Bezerra Daniel Rodrigues Barros, Jalil Cristina Moreira, Jalil Emilia Moreira, Coelho Lara Esteves, Netto Eduardo Carvalheira, Freitas Josias, Monteiro Laylla, Santos Toni, Souza Cleo, Hoagland Brenda, Veloso Valdilea Gonçalves, Grinsztejn Beatriz, Cardoso Sandra Wagner, Torres Thiago Silva
Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil.
JMIR Form Res. 2022 Aug 4;6(8):e33309. doi: 10.2196/33309.
Internet and mobile phones, widely available in Brazil, could be used to disseminate information about HIV prevention and to recruit gay, bisexual, and other cisgender men who have sex with men (MSM) to HIV prevention services. Data evaluating the characteristics of MSM recruited through different web-based strategies and estimating their cost and yield in the country are not available.
We aimed to describe a web-based recruitment cascade, compare the characteristics of MSM recruited to a large HIV prevention service in Rio de Janeiro according to web-based venues, and estimate the cost per participant for each strategy.
We promoted advertisements on geosocial networking (GSN) apps (Hornet and Grindr) and social media (Facebook and Instagram) from March 2018 to October 2019. The advertisements invited viewers to contact a peer educator to schedule a visit at the HIV prevention service. Performance of web-based recruitment cascade was based on how many MSM (1) were reached by the advertisement, (2) contacted the peer educator, and (3) attended the service. We used chi-square tests to compare MSM recruited through GSN apps and social media. The estimated advertisement cost to recruit a participant was calculated by dividing total advertisement costs by number of participants who attended the service or initiated preexposure prophylaxis (PrEP).
Advertisement reached 1,477,344 individuals; 1270 MSM contacted the peer educator (86 contacts per 100,000 views)-564 (44.4%), 401 (31.6%) and 305 (24.0%)-through social media, Grindr, and Hornet. Among the 1270 individuals who contacted the peer educator, 36.3% (n=461) attended the service with similar proportion for each web-based strategy (social media: 203/564, 36.0%; Grindr: 152/401, 37.9%; and Hornet: 107/305, 35.1%). MSM recruited through GSN apps were older (mean age 30 years vs 26 years; P<.001), more frequently self-reported as White (111/247, 44.9% vs 62/191, 32.5%; P=.03), and had higher schooling level (postsecondary: 157/254, 61.8% vs 94/194, 48.5%; P=.007) than MSM recruited through social media. GSN apps recruited MSM with higher HIV risk as measured by PrEP eligibility (207/239, 86.6% vs 133/185, 71.9%; P<.001) compared with social media, but there was no difference in PrEP uptake between the two strategies (P=.22). The estimated advertisement costs per participant attending the HIV prevention service were US $28.36 for GSN apps and US $12.17 for social media. The estimated advertisement costs per participant engaging on PrEP were US $58.77 for GSN apps and US $27.75 for social media.
Social media and GSN app advertisements were useful to disseminate information on HIV prevention strategies and to recruit MSM to a large HIV prevention service in Brazil. Compared to GSN apps, social media advertisements were less expensive and reached more vulnerable and younger MSM. Digital marketing campaigns should use different and complementary web-based venues to reach a plurality of MSM.
互联网和手机在巴西广泛普及，可用于传播艾滋病预防信息，并招募男同性恋、双性恋及其他与男性发生性关系的顺性别男性（MSM）接受艾滋病预防服务。目前尚无评估通过不同网络策略招募的MSM特征以及估算其在该国的成本和产出的数据。
我们旨在描述基于网络的招募流程，比较根据网络平台招募到里约热内卢一家大型艾滋病预防服务机构的MSM的特征，并估算每种策略的每位参与者成本。
2018年3月至2019年10月，我们在地理社交网络（GSN）应用程序（Hornet和Grindr）和社交媒体（Facebook和Instagram）上投放广告。广告邀请观众联系同伴教育者，安排前往艾滋病预防服务机构就诊。基于网络的招募流程的表现取决于有多少MSM：（1）看到广告，（2）联系同伴教育者，以及（3）接受服务。我们使用卡方检验比较通过GSN应用程序和社交媒体招募的MSM。招募一名参与者的估计广告成本通过将广告总成本除以接受服务或开始暴露前预防（PrEP）的参与者数量来计算。
广告覆盖了1477344人；1270名MSM联系了同伴教育者（每100000次浏览86次联系），其中564人（44.4%）、401人（31.6%）和305人（24.0%）分别通过社交媒体、Grindr和Hornet联系。在联系同伴教育者的1270人中，36.3%（n = 461）接受了服务，每种基于网络的策略的比例相似（社交媒体：203/564，36.0%；Grindr：152/401，37.9%；Hornet：107/305，35.1%）。通过GSN应用程序招募的MSM年龄较大（平均年龄30岁对26岁；P <.001），更频繁地自我报告为白人（111/247，44.9%对62/191，32.5%；P =.03），并且受教育程度更高（高等教育：157/254，61.8%对94/194，48.5%；P =.007），与通过社交媒体招募的MSM相比。通过PrEP资格衡量，GSN应用程序招募的MSM感染艾滋病的风险更高（207/239，86.6%对133/185，71.9%；P <.001），与社交媒体相比，但两种策略在PrEP采用率上没有差异（P =.22）。参加艾滋病预防服务的每位参与者的估计广告成本，GSN应用程序为28.36美元，社交媒体为12.17美元。参与PrEP的每位参与者的估计广告成本，GSN应用程序为58.77美元，社交媒体为27.75美元。
社交媒体和GSN应用程序广告有助于传播艾滋病预防策略信息，并将MSM招募到巴西一家大型艾滋病预防服务机构。与GSN应用程序相比，社交媒体广告成本更低，覆盖了更易感染和更年轻的MSM。数字营销活动应使用不同且互补的网络平台，以覆盖更多的MSM。
