Discussion
HIV testing frequency, sexual behaviors, MSM
This study found the delivery of HIV risk assessment tools and feedback by a phone-based GSN app improved the number of HIV tests over 1 year among MSM app users in Beijing, China. UAI did not significantly improve compared with controls; however, all UAI declined from baseline to 6 months. Overall, this study suggests app-based, tailored feedback from HIV risk assessment tools could be an effective, low-cost strategy for increasing HIV testing frequency among MSM in China, although longer follow-up is required to establish a definite benefit.This study shows HIV assessment along with tailored feedback significantly improved the number of HIV tests administered per person, but HIV assessment without feedback did not significantly improve testing compared with controls. This is consistent with the literature purporting that the addition of feedback to HIV assessment has additional benefits [Interestingly, the controls also improved their HIV testing rates to the expectations of the Chinese CDC and behaved in a similar fashion to the HIV assessment–only group. In this study, controls received access to a free web-based appointment-making platform to schedule an HIV test. This choice of control is more than what has been offered in other similar studies (eg, relaxation skills [This study also found that HIV risk assessment and feedback significantly reduced the incidence of UAI compared with controls, although it was observed in all 3 groups that UAI declined from baseline. This is in concordance with other studies, which found that completing a risk assessment alone motivated safe changes in sexual behaviors [This RCT included a large sample of MSM app users in Beijing, China, and investigated interventions that are low-cost, efficient, and scalable for MSM throughout China. The private and simple nature of the intervention likely makes it desirable to MSM, which may increase its success and impact compared to other face-to-face interventions [Despite the strengths of this study, some limitations should also be acknowledged. First, the number of participants lost to follow-up was high, but this was expected considering web-based interventions are known to have high dropout rates [