness to use oral rapid HIV self-tests (ORST) — at-home tests that people can perform themselves. Using a psychological framework called the Theory of Planned Behavior, the researchers found that attitudes, perceived social norms, and feelings of control over testing all play a role in whether someone intends to use ORST, and that these factors operate differently depending on whether a person has ever been tested for HIV before. For young men who had never tested for HIV before, the strongest motivators for considering ORST were convenience (feeling the test wouldn't disrupt their school or work schedule) and sexual behavior context (wanting to have condomless anal sex). For those who had previously tested for HIV, privacy concerns were more central — specifically, valuing that ORST allows them to avoid having to disclose their HIV status to others, and the ability to order test kits online anonymously. Men who had previously used ORST were particularly likely to report intending to use it again, with roughly two to two-and-a-half times the odds compared to non-users. This research suggests that HIV prevention programs and sexual health services in Taiwan — and potentially in similar contexts — may be more effective if they tailor their messaging based on people's prior testing experience. Campaigns targeting HIV testing newcomers might emphasize ease and convenience, while outreach to people already engaged in HIV testing could focus on the privacy advantages of self-testing. The findings highlight how a one-size-fits-all approach to promoting HIV self-testing may miss important differences in what motivates different subgroups.
Hsu C, Huang J. (2025). 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.. Archives of sexual behavior. https://doi.org/10.1007/s10508-025-03236-w