Digital crowdsourced intervention to promote HIV testing among MSM in China: study protocol for a cluster randomized controlled trial

Abstract

Background Men who have sex with men (MSM) are an important HIV key population in China. However, HIV testing rates among MSM remain suboptimal. Digital crowdsourced media interventions may be a useful tool to reach this marginalized population. We define digital crowdsourced media as using social media, mobile phone applications, Internet, or other digital approaches to disseminate messages developed from crowdsourcing contests. The proposed cluster randomized controlled trial (RCT) study aims to assess the effectiveness of a digital crowdsourced intervention to increase HIV testing uptake and decrease risky sexual behaviors among Chinese MSM. Methods A two-arm, cluster-randomized controlled trial will be implemented in eleven cities (ten clusters) in Shandong Province, China. Targeted study participants will be 250 MSM per arm and 50 participants per cluster. MSM who are 18 years old or above, live in the study city, have not been tested for HIV in the past 3 months, are not living with HIV or have never been tested for HIV, and are willing to provide informed consent will be enrolled. Participants will be recruited through banner advertisements on Blued, the largest gay dating app in China, and in-person at community-based organizations (CBOs). The intervention includes a series of crowdsourced intervention materials (24 images and four short videos about HIV testing and safe sexual behaviors) and HIV self-test services provided by the study team. The intervention was developed through a series of participatory crowdsourcing contests before this study. The self-test kits will be sent to the participants in the intervention group at the 2nd and 3rd follow-ups. Participants will be followed up quarterly during the 12-month period. The primary outcome will be self-reported HIV testing uptake at 12 months. Secondary outcomes will include changes in condomless sex, self-test efficacy, social network engagement, HIV testing social norms, and testing stigma. Discussion Innovative approaches to HIV testing among marginalized population are urgently needed. Through this cluster randomized controlled trial, we will evaluate the effectiveness of a digital crowdsourced intervention, improving HIV testing uptake among MSM and providing a resource in related public health fields. Trial registration ChiCTR1900024350. Registered on 6 July 2019.

Are Chinese sexual minority youth at a disadvantage in accessibility to sexual and reproductive health services? Findings from a national survey

“…However, our ndings were consistent with ndings from the 2016 national survey on SMY in China, which reported that only a low proportion of SMY encountered di culties when receiving health care services [28]. Past efforts to implement HIV prevention interventions targeting men who have sex with men (MSM) in China to increase awareness of safe male-male sex [29][30][31] may have contributed to higher SRH awareness and higher SRH services utilization in gay men, explaining our ndings. Whilst the ndings of this study suggests that SMY have relatively better SRH services utilization than heterosexuals, it is important to note that the absolute rate of SRH services utilization was still low, indicating that the majority of SMY do not have access to appropriate SRH services.…”

Providing HIV testing in men who have sex with men through a gay social networking app in China: A qualitative interview study with multisectoral service providers

“…In 2019, with support of the National Key Science and Technology fund, the Chinese CDC cooperated with Blued, a Chinese gay dating app used in China ( 1 ), to set up a HIV booking platform called “Happy Testing”. Here, MSM could choose AHTS sites nearby (CDCs or NGOs) for HIV services.…”

“…In China, HIV (human immunodeficiency virus) has become an epidemic among men who have sex with men (MSM) and poses a serious public health challenge ( 1 , 2 ). Although China has improved the prevention of HIV through prophylaxis treatments and prevention strategies, its prevalence was estimated to be 6% in 2020 ( 3 , 4 ).…”

Co-creation using crowdsourcing to promote PrEP adherence in China: study protocol for a stepped-wedge randomized controlled trial

“…Compared to conventional approaches, crowdsourcing may facilitate community engagement, while creating novel solutions to public health problems that resonate with the community [ 22 ]. In particular, crowdsourcing can help engage vulnerable groups who are often excluded from research projects [ 23 ]. However, most crowdsourced interventions in sexual health research centered on HIV testing services and promoting sexual health programs [ 24 ].…”