Lyu Hang, Ni Yuxin, He Xi, Wang Dongya, Yu Xinxue, Tang Weiming, Zhou Yi
Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China.
University of North Carolina Project-China, Guangzhou, China.
Front Public Health. 2025 Apr 29;13:1522425. doi: 10.3389/fpubh.2025.1522425. eCollection 2025.
Support from peers is a commonly employed behavioral prevention approach aimed at key populations to enhance HIV prevention efforts. Internet-based HIV self-testing (HIVST) has been widely used among men who have sex with men (MSM) across China over the past few years.
We aimed to analyze the occurrence of Internet-based peer support and high-risk behaviors during the process of distributing HIVST kits among MSM.
The single-arm prospective cohort study was conducted among MSM in Zhuhai, China. The study utilized an HIVST online ordering system based on WeChat, which was developed by Xutong. MSM who ordered HIVST kits and distributed them to people in their network for self-testing were defined as index participants. People who received the kits from the index participants and provided testing results were defined as alters. Chi-squared tests were used to compare baseline and follow-up characteristics of the participants. Cramer's V was used to quantify the level of association between the Internet-based HIVST and condomless anal sexual behaviors among index participants. Logistic regression analysis was used to evaluate factors associated with peer support among alter participants. A -value <0.05 was regarded as statistically significant.
A total of 288 index participants were included in the study, and they distributed HIVST kits to 478 alters. In the study, 84.0% (242/288) of the index participants reported that they provided peer support to their alters, and 87.4% (418/478) of the alters reported receiving peer support from the index participants. As for the alters, 19.9% (95/478) had sex with index participants on the day of HIVST. Among them, 24.2% (23/95) had sex after the HIVST and 72.6% (69/95) used a condom during sex. Index participants who had been asked for advice about HIV and other sexually transmitted infections were more likely to provide peer support to alters (OR: 1.85, 95% CI: 1.01-3.37).
This study has enhanced our understanding of the occurrence of peer support and high-risk behaviors during the process of HIVST kits secondary distribution and provided evidence that Internet-based HIVST appears to be a promising approach for behaviors interventions among MSM.
同伴支持是一种常用的行为预防方法，旨在针对重点人群加强艾滋病病毒（HIV）预防工作。在过去几年中，基于互联网的HIV自我检测（HIVST）在中国男男性行为者（MSM）中得到了广泛应用。
我们旨在分析在向MSM分发HIVST试剂盒过程中基于互联网的同伴支持和高危行为的发生情况。
在中国珠海的MSM中开展单臂前瞻性队列研究。该研究使用了由旭通开发的基于微信的HIVST在线订购系统。订购HIVST试剂盒并将其分发给其社交网络中的人进行自我检测的MSM被定义为索引参与者。从索引参与者处收到试剂盒并提供检测结果的人被定义为受影响者。采用卡方检验比较参与者的基线和随访特征。使用克莱姆V系数来量化索引参与者中基于互联网的HIVST与无保护肛交行为之间的关联程度。采用逻辑回归分析评估受影响参与者中与同伴支持相关的因素。P值<0.05被视为具有统计学意义。
该研究共纳入288名索引参与者，他们将HIVST试剂盒分发给了478名受影响者。在研究中，84.0%（242/288）的索引参与者报告称他们为受影响者提供了同伴支持，87.4%（418/478）的受影响者报告从索引参与者那里获得了同伴支持。对于受影响者，19.9%（95/478）在进行HIVST当天与索引参与者发生了性行为。其中，24.2%（23/95）在HIVST后发生了性行为，72.6%（69/95）在性行为时使用了避孕套。曾被咨询过有关HIV和其他性传播感染问题的索引参与者更有可能为受影响者提供同伴支持（比值比：1.85，95%置信区间：1.01-3.37）。
本研究增进了我们对HIVST试剂盒二次分发过程中同伴支持和高危行为发生情况的理解，并提供了证据表明基于互联网的HIVST似乎是一种对MSM进行行为干预的有前景的方法。
