ArticleSexually transmitted diseases2020
A Secondary Mixed Methods Analysis of a Pay-it-Forward Gonorrhea/Chlamydia Testing Program Among Men Who Have Sex With Men in China.
Article in Sexually transmitted diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Motivations, Facilitators, and Barriers of Donation-Based Interventions in HIV and Sexually Transmitted Infection Research: A Systematic Review.JAMA network open · 2025Pooled it
- Prosocial Interventions and Health Outcomes: A Systematic Review and Meta-Analysis.JAMA network open · 2023Pooled it
- Feasibility and Acceptability of Pay-it-forward in Increasing Uptake of HPV Vaccination among 15- to 18-Year-Old Girls in China: Pilot RCT Results.Cancer prevention research (Philadelphia, Pa.) · 2025Trial
- Pay-it-forward incentives for hepatitis virus testing in men who have sex with men: a cluster randomized trial.Nature medicine · 2023Trial
- A Pay-It-Forward Approach to Improve Chlamydia and Gonorrhea Testing Uptake Among Female Sex Workers in China: Venue-Based Superiority Cluster Randomized Controlled Trial.JMIR public health and surveillance · 2023Trial
- Potential Strategies for Participation and Community Engagement in Syphilis Clinical Research.Sexually transmitted diseases · 2026Article
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- Pay-it-forward influenza vaccination among older adults and children: A cost-effectiveness analysis in China.PLOS global public health · 2023Article
- Effectiveness of a pay-it-forward intervention compared with user-paid vaccination to improve influenza vaccine uptake and community engagement among children and older adults in China: a quasi-experimental pragmatic trial.The Lancet. Infectious diseases · 2022Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundGonorrhea and chlamydia are common among Chinese men who have sex with men (MSM), but testing rates are low. We developed a pay-it-forward program where men receive a free gonorrhea/chlamydia test and can then donate toward future participants' tests. This study aims to investigate drivers of testing uptake and donation using a mixed methods approach.
methodsWe used a sequential explanatory design to explore drivers of testing uptake and donation unique to pay-it-forward through a quantitative cross-sectional survey and a qualitative thematic analysis of semistructured interviews. We collected data on sociodemographics and perceived benefits of pay-it-forward among men offered the pay-it-forward interventionand analyzed testing uptake and donations using descriptive statistics and logistic regression. We then conducted 30 semistructured interviews with men and coded interview data to identify themes.
resultsThree hundred and one MSM were offered pay-it-forward and 55% (165/301) received gonorrhea/chlamydia testing. Ninety-one percent (150 of 165) donated any amount with a mean of 58.31 ± 53.39 RMB (US $8.61 ± 7.88), or 39% of the standard price of gonorrhea/chlamydia testing. Getting tested was not associated with income, but donations were higher in the highest income bracket (adjusted odds ratio, 7.12; 95% confidence interval, 1.61-31.52). Fifty-eight percent (94 of 162) selected "more MSM can get tested," and 54% (88 of 162) selected "I can help someone else" as benefits of pay-it-forward. Qualitative themes for drivers of testing and donation included flexible pricing, generosity and reciprocity, and MSM community identity.
conclusionsQuantitative and qualitative results suggest that this pay-it-forward program may increase gonorrhea/chlamydia testing by reducing cost barriers, leveraging generosity and reciprocity, and mobilizing community altruism.
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