Comparing the effectiveness of secondary distribution of HIV/syphilis dual self-testing to testing card referral in promoting HIV testing among gay, bisexual, and other men who have sex with men in Guangzhou, China: a quasi-experimental study

Sha, Yongjie; Xiong, Yujie; Ong, Jason J.; Wang, Yehua; Cheng, Man; Ni, Yushan; Lü, Ying; Tucker, Joseph D.; Tang, Weiming

doi:10.1071/sh21176

Cited by 9 publications

(18 citation statements)

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“…We observed that indexes and alters in both intervention arms were more likely to provide test kits to their peers than those in the standard-of-care arm. This is consistent with the results in studies of secondary distribution of HIVST in China (Sha et al, 2022 ; Zhou et al, 2022 ) and in Uganda (Okoboi et al, 2020 ). We found a higher distribution rate for face-to-face distribution of self-testing kits (S-SST) than the other two arms and a higher rate of returned verified test kits amongst alters in this study arm at primary level.…”

Section: Discussionsupporting

confidence: 91%

Optimizing Peer Distribution of Syphilis Self-Testing Among Men Who Have Sex with Men in China: A Multi-City Pragmatic Randomized Controlled Trial

Wang

Zhang

Gong³

et al. 2023

Arch Sex Behav

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Syphilis testing uptake is low among men who have sex with men (MSM) around the world. Syphilis self-testing (SST) may complement facility-based testing; the distribution model is yet to be explored. This study aimed to investigate the effectiveness of peer distribution of syphilis self-testing on promoting syphilis testing. We conducted a three-arm, unblinded, parallel individually randomized controlled trial among MSM in three cities in Guangdong, China. Inclusion criteria were: men who were born biologically male, aged 18 or above, have ever had sex with a man, will refer the interventions to peers, and will take the three-month follow-up survey. Enrolled indexes were randomly assigned in a 1:1:1 ratio into standard-of-care arm (SOC arm), standard SST delivery arm (S-SST arm), and a web-based referral link SST delivery arm (RL-SST arm). The primary outcome was the number of returned photograph-verified syphilis testing results per index. A total number of 300 indexes were enrolled, with 100 indexes in each arm. The number of verified syphilis tests per index conducted by alters was 0.05 in the control arm, 0.51 in the S-SST arm, and 0.31 in the RL-SST arm. The cost per alter tested was $760.60 for SOC, $83.78 for S-SST, and $93.10 for RL-SST. Minimal adverse event was reported among both indexes and alters during the study. This study showed that peer distribution of SST could improve syphilis testing uptake among MSM in China compared to facility-based testing. This approach warrants further consideration as part of expanding syphilis self-testing.

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Section: Discussionsupporting

confidence: 91%

Optimizing Peer Distribution of Syphilis Self-Testing Among Men Who Have Sex with Men in China: A Multi-City Pragmatic Randomized Controlled Trial

Wang

Zhang

Gong³

et al. 2023

Arch Sex Behav

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“…Six studies were from high-income countries, 19 in middle-income countries, and eight in low-income countries. The included studies were conducted in eight countries from 2010-2021, six in China [23–28], six in South Africa [29–34], six in the US [35–40], five in Uganda [41–45], four in Kenya [46–49], three in Malawi [50–52], two in Vietnam [53, 54], and one in Zambia [55].…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 15 studies recruited index participants and encouraged participants to distribute them to people in their social networks (alters) [23–25, 27, 28, 30, 32, 33, 35, 39, 40, 43–45, 48]. Most studies had multiple HIVST kits provided directly to index participants by healthcare workers (HCWs) for distribution to alters.…”

Section: Resultsmentioning

confidence: 99%

“…By recruiting index participants, participants are encouraged to distribute HIVST kits to members in their social networks face-to-face or by sharing online links and mail. In most studies, HIVST kits were distributed person-to-person, with participants applying for HIVST kits and then distributing them face-to-face in their social networks [23, 26, 30–34, 42, 46, 47, 49–52]. In contrast, a subset of studies were based on social media, an HIVST application link on a phone app [24, 25, 27], or a web-based platform [28, 35, 40] that provides HIVST kits in the form of online ordering and mailing.…”

Section: Resultsmentioning

confidence: 99%

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Social Network Strategies to Distribute HIV Self-testing Kits: A Global Systematic Review and Network Meta-analysis

Hu,

Jing,

Fan

et al. 2023

Preprint

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IntroductionSocial network strategies, in which social networks are utilized to influence individuals or communities, are increasingly being used to deliver human immunodeficiency virus (HIV) interventions to key populations. We summarized and critically assessed existing research on the effectiveness of social network strategies in promoting HIV self-testing (HIVST).MethodsUsing search terms related to social network interventions and HIVST, we searched five databases for trials published between January 1st, 2010, and June 30th, 2023. Outcomes included uptake of HIV testing, HIV seroconversion, and linkage to antiretroviral therapy (ART) or HIV Care. We used network meta-analysis to assess the uptake of HIV testing through social network strategies compared with control methods. A pairwise meta-analysis of studies with a comparison arm that reported outcomes was performed to assess relative risks (RR) and their corresponding 95% confidence intervals (CI).Results and discussionAmong the 3,745 manuscripts identified, 33 studies fulfilled the inclusion criteria, including one quasi-experimental study, 17 RCTs and 15 observational studies. Networks HIVST testing was organized by peers (distributed to known peers, 15 studies), partners (distributed to their sexual partners, 10 studies), and peer educators (distributed to unknown peers, 8 studies). The results showed that all of the three social network distribution strategies enhanced the uptake of HIV testing compared to standard facility-based testing. Among social networks, peer distribution had the highest uptake of HIV testing (79% probability, SUCRA 0.92), followed by partner distribution (72% probability, SUCRA 0.71), and peer educator distribution (66% probability, SUCRA 0.29). Pairwise meta-analysis showed that peer distribution (RR 2.29, 95% CI 1.54-3.39, 5 studies) and partner distribution (RR 1.45, 95% CI 1.05-2.02, 7 studies) also increased the probability of detecting HIV reactivity during testing within the key population when compared to the control. Linkage to ART or HIV Care remained comparable to facility-based testing across the three HIVST distribution strategies.ConclusionsNetwork-based HIVST distribution is considered effective in augmenting HIV testing rates and reaching marginalized populations compared to facility-based testing. These strategies can be integrated with the existing HIV care services, to fill the testing gap among key populations globally.PROSPERO Number: CRD42022361782

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“…Importantly, they provide helpful recommendations informed by a social justice lens to ensure digital health benefits all. Sha and colleagues' 15 trial in China offers an example of how social networkbased strategies can promote the uptake of HIV/syphilis self-testing kits among men who have sex with men.…”

Section: Smarter Use Of Technologies To Enhance Sexual Health Servicesmentioning

confidence: 99%

How should we deliver sexual health services in the 2020s?

et al. 2022

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Comparing the effectiveness of secondary distribution of HIV/syphilis dual self-testing to testing card referral in promoting HIV testing among gay, bisexual, and other men who have sex with men in Guangzhou, China: a quasi-experimental study

Cited by 9 publications

References 0 publications

Optimizing Peer Distribution of Syphilis Self-Testing Among Men Who Have Sex with Men in China: A Multi-City Pragmatic Randomized Controlled Trial

Optimizing Peer Distribution of Syphilis Self-Testing Among Men Who Have Sex with Men in China: A Multi-City Pragmatic Randomized Controlled Trial

Social Network Strategies to Distribute HIV Self-testing Kits: A Global Systematic Review and Network Meta-analysis

How should we deliver sexual health services in the 2020s?

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