Organizational characteristics of HIV/syphilis testing services for men who have sex with men in South China: a social entrepreneurship analysis and implications for creating sustainable service models

Abstract

BackgroundUNAIDS has called for greater HIV/syphilis testing worldwide just as local HIV/syphilis testing programs are cut or altered. New models are needed to make HIV/syphilis testing services sustainable while retaining their essential public health function. Social entrepreneurship, using business principles to promote a social cause, provides a framework to pilot programs that sustainably expand testing. Drawing on fieldwork in two South Chinese cities, we examined organizational and financial characteristics of current HIV/syphilis testing systems for men who have sex with men (MSM) in addition to new pilot programs focused on revenue-generation for sustainability.MethodsWe undertook a qualitative study to explore organizational and financial characteristics of HIV/syphilis testing for MSM. Data were collected from men who have sex with men and policy stakeholders in Guangzhou and Hong Kong. Framework analysis was used to identify themes and then code the data.ResultsOur qualitative research study included MSM and policy stakeholders (n = 84). HIV/syphilis testing services were implemented at a wide range of organizations which we grouped broadly as independent community-based organizations (CBOs), independent clinics, and hybrid CBO-clinic sites. From an organizational perspective, hybrid CBO-clinic sites offered the inclusive environment of an MSM CBO linked to the technical capacity and trained staff of a clinic. From a financial perspective, stakeholders expressed concern about the sustainability and effectiveness of sexual health services reliant on external funding. We identified four hybrid CBO-clinic organizations that launched pilot testing programs in order to generate revenue while expanding HIV testing.ConclusionMany MSM CBOs are searching for new organizational models to account for decreased external support. Hybrid CBO-clinic organizations create a strong foundation to increase HIV/syphilis testing using social entrepreneurship models in China.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0601-5) contains supplementary material, which is available to authorized users.

Will Gay Sex–Seeking Mobile Phone Applications Facilitate Group Sex? A Cross-Sectional Online Survey among Men Who Have Sex with Men in China

“…First, as this study was based on an online survey, selection bias may be an inherent part of the online recruitment approach, as it restricts those who were not able to access to Internet from participating. The MSM in our study were younger and more highly educated compared to non-online gay men [10]. However, national data [22] suggest that young gay men do carry a disproportionate burden of syphilis and HIV.…”

“…Based on interview discussions and a literature search, the survey instrument was developed (the literature search was separated into different sections, based on the measures of this study, which was described in detail at the “Measures” part). After development, the instrument was further reviewed by Chinese MSM who had previously participated in online surveys, leaders of local community-based organization (CBO) leaders, social media experts, physicians and public health experts [2, 10]. The revised survey instrument was then piloted among 144 MSM prior to the final survey.…”

Syphilis

“…Innovations in promoting uptake of testing and developing user-friendly services are important in the control of syphilis in these communities to reduce transmission. Social entrepreneurship and crowdsourcing approaches have been shown as innovative approaches to improve HIV and syphilis testing coverage rates and accelerate linkage to care, two fundamental elements within the cascade of STI service delivery 178,179 . Evaluation studies of other interventions, such as pre-exposure prophylaxis (PrEP) for syphilis, are also underway 180 .…”

Innovation contests to promote sexual health in china: a qualitative evaluation

“…The contest was designed and implemented by our SESH (Social Entrepreneurship for Sexual Health) team that included public health authorities, CBO (community-based organization) leaders, and researchers. A series of community-based workshops and discussions among local partners [15, 16] informed the development of an open call for submissions. The call for entries clarified that the purpose was to solicit images promoting sexual health among young people.…”