Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 25, 2023
Date Accepted: Jun 25, 2024
Comparing the efficacies of two WeChat mini programs in reducing non-marital heterosexual contacts among male factory workers in China: randomized controlled trial
ABSTRACT
Background:
Male factory workers in China are vulnerable to HIV transmission. Commercial and non-marital non-commercial contacts are the driving forces of heterosexual HIV transmission among male factory workers in China. There was a lack of effective HIV interventions for male factory workers in China.
Objective:
The primary objective of this randomized controlled trial (RCT) was to compare the efficacies of the enhanced version versus the standard version of the WeChat mini program in reducing sexual intercourse with non-regular female sex partners (NRP) and female sex workers (FSW) among male factory workers in Shenzhen, China.
Methods:
A non-blinded two-arm parallel RCT was conducted between December 2021 and April 2023. Participants were adult male factory workers in Shenzhen having access to smartphone and WeChat. Those who had oral or anal sex with a man or self-reported as HIV positive were excluded. A total of 247 participants were randomly assigned into the intervention group (n=125) or the control group (n=122); 221 and 220 completed follow-up web-based surveys at T1 (six months after completion of the interventions) and T2 (six months after T1). Participants in the control group had access to the standard and fully automated WeChat mini program that provided basic HIV-related knowledge and information about local free HIV testing services. Participants in the intervention group had access to the fully automated enhanced WeChat mini program. The enhanced mini program covered all information in the standard mini program. In addition, the enhanced mini program assessed users’ behaviors and invited users to watch different online videos reducing non-marital sexual contacts and promoting HIV testing based on their behavioral characteristics at Month 0 and 1. Intention-to-treat analysis was used for outcome analyses. Multiple imputation was used to replace missing outcome values at T1 and T2.
Results:
At T1, fewer participants in the intervention group reported sexual intercourse with an NRP in the past six months, as compared to the control group (0.8% versus 6.6%; relative risk: 0.12, 95%CI: 0.02, 0.96; P=.02). However, there were no between-group differences in sexual intercourse with an NRP at T2 (8.0% versus 11.4, P=.36), or sexual intercourse with an FSW at T1 (1.6% versus 1.6%, P=.98) or T2 (6.4% versus 6.6%, P=.96).
Conclusions:
The enhanced WeChat mini program was more effective than the standard WeChat mini program in reducing sexual intercourse with NRP among male factory workers in short term, but not in longer term. Improvements should be made for the WeChat mini program before implementation. Clinical Trial: ClinicalTrials.gov NCT05811611
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