Using Social Media to Deliver HIV Self-Testing Kits and Link to Online PrEP Services
Condition: HIV Infections
MeSH terms: HIV Infections
Study type: Observational

Summary: 
      The primary objective of this study is to compare the relative effectiveness of three
      web-based platforms: social media sites (e.g., Facebook), dating applications [apps] (e.g.,
      Grindr), and informational sites (e.g., Google) to promote self-testing of Human
      Immunodeficiency Virus (HIV) infection among men who have sex with men (MSM) who are at
      increased risk of HIV exposure and/or infection. In addition, we will measure Pre-Exposure
      Prophylaxis (PrEP) uptake and evaluate the degree to which substance use and, separately, the
      participant's intention to test affect HIV self-testing and PrEP uptake. Through this
      research, we will also examine how participants' social media use, attitudes on HIV testing,
      perceptions of sexual risk behavior, medical mistrust, and stigma impact HIV testing and PrEP
      uptake.
    

Detailed description: 
      Culturally appropriate advertisements (designed specifically for the study population and
      advertisement method) for promoting HIV testing and PrEP uptake will be created by the study
      team. These advertisements will be placed on social media sites (Facebook, Instagram,
      Twitter), informational sites (Google, Bing, Yahoo) and dating apps (Grindr, Hornet, Jack'd)
      in the form of blast advertisements ("ads"). The advertisements will display on specific days
      and times (e.g., high traffic utilization) in the geographical locations selected for
      participation in the study.

      Upon clicking the ad, users will land on the study informational page on Qualtrics, where
      they will receive information about the study, undergo eligibility screening and, if
      eligible, electronically sign the informed consent. Participants will receive information
      about HIV testing and PrEP and will be asked to complete the baseline assessment and order
      their HIV home self-test kit.

      Participants will be followed up at two intervals after the baseline assessment. The first
      will occur 14 days post-baseline, where participants will be asked about their test use and
      may be asked if they visited a PrEP provider and/or if they started PrEP and about PrEP
      opinions and facilitators and barriers. If they tested positive for HIV on the home self-test
      kit, they will be asked whether they have visited an HIV treatment provider. Participants
      will be asked to upload a picture of their test result for validation on the secure Qualtrics
      server during the 14-day follow-up assessment. Photographs will be interpreted by the study
      team and the result will be entered into the study database; photographs will then be
      deleted.

      At the 60-day follow-up, all participants will be asked to respond to study evaluation
      questions. Additionally, participants may respond to a subset of the questions that is the
      same as the 14-day follow-up, based on their responses on the first follow-up survey. Those
      who reported that they received a negative HIV self-test result and started PrEP at the
      14-day follow-up will not be asked to answer these questions at the 60-day follow-up.
      Participants who either did not take the HIV test or did not start PrEP by the 14-day
      follow-up may be asked about PrEP facilitators and barriers, their self-test use, if they
      visited a PrEP provider, whether they started PrEP, and if applicable, whether they have
      visited an HIV treatment provider, depending on their responses during the 14-day follow-up.
      Participants will be asked to upload a picture of their test result (unless provided at the
      14-day follow-up) for validation on the secure Qualtrics server during the 60-day follow-up
      assessment. Photographs will be interpreted by the study team and the result will be entered
      into the study database; photographs will then be deleted.

      Participants who report a preliminary positive, invalid, or indeterminate result on the HIV
      home self-test kit will be referred to local brick-and-mortar clinics for additional services
      and asked to continue participating in follow-up assessments. Regardless of their result, all
      participants will be offered information on HIV and STD prevention, and locations of clinics
      and PrEP providers near them.

      Data will be collected both indirectly from each website's metrics and directly from the
      online questionnaires that the participants will complete.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        This study is recruiting men who have sex with men who actively use social media sites,
        dating apps, or informational sites.
      
Keywords: HIV; Pre-exposure prophylaxis; Social media; Online advertising