Social media influencers can play a role in getting gay men to test for HIV
Both social media influencers and community organisations can effectively recruit gay men for HIV self-testing in China - but reach different subgroups.
A Chinese study comparing the use of social media influencers against peer-led community-based organisations (CBOs) to encourage HIV self-testing among men who have sex with men finds that both are effective strategies, but differ in the subgroups they reach.
The study worked with six openly-gay social media influencers in China, each of whom manages an ‘official’ WeChat account, with a collective total of 239,000 WeChat users follow. It also enrolled 21 CBOs from 14 areas of China that have men who have sex with men as volunteers or staff.
Between January and December 2018, the influencers used WeChat to distribute HIV self-testing advertisements to men who have sex with men while the CBOs used a mix of social media and offline events.
Men who have sex with men who registered an interest via either approach were sent a self-testing kit. Trained staff offered counselling before and after testing, plus treatment referrals if needed, by telephone or WeChat.
Each approach had certain advantages over the other. WeChat reached more young people and resulted in more people with positive results receiving treatment. It was also cheaper per person tested and diagnosed. But the CBOs reached more first-time testers, and those they reached were more likely to be living with HIV.
Around 1,700 men who have sex with men reached by WeChat influencers received a self-testing kit, of whom 90% used it. In comparison, 1,000 men who have sex with men reached by a CBO received a kit, of whom 78% used it.
Around 2% of those self-testing via WeChat tested positive, compared to 12.5% of those reached by CBOs. But 82% of people in the WeChat group with a positive result accessed care and 94% began treatment. In comparison, 72% with a positive result in the CBO group accessed care and 29% began treatment.
Participants recruited via WeChat influencers were more likely to have had condomless anal sex, but less likely to have had two or more male partners, than those in the CBO group. Around half were under 24, compared to around one fifth of those reached by the CBOs. They were also likely to have a higher education level.
Around half of those reached by the CBOs were first-time HIV testers, compared to around a quarter of those reached by the WeChat influencers, underlining one of the key values of self-testing initiatives led by CBOs.
Social media influencers recruited more people than individual CBOs (290 compared to 49). The influencers were also able to reach men from 30 areas in China, while the CBOs only reached men in the 14 areas where they operate.
Due to the strengthens and weaknesses of the two approaches, the findings suggest that seeing them as complementary, and so using them both, is the best route for reaching as wide a range of men who have sex with men as possible.
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