Effects of a Mobile Health Intervention to Promote HIV Self-testing with MSM in China: A Randomized Controlled Trial

Zhu, Xiaofang; Zhang, Wenhan; Operario, Don; Zhao, Yue; Shi, Anxia; Zhang, Zhihua; Gao, Pan; Pérez, Ashley E.; Wang, Jun; Zaller, Nickolas; Yang, Cui; Sun, Yehuan; Zhang, Hongbo

doi:10.1007/s10461-019-02452-5

Cited by 63 publications

(114 citation statements)

References 32 publications

(34 reference statements)

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“…Our results showed that HIVST Users had a higher frequency of gay apps use than Non-HIVST users in the prior 6 months. As with previous ndings, the utility of mobile health interventions can engage MSM in HIVST in Heifei and Shenzhen, China 27,28 , and increase rates of con rmed HIV diagnoses and linkage to clinical care in the UK 29 . Furthermore, consistent with ndings in other studies 22 , those who had high-risk sex behavior, including multiple male sex partners, frequency of male-male sexual contact more than once per week and syphilis infection were more likely to have had HIVST.…”

Section: Discussionsupporting

confidence: 65%

Prevalence and Factors Associated With HIV Self-testing Uptake Among Men Who Have Sex With Men in Ningbo, China: A Cross-sectional Study

Hong

Shi

Jiang

et al. 2020

Preprint

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BackgroundHIV testing and early linkage to care are critical for reducing the risk of HIV transmission. HIV self-testing (HIVST) is an useful tool for increasing HIV testing frequency.This study aimed to investigate HIVST rates among men who have sex with men (MSM), the characteristics of MSM who had HIVST, and factors associated with HIVST uptake among MSM in Ningbo, China. MethodsA cross-sectional study was conducted from April to October 2019 in Ningbo,China. Participants were aged at least 18 years and having had sexual contact with men in the past year. Proportions were used for categorical variables. Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) for characteristics associated with HIVST uptake was processed by multiple logistic regression models.ResultsAmong a sample of 699 MSM recruited, 38.2% had reported previous use of an HIV self-test kit. A greater proportion of HIVST Users had a higher frequency of HIV testing(≥2 times: 70.0% versus 41.2%, p<0.001) in the past one year. Factor associated with HIVST uptake was gay apps use(AOR=1.86,CI=1.13-3.05), multiple male sex partners (AOR=1.90,CI=1.29-2.80), frequency of male-male sexual contact ≥1 times per week(AOR=1.86, CI=1.30-2.66), syphilis infection(AOR=5.48, CI=2.53-11.88).ConclusionsFurther HIVST education should be strengthened for school-aged children and teenagers, and free HIVST kits may be provided to low-income high-risk MSM through gay apps and NGOs to achieve the increased HIV testing frequency.

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Section: Discussionsupporting

confidence: 65%

Prevalence and Factors Associated With HIV Self-testing Uptake Among Men Who Have Sex With Men in Ningbo, China: A Cross-sectional Study

Hong

Shi

Jiang

et al. 2020

Preprint

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“…The length of follow-up ranged from immediate after intervention [61] to 12 months [49,58,[62][63][64] with the average retention rate of 79.8% (ranging from 46.0 [65] to 100% [66][67][68][69]). Four studies measured pre and post-evaluations in different participants [70][71][72][73].…”

Section: Length Of Follow-up and Retention Ratementioning

confidence: 99%

“…Two studies using smartphone applications (apps) are pilot RCTs [57,68], and one study was pilot pre-post experiment [78]. Bauermeister et al developed an application with six sessions based on the Dual Processing Cognitive-Emotional Decision-Making Framework [57].…”

Section: Smartphone Applications (N = 3)mentioning

confidence: 99%

“…However, results indicated that intervention group was less likely to report foregoing condoms (OR = 0.43, 95% CI 0.28-1.44) compared to the control group (p < 0.01), while no differences were found in other sexual risk behavior, HIV testing and PrEP uptake between two arms [57]. In contrast, Zhu et al built a "WeTest"-a WeChat group to provide app-based messages and referrals to health services related to HIV [68]. Using the IMB theory, authors achieved the increase of HIV testing (RR = 1.99, 95% CI 1.07-3.84) and self-testing rate (RR = 2.17, 95% CI 1.08-4.37) in the intervention group compared to the control group [68].…”

Section: Smartphone Applications (N = 3)mentioning

confidence: 99%

“…In contrast, Zhu et al built a "WeTest"-a WeChat group to provide app-based messages and referrals to health services related to HIV [68]. Using the IMB theory, authors achieved the increase of HIV testing (RR = 1.99, 95% CI 1.07-3.84) and self-testing rate (RR = 2.17, 95% CI 1.08-4.37) in the intervention group compared to the control group [68]. Meanwhile, the pre-post trial performed by Sullivan et al provided a smartphone apps called "HealthMindr", which was built based on the Social Cognitive Theory aiming to facilitate goal setting, self-efficacy, outcome expectations and self-regulation [78].…”

Section: Smartphone Applications (N = 3)mentioning

confidence: 99%

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A Systematic Review of eHealth Interventions Addressing HIV/STI Prevention Among Men Who Have Sex With Men

et al. 2019

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A systematic review was conducted to summarize and appraise the eHealth interventions addressing HIV/STI prevention among men who have sex with men (MSM), and characterize features of successful eHealth interventions. Fifty-five articles (17 pilots and 38 full efficacy trials) were included with the predominance of web-based interventions in the United Statesbased settings. Intervention modalities include web-based, short message service (SMS)/text messges/email reminder, online video-based, computer-assisted, multimedia-based, social network, live chat and chat room, virtual simulation intervention, and smartphone applications. Forty-nine eHealth interventions achieved a short-term behaviour change among participants. Four studies were conducted with 12-month follow-ups; and only one of them could maintain the behaviour change over this longer time period which could be due to the lack of booster interventions. Our study suggests that eHealth interventions can achieve short term behaviour change among MSM, however limited interventions could maintain behaviour change over 12 months. Further eHealth intervention strategies to promote HIV prevention among MSM should be conducted and rigorously evaluated.

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Sexual behaviour change following HIV testing services: a systematic review and meta‐analysis

et al. 2020

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Introduction Learning one’s HIV status through HIV testing services (HTS) is an essential step toward accessing treatment and linking to preventive services for those at high HIV risk. HTS may impact subsequent sexual behaviour, but the degree to which this varies by population or is true in the setting of contemporary HIV prevention activities is largely unknown. As part of the 2019 World Health Organization Consolidated Guidelines on HTS, we undertook a systematic review and meta‐analysis to determine the effect of HTS on sexual behaviour. Methods We searched nine electronic databases for studies published between July 2010 and December 2019. We included studies that reported on at least one outcome (condom use [defined as the frequency of condom use or condom‐protected sex], number of sex partners, HIV incidence, STI incidence/prevalence). We included studies that prospectively assessed outcomes and that fit into one of three categories: (1) those evaluating more versus less‐intensive HTS, (2) those of populations receiving HTS versus not and (3) those evaluating outcomes after versus before HTS. We conducted meta‐analyses using random‐effects models. Results and discussion Of 29 980 studies screened, 76 studies were included. Thirty‐eight studies were randomized controlled trials, 36 were cohort studies, one was quasi‐experimental and one was a serial cross‐sectional study. There was no significant difference in condom use among individuals receiving more‐intensive HTS compared to less‐intensive HTS (relative risk [RR]=1.03; 95% CI: 0.99 to 1.07). Condom use was significantly higher after receiving HTS compared to before HTS for individuals newly diagnosed with HIV (RR = 1.65; 95% CI: 1.36 to 1.99) and marginally significantly higher for individuals receiving an HIV‐negative diagnosis (RR = 1.63; 95% CI: 1.01 to 2.62). Individuals receiving more‐intensive HTS reported fewer sex partners at follow‐up than those receiving less‐intensive HTS, but the finding was not statistically significant (mean difference = −0.28; 95% CI: −3.66, 3.10). Conclusions Our findings highlight the importance of using limited resources towards HTS strategies that focus on early HIV diagnosis, treatment and prevention services rather than resources dedicated to supplementing or enhancing HTS with additional counselling or other interventions.

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Effects of a Mobile Health Intervention to Promote HIV Self-testing with MSM in China: A Randomized Controlled Trial

Cited by 63 publications

References 32 publications

Prevalence and Factors Associated With HIV Self-testing Uptake Among Men Who Have Sex With Men in Ningbo, China: A Cross-sectional Study

Prevalence and Factors Associated With HIV Self-testing Uptake Among Men Who Have Sex With Men in Ningbo, China: A Cross-sectional Study

A Systematic Review of eHealth Interventions Addressing HIV/STI Prevention Among Men Who Have Sex With Men

Sexual behaviour change following HIV testing services: a systematic review and meta‐analysis

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