Social-media-based interventions prompted men who have sex with men (MSM) to seek HIV testing more than when compared to standard HIV prevention methods, according to a recent study conducted in Lima, Peru.
The study, which was published in The Lancet HIV, followed 556 MSM who were randomized to receive a Harnessing Online Peer Education (HOPE) intervention or standard HIV prevention enhanced by social media. The HOPE intervention consisted of trained peer leaders acting as HIV prevention mentors in closed Facebook groups. The study was conducted in 2012 in two separate waves of 12 weeks each, with 300 and 256 MSM taking part in the two waves.
Participants in the HOPE intervention arm were almost three times as likely to seek HIV testing than those in the control group receiving the standard HIV prevention messaging. About 31% of those in the intervention group and 15% of those in the control group requested HIV tests, with 17% in the intervention group and 7% in the control group actually being tested.
The demographic characteristics of both groups matched fairly closely. About 76% of the men identified as homosexual and another 19% as bisexual. Eighty percent were single and the average age was about 29. Their educational level was relatively high for Peru, where adults attend school for 7.6 years on average: Only 8% of study participants reported an educational level of high school or less, and 22% had a bachelor's degree.
Peer leaders for the Facebook groups in the intervention arm were recruited through a local community center for gay men, Epicentro. The 34 leaders who completed nine hours of training at Epicentro attempted to build rapport with the participants assigned to them and to communicate the importance of HIV prevention and testing. Each Facebook group was relatively small (fewer than 40 members), allowing for individualized communication.
Retention over the course of the 12-week study was slightly higher in the intervention arm (91%) than in the control group (88%), although in both cases significantly higher than the less-than-70% retention rate usually seen in online studies. This social media model may be helpful in other ways, as well, the study authors suggested:
Results are also encouraging because communities of HIV at-risk participants remained highly engaged in group discussions, improving likelihood that these communities can increase linkage to care among those who test positive.
Seven of the eight study participants who tested positive for HIV were, in fact, linked to care at a local HIV clinic.
As the authors noted, social-media-based interventions cost relatively little and smartphones are becoming increasingly common in low- and middle-income countries, such as Peru. In these settings, HOPE-style interventions may broaden the reach of HIV prevention and testing messages beyond traditional public health channels.