Procedures
HIV infection, sexual behaviors
HIV INFECTION, RECRUITMENT
Recruitment messages were privately sent through the app to Blued users from a Blued administrative account. The message briefly introduced the study and provided a link to participate. MSM who clicked the link were directed to eligibility screening, the consent form, and the baseline survey. The baseline questionnaire covered demographics, HIV testing history, GSN app use, and sexual risk behaviors. Group 1 and group 2 took the HIV RISK Assessment tool at baseline and 6 months after randomization. The HIV RISK Assessment tool was based on a validated, 8-item questionnaire developed in China [Group 1 also received tailored feedback based on their responses to the HIV RISK Assessment tool, which included their HIV risk score, probability of acquiring HIV, high-risk sexual behaviors contributing to their risk of HIV infection, and personalized measures to reduce their risk of HIV infection. An example of this bespoke feedback is captured in All participants, regardless of randomization, received a link at baseline and 6 months post randomization to sign up for free HIV testing at convenient drop-in testing sites managed by Blued. If participants scheduled an HIV test, they would receive an SMS text message confirming the location and time of the appointment. Only rapid screening tests were conducted at Blued drop-in testing sites, and those who tested positive were referred to the appropriate district CDC in Beijing for further HIV confirmatory testing by Western blot test and were engaged in antiretroviral therapy, if appropriate. The number of rapid HIV tests taken by participants was collected by working staff at drop-in testing sites run by Blued 1 year after randomization.Follow-up was conducted at 1 month, 3 months, 6 months, and 12 months following randomization, and the same baseline questionnaire was to be completed, excluding demographic information. The baseline survey was not administered at 12 months post randomization due to low follow-up rates. All questionnaires were conducted on the internet through a unique website developed for the study. If participants did not respond to the initial follow-up surveys, a second link was sent as a reminder 1 week later. Participants were considered lost to follow-up if they had not responded to the second reminder within 1 week.An example of 1 of the 8 items in the HIV RISK Assessment tool. The text reads: “How many HIV-positive homosexual partners did you have in the past 6 months?” Participants would then choose one of the responses: “1,” “2-5,” “6-9,” or “more than or equal to 10”.Tailored prevention messaging based on the participant’s risk assessment score. The text reads: “HIV risk assessment report: your current HIV infection risk score is 6 (the total score is 15), and your probability of HIV infection is 28.09% according to your answers to the HIV risk assessment tool. Measures you should take include ordering an offline HIV test in one of the app-based clinics by clicking the button and reducing the number of homosexual partners.”.