Willingness to Undergo Human Papillomavirus Testing Among Men Who Have Sex With Men in China Based on the Information-Motivation-Behavioral Skills Model: Online Cross-Sectional Study.

Background: Men who have sex with men (MSM) are at high risk of human papillomavirus (HPV) infection, and HPV testing can facilitate early detection and timely intervention. However, evidence on the willingness to undergo different HPV testing modalities among MSM remains limited. The information-motivation-behavioral skills model provides a theoretical framework for understanding factors associated with the willingness to undergo HPV testing. Objective: This study aimed to investigate the current status of HPV testing and screening among MSM in China; assess their willingness to undergo professional-collected HPV testing, self-collected HPV testing, and regular HPV testing; and identify associated factors. Methods: A cross-sectional study was conducted through the Blued application (Danlan Public Welfare) from July 15, 2024, to August 2, 2024. The questionnaire collected information on participants' sociodemographic characteristics, sexual behaviors, willingness to undergo HPV testing, HPV testing and infection history, HPV knowledge level, motivation, and behavioral skills related to HPV testing. Chi-square tests and 2-tailed t tests were used to compare the distribution of variables between groups. Multivariable logistic regression analyses were used to identify factors associated with willingness to undergo each HPV testing modality among MSM. Results: Among the 1080 participants recruited, 88.3% (n=954) were willing to receive professional-collected HPV testing, 83.6% (n=903) were willing to receive self-collected HPV testing, and 78.7% (n=850) were willing to engage in regular HPV testing. In multivariable analyses, willingness to undergo professional-collected HPV testing was positively associated with higher HPV knowledge (odds ratio [OR] 1.04, 95% CI 1.00-1.08), greater perceived susceptibility (OR 1.24, 95% CI 1.01-1.53), and higher self-efficacy (OR 1.69, 95% CI 1.14-2.50), while it was negatively associated with perceived barriers (OR 0.61, 95% CI 0.47-0.78). Participants who were retired or unemployed (OR 0.48, 95% CI 0.27-0.83) and those with prior testing experience (OR 0.49, 95% CI 0.33-0.73) were less likely to undergo self-collected HPV testing. Moreover, willingness to undergo regular HPV testing was positively associated with perceived susceptibility (OR 1.20, 95% CI 1.02-1.40), whereas living with a partner (OR 0.54, 95% CI 0.33-0.88) and living with family members (OR 0.69, 95% CI 0.48-0.99) were negatively associated. Conclusions: This study suggests that willingness to undergo HPV testing among MSM in China is high, whereas prior HPV testing uptake remains low, indicating a gap between testing intention and behavior. By applying the information-motivation-behavioral skills framework to different HPV testing modalities, this study extends the previous evidence from testing willingness to understanding of testing initiation and sustained HPV screening behavior. These findings suggest that personalized health education initiatives and differentiated, privacy-sensitive, and accessible HPV testing strategies may help improve HPV testing uptake and support sustained HPV testing among MSM in China.