Protect MSM from HIV and other sexually transmitted diseases by providing mobile health services of partner notification: protocol for a pragmatic stepped wedge cluster randomized controlled trial

Xiangyu Yan, Yongjie Li, Hexuan Su, Yi Xing, Bo Zhang, Zuhong Lu, Zhongwei Jia, Xiangyu Yan, Yongjie Li, Hexuan Su, Yi Xing, Bo Zhang, Zuhong Lu, Zhongwei Jia

Abstract

Background: Recently, more and more men who have sex with men (MSM) look for casual partners through online dating platforms in China. However, most are unable to know their partners' HIV and other sexually transmitted diseases (STD) statuses, leading to the rapid increase in HIV infection among Chinese MSM. Effective partner notification is urgently needed to increase the risk awareness of MSM and prevent HIV and other STDs transmission. However, the traditional intervention mainly targets to the HIV-positive MSM and the effect is not promising. Our study aims to provide Internet-based partner notification, along with a series of health services for HIV-negative MSM to protect them from HIV and other STDs.

Methods: A pragmatic stepped wedge cluster randomized controlled trial design is used to evaluate the effectiveness of a new intervention paradigm, which aims to reduce HIV and other STDs incidences among MSM in China. Through integrating a mobile health (mHealth) service application (app) to the current HIV and other STDs prevention and control methods, the new paradigm provides partner notification of HIV, syphilis, hepatitis B, and hepatitis C statuses. A total of 6172 MSM in 16 districts of Beijing, China will be recruited and randomized to sequentially receive partner notification intervention through the app at 6-month intervals. The primary outcomes are HIV incidence and the additional cost of the intervention. The secondary outcomes include incidences of syphilis, hepatitis B, and hepatitis C, disease transmission social networks, testing adherence, knowledge of HIV and STDs control, health self-responsibility awareness, changes of high risk behaviors and other related outcomes. The generalized linear mixed models (GLMM) will be used to analyze the differences of outcomes in the control period and in the intervention period.

Discussion: We expect that the HIV incidence will be significantly lower and the secondary outcomes will also be improved with providing health service of partner notification through mhealth intervention. The feasible and affordable public health intervention paradigm will have implications for HIV and STDs prevention and control among MSM and other key populations.

Trial registration: ClinicalTrials.gov, NCT04349748 . Registered on 16 April 2020.

Keywords: HIV incidence; Men who have sex with men; Partner notification; Sexually transmitted disease; Stepped wedge cluster randomized controlled trial; mHealth application.

Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Stepped wedge design of the intervention implementation
Fig. 2
Fig. 2
The framework of the partner notification
Fig. 3
Fig. 3
Types of request results and corresponding warning messages
Fig. 4
Fig. 4
Flow chart of the “Mailing rapid test reagent kit” testing service. (The images were drawn by the author team of this study)

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