Effects Of Promoting HIV Self-Testing Via Wechat Service Among Men Who Have Sex With Men

Objective To investigate the status of previous HIV testing and demand for HIV self-test among men who have sex with men,and to explore the feasibility of developing oral HIV self-test service among men who have sex with men.Method According to the inclusion criteria and requirements of the research design for the characteristics of age,marital status,sexual orientation and HIV testing experience of the participants,36 MSM were recruited in Hefei to conduct in-depth qualitative interviews after independent completion of oral HIV self-testing operation.The interviews mainly included the previous experience and obstacles of HIV testing,the views on the operation process and the difficulty of interpreting the results of HIV oral self-testing,the need for testing counseling services,the willingness to use HIV oral self-test and the trust in the test result,the prefer access to obtain the test kit,and the views on the feasibility of promoting HIV oral self-testing among the MSM population.The interviews were recorded by recording and transcribed into text materials.Then the transcribed text materials were imported into MAXQDA software to analyze the research topics.Results Of the 36 participants,27 identified themselves as homosexual,and 9 married with a female currently.Thirty-two of the participants successfully completed the oral HIV self-test operation,and four of them failed in the first time.Concerning aboutdiscrimination and privacy exposure were the main obstacle for MSM to seek HIV testing services.Other obstacles for HIV test include inconvenience of testing time and site,long waiting time,blood collection trauma and pain,and worry about sanitary problems of sampling devices.All participants believed that the operation process of oral HIV self-test was simple,and they could complete the detection and result determination by themselves.The interviewees all indicated that MSM people had high acceptance of oral HIV self-test,and that oral HIV self-test had the advantages of simple operation,privacy protection and no need for blood samples.Participant expressed their concern of the accuracy of oral self-test results,which would lead them to conduct blood tests again after oral self-test.It is necessary to develop pre-and post-HIV self-test counseling services to meet the needs of MSM for oral HIV self-testing.Conclusions In-depth interviews found that oral HIV self-test has a wide acceptance among MSM for it’s easy to operate and privacy exposure is avoidance as well.In addition,to develop pre-and post-test counseling services that are suitable for HIV oral self-test among MSM is helpful in providing knowledge related HIV and mental surport.Objective To explore the feasibility of providing oral HIV self-test service for men who have sex with men(MSM)via We Chat platform and its effect on improving HIV testing among MSM through a randomized controlled intervention trial.Methods We recruited MSM with the help of a MSM community group in Hefei,and a total of 200 MSMs who met the inclusion criteria were recruited anonymously.Each participant was randomly assigned to the intervention group(n_ = 100)and the control group(n_ = 100)after providing written informed consent.Participants in the intervention group received six-month intervention activities by following the We Chat official account named We Test program which provided a HIV-related knowledge and information library,regularly push information related to risk of HIV infection and HIV testing targeted MSM population,provided counseling services for HIV testing and motivated two-way communication,etc.The control group did not follow the official account and did not participate in the intervention activities mentioned above.Each participant in both groups got two oral HIV self-test kits which was free in baseline during the intervention period and all participants were told to send result pictures of HIV oral self-test to specific staff of We Test project via We Chat.Pre-and post-intervention surveys were conducted with E-questionnaires included the socio-demographic characteristics of the participants,HIV testing in the last six months,attitude on result of oral self-test,status of sexual partners and condom use during sexual behavior.Results Among 200 MSM participants,74.5% were between 18 and 29 years old,76.0% were homosexual orientation,and 58.0% were below undergraduate education.The results of baseline survey showed that 56.5% of participants reported HIV testing and 14.5% reported oral HIV self-testing in the past six months.Of participants in baseline,16.8% and 6.0% insisted on condom use when they had receptive or insertive anal intercourse with men in the past six months.Those characteristics and behaviors mentioned above of participants were no significant difference between intervention group and control group.The proportion of participants who reported HIV testing and oral HIV self-testing in the past 6 months in intervention group increased from 57.0% and 12.0% at baseline to 92.7% and 87.5% at follow-up respectively,while the control group increased from 56.0% and 17.0% at baseline to70.7% and 55.6% at follow up accordingly.The confidence on result of HIV oral self-test in the intervention group was also significantly improved from baseline to follow up.The proportion of participants who insisted on condom use in each sexual intercourse increased in both group.The GEE analysis showed that the intervention effect and time effect not only increased the confidence of the participants in the results of oral HIV self-test(RR=1.623 and RR=2.071 respectively),but also promoted the usage of oral HIV self-test(RR=2.361 and RR=18.394,respectively).Additionally,the intervention effect and time effect also could improve the HIV testing rate among MSM(RR = 1.758 and RR = 3.677,respectively).Intervention has limited effect on improving condom use in homosexual intercourse.During the 6 months follow-up period,among the participants who reported using the oral HIVST kit,92.9% of participants in the intervention group and 40.0% of participants in the control group submitted their result of oral HIV self-testing and the difference between two groups was statistically significant by Chi-square analysis.Conclusions HIV oral self-testing service based on We Chat were feasible and acceptable among MSM,which can promote the coverage of HIV testing among MSM,but has limited effect on increasing condom usage during same sexual intercourse.The results of this study will be helpful to establish HIV oral self-test service meeting MSM needs.