Social Media-Based Secondary Distribution of Hiv/Syphilis Self-Testing Among Chinese Men Who Have Sex with Men

Background: Social media and secondary distribution (distributing self-testing kits by indexes through their networks) both show strong promise to improve HIV self-testing uptake. We assessed an implementation program in Zhuhai, China, which focused on the secomdary distribution of HIV/syphilis self-test kits via social media. Methods: Men of age 16 or above, born biologically male, and ever had sex with another man were recruited as indexes. Banner ads on a social media platform invited the participants to apply for up to five self-test kits every three-months. Index men paid a deposit of 15 USD/kit (refundable) upon submitting a photograph of a completed test result via an online submission system. They were informed that they could distribute the kits to others (referred to as “alters”). Findings: A total of 649 men applied for 1150 kits (mean age=28•7±6.9), of which 1141 test results were returned (99%). Among them, 1099 were valid test results, 810 (74%) were from 331 unique index men, and 289 tests (26%) were from 281 unique alters. Compared to index men, a higher proportion of alters were HIV new testers (40% VS. 21%. The total HIV self-test reactivity rate was 3% (20/612), with alters having a significantly higher rate than indexes (5% VS 2%). A total of 21 people (3%) had a reactive syphilis test result. Interpretation: Integrating social media with the secondary distribution of self-test kits may hold promise to increase HIV/syphilis testing coverage and case identification among men who have sex with men. Funding: Zhuhai CDC and NIH. Declaration of Interest: None declared. Ethical Approval: The study protocol was approved by the Zhuhai Municipal Center for Diseases Control and Prevention. Inform consent was collected from each index participants. This study was reported by following the STROBE Statement.