Comparing Web-Based Platforms for Promoting HIV Self-Testing and PrEP Uptake in High-Risk Men

Addiction Science Made Easy for November 2020
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ASME Article 1Men who have sex with men (MSM) account for 6% of the U.S. population, but 61% of those infected with HIV, as well as 69% of new  infections. More than 30% of new infections occur in young (under age 35) MSM who identify as Black or Hispanic/Latino. And though minority MSM are not more likely to engage in risky sexual behavior than other MSM, they are disproportionately affected by societal factors like discrimination, lack of social support, and financial barriers that are associated with elevated HIV risk behavior and problematic substance use.

HIV testing and treatment initiation can reduce the transmission of infection by 95%, but rates of testing and use of pre-exposure prophylaxis (PrEP) remain lower than recommended. Promoting HIV testing and PrEP updake using advertisements on web-based platforms, such as social media websites and dating apps, is a promising approach, but the relative effectiveness of HIV prevention advertising on different platforms for different populations is not well-studied.

This study, “Using Social Media to Deliver HIV Self-Testing Kits and Link to Online PrEP Services” (CTN-0083), aims to evaluate the relative effectiveness of ads for testing and PrEP placed on 3 types of web-based platforms: social media websites, dating apps, and information websites.  

To conduct this longitudinal cohort study, ads were placed on three social media sites (Facebook, Instagram, and Twitter), three dating apps (Grindr, Jack’d, and Hornet) and three informational search websites (Google, Yahoo, and Bing) to recruit about 400 young (18-30 years old), minority (Black or Latino) MSM at elevated risk of HIV exposure.

Recruitment, which was completed in July 2020, took place in 3 waves, with each running ads on 1 website from each type of platform. Participants will next complete a baseline survey assessing risk behavior, substance use, psychological readiness to test, and attitudes, and then receive an electronic code to order a free home-based HIV self-test kit. Two follow-ups will then take place to assess test results and PrEP uptake.

This study will have a number of useful implications for future research and public health promotion. Although previous studies have used dating and social media websites to promote HIV testing, this is the first study to include informational search websites like Google in an evaluation of online HIV prevention efforts. Findings may contribute to our understanding of how different users of different platforms respond to advertisements related to HIV prevention services, as well as provide information on the relative costs of different approaches for promoting health behavior.

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Lemley SM, et al. Comparing web-based platforms for promoting HIV self-testing and PrEP uptake in high-risk MSM: Protocol for a longitudinal cohort study. JMIR Research Protocols 2020 (in press).