Social Network Approach for Increasing Testing Coverage Among Men Who Have Sex With Men

Study Overview
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Brief Summary
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HIV testing is essential in shortening the time to identify a new infection, the first 90 of the UNAIDS 90-90-90 targets. However, over one-third of the men who have sex with men (MSM) had never been tested for HIV; even if they did, one-fifth had their tests done more than a year ago. Assortative mixing pattern observed in the HIV-positive MSM group shaped the transmission dynamics and could be leveraged for intervention. Barriers to access HIV testing services could, on the other hand, be hurdled by self-tests. A network approach for intervention could therefore be promising in delivering effective HIV self-tests. To experiment with such an approach, a 2-phase study was conceptualised incorporating actual network-based referred HIV self-tests and an agent-based simulation evaluating its impact. Sixty-four MSM would be recruited as seeds for promoting HIV self-tests within their network and those being referred could refer their friends for the same after passing online training. To facilitate the process, an online platform would be developed offering information, collecting informed consent, requesting HIV self-test kits, returning results, performing online training, and referring peers. Participants could opt to receive self-tests by delivery or to conduct it on-site with staff assistance. A hotline with video conferencing support would be maintained to assist those who self-test at home. They could also choose between blood and oral fluid tests. Two user interfaces, namely gamification and neumorphism, would be randomly assigned. Primary outcomes to measure are number and proportion of MSM who had never or not tested within 12 months and the associating factors, and usability of the two user interfaces. Data collected in the empirical study would be used for parameterising the agent-based simulation to evaluate the impact of the approach in increasing testing coverage and shortening time to diagnosis. Its economic assessment would also be performed to cost each new infection to be identified. The approach could be feasible and effective to be adopted for future broader implementation for peer-led HIV self-test kit or HIV prevention message distribution.

Official Title
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Social Network Approach for Increasing Testing Coverage Among Men Who Have Sex With Men

Conditions
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HIV Infections

Intervention / Treatment
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* Diagnostic Test: HIV self-test kit
* Other: Graphical User Interface


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: male had sex with another male in the preceding year able to communicate in written Chinese or English normally resided in Hong Kong Exclusion Criteria: prisoners having mental illnesses that informed consent cannot be obtained

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Men who have sex with men<br>MSM receiving a self-test kit with optional assistance | Diagnostic Test: HIV self-test kit<br>* fingerprick and oral fluid HIV self-tests with optional on-site or hotline staff assistance<br>Other: Graphical User Interface<br>* Gamification or neumorphism user interface<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| effectiveness of the approach in reaching MSM who have never or not recently tested for HIV | proportion of testers who have never or not recently tested for HIV | Through study completion, at year 2 | 
| Usability and acceptability of two user interfaces | System Usability Scores (SUS) and proportion of testers giving a score of at least 71 | Through study completion, at year 2 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determinants of key actors in the social network | Network metrics predicting important actors in the referral network | Through study completion, at year 2 | 
| Preference of two forms of HIV self-testing | Proportion of testers favouring each form of self-testing | Through study completion, at year 2 | 
| Effect of network-based HIV self-test promotion in controlling transmission among MSM | Number of infections identified from the agent-based model | Through study completion, at year 2 | 
| Proportion and characteristics of promoters | Promoters are testers giving an SUS score of at least 80 | Through study completion, at year 2 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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men who have sex with men, self-testing, social network, agent-based model, HIV, Gamification, Neumorphism