Social Media Engagement and HIV Testing Among Men Who Have Sex With Men in China: A Nationwide Cross-Sectional Survey

Abstract

BackgroundMany interventions find that social media engagement with health promotion materials can translate into behavioral changes. However, only a few studies have examined the ways in which specific actions on various social media platforms are correlated with health behaviors.ObjectiveThe objective of this study was to examine the association between social media use and HIV testing behaviors among Chinese men who have sex with men (MSM).MethodsIn July 2016, a Web-based survey was conducted to recruit MSM in 8 Chinese cities through Blued (Blue City Holdings Ltd.), the world’s largest gay mobile phone app. Data on sociodemographic variables, social media use platforms and behaviors, sexual behaviors, and HIV testing histories were collected. HIV testing–related social media use was defined as having ever engaged with HIV testing content on social media, which was further divided into observing (ie, receiving), endorsing (eg, liking and sharing), and contributing (eg, posting or commenting on HIV testing materials). Confirmatory factor analysis (CFA) was conducted to determine the best division of HIV testing–related social media use. Univariate and multivariable logistic regressions were used to examine the association between HIV testing–related social media use and HIV testing behaviors.ResultsA total of 2105 individuals participated in the survey. Among them, 46.75% (984) were under the age of 24 years, 35.43% (746) had high school education or less, and 47.74% (587) had condomless sex in the last 3 months. More than half of the respondents (58.14%, 1224/2105) reported HIV testing–related social media use. Additionally, HIV testing–related social media use, especially on multifunctional platforms such as WeChat, was found to be associated with recent HIV testing (adjusted odds ratio [aOR] 2.32, 95% CI 1.66-3.24). Contributing on social media was correlated with recent HIV testing (aOR 2.10, 95% CI 1.40-3.16), but neither observing (aOR 0.66, 95% CI 0.38-1.15) nor endorsing (aOR 1.29, 95% CI 0.88-1.90) were correlated.ConclusionsOur data suggest that social media use, particularly on multifunctional platforms such as WeChat and with contributing behaviors, is correlated with HIV testing among MSM in China. Campaigns that promote active participant contribution on social media beyond passive observation and endorsement of promotional materials are needed. This study has implications for the design and implementation of social media interventions to promote HIV testing.

Recalling, Sharing and Participating in a Social Media Intervention Promoting HIV Testing: A Longitudinal Analysis of HIV Testing Among MSM in China

“…In addition, recalling local contest information increased the likelihood of facility-based HIV testing. This effect may have been related to asking MSM to share stories on HIV testing, thus encouraging community participation and engagement [6,47]. However, we did not find an association between sharing or participating in social media components and facility-based HIV testing.…”

“…In addition, nearly 70% of men who recalled the images or texts shared these messages with others. This dissemination rate is substantially higher than the results from a previous study that found around 15% of MSM in China had shared information they received on HIV testing via social media [6,43]. The images and texts distributed in this study were developed through crowdsourcing contests and the community-driven nature of the intervention may have contributed to higher sharing rates.…”

“…Previous studies found that observation (recalling a message), endorsement (sharing a message) and contribution (participating in creating a message) are important aspects of social media interventions. These three measurements indicate participants' different degree of engagement in the social media intervention [6]. For each of the six images or texts, men were asked whether they saw or read that image or text in the last three months.…”

“…Social media is increasingly used to promote health [1][2][3]. Several studies suggest that social media interventions, broadly defined as interventions that are implemented on social media platforms, can improve health outcomes [3][4][5][6][7]. Social media interventions have been used to improve HIV services, especially HIV testing services [3,8].…”

Access to digital and social media among Romanian HIV/AIDS clinical providers

“…Therefore, the purpose of this study was to determine how Romanian clinical providers interact with specific social media platforms to better understand the potential of the current ICT infrastructure, specifically social media and other online sites used to further clinical education, and to improve HIV-related care. As online information exchanges, social support groups, and training modules have been effective in other contexts [9,11,12,15–17], this study will determine the current social media practices specifically in Romania as a foundation of future collaborative construction of a new digital platform.…”