Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jul 10, 2023
Open Peer Review Period: Jul 7, 2023 - Jul 21, 2023
Date Accepted: Feb 15, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effectiveness of a machine learning model in identifying sexual health influencers to promote the secondary distribution of HIV self-testing among men who have sex with men in China: Results from a quasi-experimental study
ABSTRACT
Background:
Sexual health influencers (SHIs) play an important role in HIV care services, including promote the secondary distribution of HIV self-testing (SD-HIVST). However, how to identify SHIs is always a concern.
Objective:
We compared the effectiveness of SD-HIVST initiated by SHIs identified by a machine-learning model against the six-item leadership empirical scale through a quasi-experimental study.
Methods:
We recruited 1828 adult men who have sex with men (MSM) online between January 7, 2021, and December 11, 2021. We applied different methods (model VS. scale) to identify eligible SHIs. Consented SHIs could order HIVST or share personalized peer-referral links with their social contacts (defined as "alters"). SHIs received $3 incentives for each photo-verified result uploaded by the corresponding alter. We conducted negative binomial regression to evaluate primary outcomes, i.e., the number of alters and newly-tested alters motivated by SHIs in each group.
Results:
Overall, 393 SHIs (scale: 195, model:198) agreed to participate. Among them, 229 SHIs (scale: n=116, model: n=113) ordered HIVST online. Compared with the scale group, SHIs in the model group motivated more alters to conduct HIVST (mean difference [MD] = 0.88, 95% CI: 0.02, 2.22; adjusted incidence risk ratio [aIRR] = 1.77, 95% CI= 1.07, 2.95). The mean number of newly-tested alters was slightly higher in the model group than in the scale group, although the difference was insignificant (MD = 0.35, 95% CI: -0.17, 0.99; aIRR = 1.49, 95% CI = 0.74, 3.02).
Conclusions:
SHIs identified by the model can motivate more individuals to conduct HIVST than those identified by the scale in SD-HIVST programs among Chinese MSM. Future research can focus on adapting the model in enhancing newly-tested individuals to initiate HIVST. Clinical Trial: We registered this trial on the Chinese Clinical Trial Registry website (#ChiCTR2000039632). We obtained IRB approval through the Dermatology Hospital of Southern Medical University (#2019020[R3]).
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