School of Nursing, Binzhou Medical University, Yantai, China.
The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
J Med Internet Res. 2023 Sep 1;25:e45262. doi: 10.2196/45262.
Men who have sex with men (MSM) in China hold a low-risk perception of acquiring HIV. This has resulted in an inadequate HIV testing rate.
This study aims to investigate whether administering HIV risk self-assessments with tailored feedback on a gay geosocial networking (GSN) app could improve HIV testing rates and reduce sexual risk behaviors in Chinese MSM.
We recruited MSM from Beijing, China, who used the GSN platform Blued in October 2017 in this 12-month double-blinded randomized controlled trial. From October 2017 to September 2018, eligible participants were randomly assigned to use a self-reported HIV risk assessment tool that provided tailored feedback according to transmission risk (group 1), access to the same HIV risk assessment without feedback (group 2), or government-recommended HIV education materials (control). All interventions were remotely delivered through the mobile phone-based app Blued, and participants were followed up at 1, 3, 6, and 12 months from baseline. The number of HIV tests over the 12-month study was the primary outcome and was assessed using an intention-to-treat analysis with an incident rate ratio (IRR). Unprotected anal intercourse (UAI) over 6 months was assessed by a modified intention-to-treat analysis and was the secondary outcome. All statistical analyses were conducted in SAS 9.3 (SAS Institute, Inc.), and a P value <.05 was considered statistically significant.
In total, 9280 MSM were recruited from baseline and were randomly assigned to group 1 (n=3028), group 2 (n=3065), or controls (n=3187). After follow-up, 1034 (34.1%), 993 (32.4%), and 1103 (34.6%) remained in each group, respectively. Over 12 months, group 1 took 391 tests (mean of 2.51 tests per person), group 2 took 352 tests (mean of 2.01 tests per person), and controls took 295 tests (mean of 1.72 tests per person). Group 1 had significantly more HIV testing than the control group (IRR 1.32, 95% CI 1.09-4.58; P=.01), while group 2 did not differ significantly from the controls (IRR 1.06, 95% CI 0.86-1.30; P=.60). The proportion of UAI was not statistically different among different groups, but all 3 groups had UAI, which declined from baseline.
Repeated HIV risk assessments coupled with tailored feedback through GSN apps improved HIV testing. Such interventions should be considered a simple way of improving HIV testing among MSM in China and increasing awareness of HIV status.
ClinicalTrials.gov NCT03320239; https://clinicaltrials.gov/study/NCT03320239.
中国男男性行为者（MSM）对感染艾滋病毒的风险认知较低，这导致艾滋病毒检测率不足。
本研究旨在探讨在基于同志的社交网络（GSN）应用程序上提供艾滋病毒风险自我评估和个性化反馈，是否可以提高中国 MSM 的艾滋病毒检测率并减少性风险行为。
我们于 2017 年 10 月在北京使用 GSN 平台 Blued 招募了 MSM ，他们参加了为期 12 个月的双盲随机对照试验。从 2017 年 10 月到 2018 年 9 月，合格的参与者被随机分配使用自我报告的艾滋病毒风险评估工具，该工具根据传播风险提供个性化反馈（第 1 组），或者获得相同的没有反馈的艾滋病毒风险评估（第 2 组），或者使用政府推荐的艾滋病毒教育材料（对照组）。所有干预措施都是通过基于手机的 Blued 应用程序远程提供的，参与者在基线时进行随访，随访时间为 1、3、6 和 12 个月。12 个月内的艾滋病毒检测次数是主要结局，采用意向治疗分析的发生率比（IRR）进行评估。6 个月内的无保护肛交（UAI）通过改良的意向治疗分析进行评估，这是次要结局。所有统计分析均在 SAS 9.3（SAS Institute，Inc.）中进行，P 值<.05 被认为具有统计学意义。
共有 9280 名 MSM 参与了基线研究，并被随机分配到第 1 组（n=3028）、第 2 组（n=3065）或对照组（n=3187）。随访后，每组分别有 1034（34.1%）、993（32.4%）和 1103（34.6%）名参与者继续留在组内。在 12 个月内，第 1 组进行了 391 次检测（每人平均 2.51 次），第 2 组进行了 352 次检测（每人平均 2.01 次），对照组进行了 295 次检测（每人平均 1.72 次）。第 1 组的艾滋病毒检测次数明显多于对照组（IRR 1.32，95%CI 1.09-4.58；P=.01），而第 2 组与对照组无显著差异（IRR 1.06，95%CI 0.86-1.30；P=.60）。不同组之间 UAI 的比例没有统计学差异，但所有 3 组都有 UAI，且从基线开始下降。
通过 GSN 应用程序反复进行艾滋病毒风险评估并提供个性化反馈，可以提高艾滋病毒检测率。这种干预措施可以被认为是提高中国 MSM 艾滋病毒检测率和提高艾滋病毒感染意识的一种简单方法。
ClinicalTrials.gov NCT03320239；https://clinicaltrials.gov/study/NCT03320239。
