S08.3b Using Social Media and Social Network to Expand HIV Self-Testing in China

Abstract

HIV self-testing (HIVST) is considered as an effective strategy to enhance HIV testing, especially among the marginalized populations such as men who have sex with men (MSM). We aimed to evaluate the effectiveness of social network-based secondary distribution model of HIVST among MSM in China. MSM participants (defined as ‘indexes’) who were were recruited through an online platform. Indexes could order up to 5 HIVST kits through the online platform. Refundable deposits of 15 USD were attached to each HIVST kits. Indexes were encouraged to distribute HIVST kits to members (defined as ‘alters’) within their social networks. All testers were required to upload photos of results to the platform, and indexes could get fully refunded after the results were verified. We firstly tested the feasibility of the model, and then conducted a three-arm RCT (Intervention 1: monetary incentives, Intervention 2: monetary incentives+online peer referral; Control: standard approach). Indexes could send personalized referral links to alters and receive 3 USD for each successfully distributed HIVST kit. Overall, a total of 640 eligible indexes ordered 1984 HIVST kits via our online platform. In summary, 1935 results (returning rate: 97.5%, 1935/1984) were returned, of which 648 results were from 625 alters. For the three-arm RCT implemented between September 2019 and June 2020, the mean number of unique tested alters motivated by each index was 0·57±0·96 in the standard of care group, compared with 0·98±1·38 in the intervention 1 group (mean difference [MD] 0·41, 95% CI: 0·08–0·74), and 1·78±2·05 in the intervention 2 group (MD=1·21, 95% CI: 0·77–1·65). We conclude that social network-based secondary distribution model of HIVST is acceptable and effective in expanding HIV testing among MSM. Using social network strategies can optimize the current HIV testing services among the marginalized populations and it is promising to be scaled up.