Crowdsourced partner services among men who have sex with men living with HIV: A pilot randomized controlled trial in China

Abstract

Background To improve the uptake of HIV partner services (HIV PS) among men who have sex with men living with HIV (MLWH) in China, our team used a crowdsourcing approach to develop a tailored intervention package. This study assessed the acceptability, feasibility, and preliminary effectiveness of a crowdsourced HIV PS intervention compared to conventional HIV PS. Methods The study conducted a pilot two-arm randomized controlled trial (RCT) to compare the proportion of HIV testing among sexual partners of MLWH. Indexes in the control arm received conventional HIV PS using referral cards. Indexes in the intervention arm received a crowdsourced HIV PS intervention which included HIV self-testing kits for secondary distribution (HIVST-SD), digital education materials, and assisted PS via provider/contract referral. The primary outcomes were (1) intervention feasibility (i.e., the frequency of indexes using crowdsourced intervention components), (2) intervention acceptability (i.e., the evaluation of indexes on intervention components using Likert scales), and (3) the preliminary impact of the intervention (i.e., the proportion of partners getting HIV testing within three months of index enrollment). Descriptive analysis was conducted and Chi-squared tests were used to test whether the proportional differences were significant. Results A total of 121 MSM newly diagnosed with HIV were enrolled between July 2021 and May 2022 in Guangzhou and Zhuhai, China, with 81 in the intervention arm and 40 in the control arm. The 3-month follow-up rates were 93% (75/81) and 83% (33/40), respectively. The crowdsourced intervention components were feasible, as 31 indexes received and 23 indexes used HIVST-SD, 6 indexes used provider-referral to notify 9 sexual partners, and indexes visited the digital educational materials 2.3 times on average. The intervention components also demonstrated acceptability, with HIVST-SD rated 4.4 out of 5 and the digital educational materials rated 4.1 out of 5. The proportion of partners getting HIV testing among all identified partners was 38% (65/171) in the intervention arm, compared to 27% (24/89) in the control arm. The difference was not statistically significant. Conclusion The crowdsourced HIV PS intervention components were acceptable and feasible among Chinese MLWH and may improve the proportion of stable partners receiving HIV testing. Further implementation science research is needed to expand PS among key populations in low and middle-income countries.