Abstract
Background: Social network–based strategies can expand HIV/syphilis self-tests among men who have sex with men (MSM). Sexual health influencers are individuals who are particularly capable of spreading information about HIV and other sexually transmitted infections (STIs) within their social networks. However, it remains unknown whether a sexual health influencer can encourage their peers to self-test for HIV/syphilis. Objective: The aims of this study were to examine the impact of MSM sexual health influencers on improving HIV/syphilis self-test uptake within their social networks compared to that of nonsexual health influencers. Methods: In Zhuhai, China, men 16 years or older, born biologically male, who reported ever having had sex with a man, and applying for HIV/syphilis self-tests were enrolled online as indexes and encouraged to distribute self-tests to individuals (alters) in their social network. Indexes scoring >3 on a sexual health influencer scale were considered to be sexual health influencers (Cronbach α=.87). The primary outcome was the mean number of alters encouraged to test per index for sexual health influencers compared with the number encouraged by noninfluencers. Results: Participants included 371 indexes and 278 alters. Among indexes, 77 (20.8%) were sexual health influencers and 294 (79.2%) were noninfluencers. On average, each sexual health influencer successfully encouraged 1.66 alters to self-test compared to 0.51 alters encouraged by each noninfluencer (adjusted rate ratio 2.07, 95% CI 1.59-2.69). More sexual health influencers disclosed their sexual orientation (80.5% vs 67.3%, P=.02) and were community-based organization volunteers (18.2% vs 2.7%, P<.001) than noninfluencers. More alters of sexual health influencers came from a rural area (45.5% vs 23.8%, P<.001), had below-college education (57.7% vs 37.1%, P<.001), and had multiple casual male sexual partners in the past 6 months (25.2% vs 11.9%, P<.001). Conclusions: Being a sexual health influencer was associated with encouraging more alters with less testing access to self-test for HIV/syphilis. Sexual health influencers can be engaged as seeds to expand HIV/syphilis testing coverage.
Original language | English (US) |
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Article number | e24303 |
Journal | Journal of medical Internet research |
Volume | 23 |
Issue number | 6 |
DOIs | |
State | Published - Jun 2021 |
Bibliographical note
Funding Information:The authors thank the Xutong volunteers, Zhuhai Center for Disease Control research staff, and SESH research assistants for their help and support in implementing this study, as well as all participants for their cooperation. This work was supported by the National Key Research and Development Program of China (2017YFE0103800), Academy of Medical Sciences and the Newton Fund (NIF\R1\181020), National Institutes of Health (NIAID 1R01AI114310-01, NIAID K24AI143471), NIMH (R34MH109359 and R34MH119963), National Science and Technology Major Project (2018ZX10101-001-001-003), National Nature Science Foundation of China (81903371 and 81703282), Guangdong Medical Science and Technology Research Fund (A2020509), Zhuhai Medical and Health Science and Technology Plan Project (20181117A010064), and Shenzhen Philosophy and Social Sciences Fund (SZ2020C026). The funders had no role in any process of this study.
Publisher Copyright:
©Nancy Yang, Dan Wu, Yi Zhou, Shanzi Huang, Xi He, Joseph Tucker, Xiaofeng Li, Kumi M Smith, Xiaohui Jiang, Yehua Wang, Wenting Huang, Hongyun Fu, Huanyu Bao, Hongbo Jiang, Wencan Dai, Weiming Tang.
Keywords
- HIV
- Influencer
- Men who have sex with men
- Peers
- Self-test
- Sexual health
- Sexual health influencer
- Social network
- Syphilis