Integrating a Combination HIV Prevention Intervention Into a Widely Used Geosocial App for Chinese Men Who Have Sex With Men: Protocol for a Single-Arm Pilot and Repeated Cross-Sectional Study.

backgroundHIV disproportionately affects men who have sex with men in China. However, HIV prevention services use among this population remains limited, in part due to concerns of privacy and sexual identity disclosure. These concerns might be addressed through telehealth services.

objectiveThis study was designed to assess the feasibility and acceptability of Blued+, which integrates an HIV prevention services package into a geosocial networking app commonly used by Chinese men who have sex with men.

methodsThe study design was a single-arm pilot of the Blued+ intervention among men who have sex with men, using repeated cross-sectional surveys of an external population for comparison. For the pilot study, men were recruited from Beijing and Chengdu. A 3-month standard-of-care period with measurement at enrollment and month 0 (baseline) was followed by a 12-month intervention period with measurement at months 3, 6, 9, and 12. During the intervention period, participants received the enhanced version of the Blued app (Blued+) with HIV testing, linkage to care as needed, choice of condoms and condom-compatible lubricants, and pre-exposure prophylaxis (PrEP) services. PrEP was provided through in-app counseling and prescription, followed by lab tests at local clinics and mailed medication. Three cross-sectional surveys in months 0, 6, and 12 were administered to men in Beijing and Chengdu who were not enrolled in another HIV prevention study. These participants had access to the standard Blued geosocial networking app and local health services. The primary outcome of feasibility was the uptake of home HIV testing and PrEP. The coprimary outcome of intervention acceptability was measured with the System Usability Scale.

resultsThe run-in period was launched on July 15, 2022, with recruitment completed on August 24, 2022. The baseline period concluded in November 2022, and all follow-up assessments were completed by December 2023. At baseline, the pilot study enrolled 423 participants, and the cross-sectional comparison enrolled 1314 participants. Participants in the pilot were young (mean age 30, SD 7 years) and educated (324/423, 76.6% reported a college degree or higher), and most (302/423, 71.4%) reported HIV testing in the prior 3 months. Most participants (404/423, 95.5%) had heard of PrEP, and over a quarter had used PrEP (114/423, 27%). Participants in the comparison population had comparable sociodemographic characteristics, reporting HIV testing (501/857, 58.5%) in the prior 3 months, PrEP awareness (723/857, 84.4%), and PrEP use in the last 3 months (182/857, 15.4%).

conclusionsThis pilot study will provide preliminary evidence regarding the feasibility and acceptability of the Blued+ intervention. The study findings will provide evidence setting the foundation for future research that involves embedding prevention platforms into apps that are already widely used. If preliminary impact is observed, future research would include a hybrid effectiveness implementation trial of the intervention.

trial registrationClinicalTrials.gov NCT06647173; https://clinicaltrials.gov/study/NCT06647173. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/69536.