Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Apr 24, 2020
Date Accepted: Mar 8, 2021
Mobile Phone Intervention Based on the HIV Risk Prediction tool for HIV Prevention Among Men Who Have Sex with Men in China: A Randomized Controlled Trial
ABSTRACT
Background:
Electronic health (E-health) interventions based on risk stratification have not been extensively applied to HIV behavioral interventions among HIV-negative men who have sex with men (MSM).
Objective:
This study aimed to evaluate the efficacy of a mobile phone intervention based on an HIV infection risk prediction tool in promoting HIV testing and reducing high-risk behavior among HIV-negative MSM in China.
Methods:
A randomized, controlled clinical trial was conducted over WeChat, a social media app, for 12 weeks. A comprehensive intervention package was developed, consisting of four components: 1) a validated HIV risk prediction tool, which could provide tailored risk reduction intervention information; 2) a map of individualized HIV testing facility addresses based on geographic location; 3) a QR code for free HIV prevention resources, including condoms and HIV self-testing kits and; 4) general HIV health education information. MSM participants recruited from WeChat/QQ groups were randomly assigned to the intervention or control group at a ratio of 1:1. The staff sent the comprehensive intervention package QR code to MSM in the intervention group over WeChat, while only sending the HIV health education information QR code to MSM in the control group. At baseline and 12-week follow-up, data on HIV-related risk behavior and HIV testing behavior were collected through the Jinshuju online survey system.
Results:
192 MSM were recruited and assigned to the intervention group (N=96) or control group (N=96). At week 12, the total cohort retention rate was 87.5%. The number of male sexual partners in the past 3 months (P3M) in the intervention group was significantly lower than that reported in the control group (3.51±4.1 vs. 6.01±11.4, mean difference: −2.5; 95% CI: −5.115–0.115; P = .045); the rate of condom use with casual sexual partners was higher than that recorded in the control group (86.8% vs. 70.1%, OR=2.805; 95% CI: 1.230–6.393; P = .01); The rate of intention to test for HIV in the following 30 days in the intervention group was marginally higher than that observed in the control group (89.9% vs.80.2%, OR=2.198; 95% CI: 0.902–5.352; P = .07). The incremental cost-effectiveness ratio of the e-health intervention was 131.60 USD on reducing one sexual partner and 19.70 USD on the increment of one percent condom usage with casual partners.
Conclusions:
A comprehensive intervention based on an HIV infection risk prediction tool can reduce the number of male sexual partners among MSM, and increase the rate of condom use with casual partners. Hence, this intervention is a very promising preventive strategy for MSM, especially in high HIV epidemic areas. Clinical Trial: ChiCTR1800017268, at http://www.chictr.org.cn/edit.aspx?pid=29271&htm=4
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