Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Sep 14, 2020
Date Accepted: Apr 14, 2021
Sexual health influencer distribution of HIV/syphilis self-tests among men who have sex with men in China: A secondary analysis to inform community-based interventions
ABSTRACT
Background:
Social network-based strategies can expand HIV/syphilis self-tests among men who have sex with men (MSM). Sexual health influencers (SHIs) are individuals especially capable of spreading HIV and STI information within their social networks. However, it remains unknown whether a SHI can encourage their peers to self-test for HIV/syphilis.
Objective:
This study aims to examine MSM SHIs' impact on improving HIV/syphilis self-test uptake within their social networks compared to non-sexual health influencers.
Methods:
In Zhuhai, China, men 16 years or older, born biologically male, ever had sex with a man, and applying for HIV/syphilis self-tests were enrolled online as indexes and encouraged to distribute self-tests to individuals (alters) in their social network. Indexes scoring >3 on a sexual health influencer scale were considered SHIs (Cronbach alpha 0.87). The primary outcome was mean number of alters encouraged to test per SHI index compared to non-influencers.
Results:
Participants include 371 indexes and 278 alters. Among indexes, 77 (20.8%) were SHIs and 294 (79.2%) were non-influencers. On average, each SHI successfully encouraged 1.66 alters to self-test, compared to 0.51 alters encouraged by each non-influencer (aRR 2.07, 95% CI 1.59-2.69). More SHIs disclosed their sexual orientation (80.5% vs. 67.3%, P=.02) and were volunteers (18.2% vs. 2.7%, P<.001) than non-influencers. More alters of SHIs than non-influencers came from a rural area (45.5% vs. 23.8%, P<.001), had below-college education (57.7% vs. 37.1%, P<.001) and had multiple casual male sexual partners in the past 6 months (25.2% vs. 11.9%, P<.001).
Conclusions:
Being a SHI was associated with encouraging more peers with less testing access to self-test for HIV/syphilis. SHI can be engaged as seeds to expand HIV/syphilis testing coverage. Clinical Trial: NA
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