Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
The University of North Carolina at Chapel Hill UNC Project-China, Guangzhou, Guangdong, China.
Sex Transm Infect. 2024 Jul 26;100(5):302-309. doi: 10.1136/sextrans-2024-056150.
Pay-it-forward incentives effectively promote hepatitis B virus (HBV) and hepatitis C virus (HCV) testing among men who have sex with men (MSM) by offering free testing and donation opportunities. This study aims to explore the interaction between pay-it-forward incentives and recreational drug use on HBV and HCV testing uptake among Chinese MSM.
We pooled data from two pay-it-forward studies that aimed to promote dual HBV and HCV testing among MSM in Jiangsu, China. We explored factors associated with hepatitis testing uptake in the two study groups and examined the interaction between pay-it-forward incentives and recreational drug use on hepatitis testing uptake.
Overall, 511 MSM participated in these two studies, with 265 participants in the pay-it-forward incentives group and 246 participants in the standard-of-care group. Among these participants, 59.3% in the pay-it-forward incentive group and 24.8% in the standard-of-care group received dual HBV and HCV testing, respectively. In the pay-it-forward incentives group, participants who used recreational drugs in the past 12 months (adjusted OR (AOR)=1.83, 95% CI 1.09 to 3.06) were more likely to receive dual HBV and HCV testing, compared with those who never used recreational drugs, whereas in the standard-of-care group, those who used recreational drugs were less likely to receive dual HBC and HCV testing (AOR=0.38, 95% CI 0.18 to 0.78). MSM with higher community connectedness (AOR=1.10, 95% CI 1.00 to 1.21) were also more likely to receive hepatitis testing with pay-it-forward incentives. There was a synergistic interaction on both the multiplicative (ratio of ORs=4.83, 95% CI 1.98 to 11.7) and additive scales (the relative excess risk of interaction=2.97, 95% CI 0.56 to 5.38) of pay-it-forward incentives and recreational drug use behaviours on dual HBV and HCV testing uptake among MSM.
Pay-it-forward incentives may be particularly useful in promoting hepatitis testing among MSM who use recreational drugs.
通过提供免费检测和捐赠机会，“先付后惠”激励措施有效地促进了男男性行为者（MSM）中乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）的检测。本研究旨在探讨“先付后惠”激励措施与娱乐性药物使用之间的相互作用，对中国 MSM 中 HBV 和 HCV 检测的影响。
我们合并了两项旨在促进中国江苏 MSM 双重 HBV 和 HCV 检测的“先付后惠”研究的数据。我们探讨了两组研究中与肝炎检测率相关的因素，并检验了“先付后惠”激励措施与娱乐性药物使用之间在肝炎检测率方面的相互作用。
共有 511 名 MSM 参与了这两项研究，其中 265 名参与者在“先付后惠”激励措施组，246 名参与者在标准护理组。在这些参与者中，分别有 59.3%的“先付后惠”激励措施组和 24.8%的标准护理组接受了双重 HBV 和 HCV 检测。在“先付后惠”激励措施组中，与从未使用过娱乐性药物的参与者相比，过去 12 个月内使用过娱乐性药物的参与者（调整后的比值比（AOR）=1.83，95%置信区间（CI）1.09 至 3.06）更有可能接受双重 HBV 和 HCV 检测，而在标准护理组中，使用过娱乐性药物的参与者接受 HBC 和 HCV 双重检测的可能性较低（AOR=0.38，95%CI 0.18 至 0.78）。社区联系度较高的 MSM（AOR=1.10，95%CI 1.00 至 1.21）也更有可能在“先付后惠”激励措施下接受肝炎检测。在 MSM 中，“先付后惠”激励措施与娱乐性药物使用之间存在乘法（比值比（ORs）=4.83，95%CI 1.98 至 11.7）和加法（交互作用的相对超额风险=2.97，95%CI 0.56 至 5.38）的协同交互作用，这两种交互作用都与双重 HBV 和 HCV 检测的接受率有关。
“先付后惠”激励措施可能特别有助于促进使用娱乐性药物的 MSM 进行肝炎检测。
