A Peer-Led Online Community to Increase HIV Self-Testing Among African American and Latinx MSM: A Randomized Controlled Trial.

Objective: We sought to assess the effectiveness of using a peer-led online community to increase HIV self-testing among Latinx and African American men who have sex with men (MSM).
Design: Randomized controlled trial.
Methods: Throughout 6 waves, between February 18, 2017, and January 8, 2021, 900 HIV negative and/or serostatus unknown Los Angeles-based MSM (68.9% Latinx, 16.0% African American, and 7.4% White) participated in an online 12-week HIV prevention randomized controlled trial. A total of 79 trained role models (peer leaders) were randomly assigned to participants within clusters to build trust and deliver HIV testing information on Facebook groups. Participants in control groups were assigned to groups without peer leaders. Participants were not required to respond to peer leaders or to remain group members. Participants completed self-report assessments at baseline and 12-week follow-up and could receive a free HIV self-testing kit during the study period.
Results: Compared with control group participants, intervention group participants were significantly more likely to accept the offer for the HIV self-testing kit (intervention 130 of 450, 29%; control 102 of 450, 22.7%; odds ratio = 1.43, 95% confidence interval: 1.04 to 1.95, P = 0.03), report having taken an HIV self-test within the past 3 months (odds ratio = 1.47, 95% confidence interval: 1.01 to 2.13, P = 0.04), and report drinking fewer glasses of alcohol in an average week (P = 0.01). Effects seemed concentrated within later study waves. Study retention was greater than 93%.
Conclusions: A peer-led online community seems to be an effective method of increasing HIV self-testing among MSM of color. We discuss the implications of the wave effects on public health research and policy.
Competing Interests: S.Y. is on the board within the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine to advise on STI-related research and policy; S.Y. is an advisor to digital health startups, including ElevateU, which helps substance use and HIV researchers conduct online studies. The remaining authors have no conflicts of interest to disclose.
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