Oral HIV Self-Testing And Counseling Service Model Among Men Who Have Sex With Men

Object To explore the services of MSM needed when they conducted a oral HIV self-testing through qualitative interviews and to assess the feasibility and potential concerns of providing counseling services related oral HIV self-testing via We Chat.Methods With help of MSM community group in Hefei,36 MSM were enrolled the study according to the inclusion criteria study and considering the composition of social demographic characteristics.After provided written consent form,we conducted in-depth interview among participants followed the interview outline that including the help they needed in operating oral HIV self-testing,HIV related knowledge,their attitudes about HIV self-testing counseling services for MSM via We Chat as well as the model they preferred about the services.Each interview was digitally recorded and transcribed into text.The text data were uploaded and analyzed via using the MAXQDA(Software for Qualitative and Mixed Methods Research)with content analysis method according to Elo and Kyngas.Results Participants described the information they needed when taking HIV oral self-testing and the usage of We Chat in their daily life.All participants agreed that We Chat had become the preferred communication and information transmission platform and had been widely used among MSM instead of short messaging service as We Chat has many forms for information transmission and communication,lower cost and better privacy.Corresponding counseling services are needed with the use of oral HIV test kit in MSM population,such as operation guidance,HIV/AIDS knowledge and psychological support.Participants generally believed that use We Chat to provide preand post-test counseling services and referral services of following HIV confirmation testing could be widely accepted by MSM.In terms of specific service construction,such as messages pushed time,frequency,form,style and content should be suitable for MSM.Participants also expressed concerns about privacy and provided some suggestions accordingly.Conclusions The diversified information transmission functions of We Chat make it a widely used social tool for MSM population,coupled with its real-time communication function,making it feasible to provide HIV self-testing and counseling services for MSM.When providing HIV test counseling services via We Chat,we should not only pay attention to the functions of information inquiry,dynamic information push and interactive communication,but also focus on the social life and sub-cultural characteristics among MSM.Object Through follow-up study,this study explores the service model of oral HIV self-testing and counseling based on Wechat in men who have sex with men(MSM),and evaluates its role in promoting HIV testing and changing high-risk behaviors among this population.Methods With the help of MSM community volunteers,200 MSM participants were recruited in Hefei which met the inclusion criteria through peer recommendation,MSM social software and MSM community group working site.Establishing study cohort relying on We Chat,and according to the previous qualitative research results and the characteristics and needs of MSM,from the establishment of AIDS-related knowledge and information base,providing HIV testing and counseling,weekly messages push,regular interaction with users and other aspects,to build "We Test" oral HIV self-testing counseling service.A six-month follow-up study was conducted to compare HIV testing and sexual behavior before and after receiving "We Test" oral HIV self-testing counseling service,and to evaluate the effects of this service mode on promoting HIV testing among MSM and changing high-risk sexual behaviors.At the same time,during the period of receiving oral HIV self-test counseling service,the utilization of various services and its influencing factors were analyzed,and the feasibility and acceptability of the service mode in MSM population were evaluated.The baseline and follow-up surveys were conducted with electronic questionnaires,which including the social demographic characteristics,the status of sexual partners and sexual behavior,condom use,HIV testing experience and the use of We Chat and oral HIV self-testing counseling services of participants.Questionnaire data were directly stored in SPSS(Statistical Product and Service Solutions)database and analyzed by SPSS.Mc Nemar’s/paired Chi-square was used for comparison variables before and after intervention,Chi-square and Wilcoxon rank sum test were used for single factor analysis,non-conditional Logistic for multivariate analysis.Results Among 200 participants,9 dropped out during follow-up period,and the cohort retention rate was 95.5%.Through the "We Test" oral HIV self-testing counseling services,88.5%(169/191)of participants did oral HIV self-testing compared with baseline(10.0%);49.3%(69/140)used condoms every time when had sex with male fixed partners and 63.7%(51/80)used condoms every time when had sex with male occasional partners respectively compared with baseline(5.0%(7/140),6.3%(5/80));and after receiving intervention services,64.4%(123/191)agreed that We Chat influences health-related behaviors compared with baseline(44.5%).All the results of chi-square test showed that these differences were statistically significance(P < 0.05).Among the participants who did oral HIV self-testing during receiving "We Test" service period,92.9%(157/169)sent pictures of result to staff,71.0%(120/169)actively communicated with staff,8.4%(16/191)of participants asked for additional oral HIV self-test kits.About "We Test" push information,the click-through rate over50% accounted for 10%.The results of single factor analysis found that the participants who disagreed We Chat as an important way to obtain health resources,disagreed that We Chat had an impact on health-related behaviors,shared the messages of We Test with others,never used We Chat to conduct health-related information,never subscribed health related services,never looked for HIV related information,never discuss AIDS or HIV testing in We Chat group,never transmitted AIDS or HIV-related information to others by We Chat,never communicated with staff or communicated half a year via We Chat had low We Test message reading frequency compared with others.All the differences were statistically significance by using chi-square test and Wilcoxon rank sum test(P < 0.05).Multivariate Logistic analysis about low We Test message reading frequency found that the possibility of low message reading frequency of homosexuals increased to 2.4times(OR=2.405,95%CI=1.029~5.624,P=0.043),compared with non-gay.The possibility of low message reading frequency for those who didn’t take oral HIV self-testing in the past 6 months was 2.8 times(OR=2.753,95%CI=0.986~7.686,P=0.053).The possibility of low message reading frequency for those who disagreed that We Chat has impact on health-related behaviors increased to 2.7 times(OR=2.672,95%CI=1.301~5.487,P=0.007).The possibility of low message reading frequency for those who never discuss AIDS or HIV testing in We Chat group and discussed half a year increased to 25.3 times(OR=25.278,95%CI=3.284~194.546,P=0.002)and 10.1 times(OR=10.132,95%CI=1.227~83.705,P=0.032)respectively,compared with those who discussed every month.The results of single factor analysis found that the report rates about no communicating with staff among participants who had sex with casual partners in the past six months,used condoms sometimes or never when played role “0”,never subscribed health-related services,never looked for HIV-related information,never discussed AIDS or HIV testing,never shared We Test service information to others was higher than others.All the differences were statistically significance by using chi-square test and Wilcoxon rank sum test(P < 0.05).Multivariate Logistic analysis about no communicating with staff found that compared with those over 30 years old,the probability of no communicating with staff under 30 years old increased to 1.9 times(OR=1.934,95%CI=0.914~4.089,P=0.084). The possibility of no communicating with staff for those who played role “0” in sex with men in the past six months increased to 2.0 times compared with those who didn’t play(OR=1.997,95%CI=1.041~3.830,P=0.037).The possibility of no communicating with staff for those who subscribed health-related services half a year and never increased to 6.7 times(OR=6.723,95%CI=1.785~25.323,P=0.005)and 8.7 times(OR=8.694,95%CI=2.365~31.960,P=0.001)respectively,compared with those subscribed monthly.The possibility of no communicating with staff for those who transmitted AIDS or HIV testing information to others half a year was 0.3 times(OR=0.342,95%CI=0.150~0.782,P=0.011)than those who did not.Conclusions Study on the effectiveness of mode of HIV self-test service can increase the acceptability of oral HIV self-test for MSM,improve the self-protection consciousness of sex,and make up the cognitive defect about HIV prevention and test.Through the study cohort found that carrying out oral HIV self-testing counseling service via We Chat among MSM was not only feasible,but also could promote HIV self-testing,improve condom use and self-protection consciousness for MSM,and could maintain good contact between the service staff and users.