Evaluating an Innovative HIV Self-Testing Service With Web-Based, Real-Time Counseling Provided by an Artificial Intelligence Chatbot (HIVST-Chatbot) in Increasing HIV Self-Testing Use Among Chinese Men Who Have Sex With Men: Protocol for a Noninferiority Randomized Controlled Trial

BackgroundCounseling support for HIV self-testing (HIVST) users is essential to ensure support and linkage to care among men who have sex with men (MSM). An HIVST service with web-based real-time instruction, pretest, and posttest counseling provided by trained administrators...

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Main Authors: Siyu Chen, Qingpeng Zhang, Chee-kit Chan, Fuk-yuen Yu, Andrew Chidgey, Yuan Fang, Phoenix K H Mo, Zixin Wang
Format: Article
Language:English
Published: JMIR Publications 2023-06-01
Series:JMIR Research Protocols
Online Access:https://www.researchprotocols.org/2023/1/e48447
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author Siyu Chen
Qingpeng Zhang
Chee-kit Chan
Fuk-yuen Yu
Andrew Chidgey
Yuan Fang
Phoenix K H Mo
Zixin Wang
author_facet Siyu Chen
Qingpeng Zhang
Chee-kit Chan
Fuk-yuen Yu
Andrew Chidgey
Yuan Fang
Phoenix K H Mo
Zixin Wang
author_sort Siyu Chen
collection DOAJ
description BackgroundCounseling support for HIV self-testing (HIVST) users is essential to ensure support and linkage to care among men who have sex with men (MSM). An HIVST service with web-based real-time instruction, pretest, and posttest counseling provided by trained administrators (HIVST-OIC) was developed by previous projects. Although the HIVST-OIC was highly effective in increasing HIVST uptake and the proportion of HIVST users receiving counseling along with testing, it required intensive resources to implement and sustain. The service capacity of HIVST-OIC cannot meet the increasing demands of HIVST. ObjectiveThis randomized controlled trial primarily aims to establish whether HIVST-chatbot, an innovative HIVST service with web-based real-time instruction and counseling provided by a fully automated chatbot, would produce effects that are similar to HIVST-OIC in increasing HIVST uptake and the proportion of HIVST users receiving counseling alongside testing among MSM within a 6-month follow-up period. MethodsA parallel-group, noninferiority randomized controlled trial will be conducted with Chinese-speaking MSM aged ≥18 years with access to live-chat applications. A total of 528 participants will be recruited through multiple sources, including outreach in gay venues, web-based advertisement, and peer referral. After completing the baseline telephone survey, participants will be randomized evenly into the intervention or control groups. Intervention group participants will watch a web-based video promoting HIVST-chatbot and receive a free HIVST kit. The chatbot will contact the participant to implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through WhatsApp. Control group participants will watch a web-based video promoting HIVST-OIC and receive a free HIVST kit in the same manner. Upon appointment, a trained testing administrator will implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through live-chat applications. All participants will complete a telephone follow-up survey 6 months after the baseline. The primary outcomes are HIVST uptake and the proportion of HIVST users receiving counseling support along with testing in the past 6 months, measured at month 6. Secondary outcomes include sexual risk behaviors and uptake of HIV testing other than HIVST during the follow-up period. Intention-to-treat analysis will be used. ResultsRecruitment and enrollment of participants started in April 2023. ConclusionsThis study will generate important research and policy implications regarding chatbot use in HIVST services. If HIVST-chatbot is proven noninferior to HIVST-OIC, it can be easily integrated into existing HIVST services in Hong Kong, given its relatively low resource requirements for implementation and maintenance. HIVST-chatbot can potentially overcome the barriers to using HIVST. Therefore, the coverage of HIV testing, the level of support, and the linkage to care for MSM HIVST users will be increased. Trial RegistrationClinicalTrial.gov NCT05796622; https://clinicaltrials.gov/ct2/show/NCT05796622 International Registered Report Identifier (IRRID)PRR1-10.2196/48447
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spelling doaj.art-d586362f9ecf49a3beb85ac78a00d2792023-08-29T00:08:50ZengJMIR PublicationsJMIR Research Protocols1929-07482023-06-0112e4844710.2196/48447Evaluating an Innovative HIV Self-Testing Service With Web-Based, Real-Time Counseling Provided by an Artificial Intelligence Chatbot (HIVST-Chatbot) in Increasing HIV Self-Testing Use Among Chinese Men Who Have Sex With Men: Protocol for a Noninferiority Randomized Controlled TrialSiyu Chenhttps://orcid.org/0000-0002-6271-1858Qingpeng Zhanghttps://orcid.org/0000-0002-6819-0686Chee-kit Chanhttps://orcid.org/0009-0009-9776-5125Fuk-yuen Yuhttps://orcid.org/0000-0001-7869-0281Andrew Chidgeyhttps://orcid.org/0000-0001-5809-5821Yuan Fanghttps://orcid.org/0000-0003-1154-5076Phoenix K H Mohttps://orcid.org/0000-0001-9822-5424Zixin Wanghttps://orcid.org/0000-0002-1158-2304 BackgroundCounseling support for HIV self-testing (HIVST) users is essential to ensure support and linkage to care among men who have sex with men (MSM). An HIVST service with web-based real-time instruction, pretest, and posttest counseling provided by trained administrators (HIVST-OIC) was developed by previous projects. Although the HIVST-OIC was highly effective in increasing HIVST uptake and the proportion of HIVST users receiving counseling along with testing, it required intensive resources to implement and sustain. The service capacity of HIVST-OIC cannot meet the increasing demands of HIVST. ObjectiveThis randomized controlled trial primarily aims to establish whether HIVST-chatbot, an innovative HIVST service with web-based real-time instruction and counseling provided by a fully automated chatbot, would produce effects that are similar to HIVST-OIC in increasing HIVST uptake and the proportion of HIVST users receiving counseling alongside testing among MSM within a 6-month follow-up period. MethodsA parallel-group, noninferiority randomized controlled trial will be conducted with Chinese-speaking MSM aged ≥18 years with access to live-chat applications. A total of 528 participants will be recruited through multiple sources, including outreach in gay venues, web-based advertisement, and peer referral. After completing the baseline telephone survey, participants will be randomized evenly into the intervention or control groups. Intervention group participants will watch a web-based video promoting HIVST-chatbot and receive a free HIVST kit. The chatbot will contact the participant to implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through WhatsApp. Control group participants will watch a web-based video promoting HIVST-OIC and receive a free HIVST kit in the same manner. Upon appointment, a trained testing administrator will implement HIVST and provide standard-of-care, real-time pretest and posttest counseling and instructions on how to use the HIVST kit through live-chat applications. All participants will complete a telephone follow-up survey 6 months after the baseline. The primary outcomes are HIVST uptake and the proportion of HIVST users receiving counseling support along with testing in the past 6 months, measured at month 6. Secondary outcomes include sexual risk behaviors and uptake of HIV testing other than HIVST during the follow-up period. Intention-to-treat analysis will be used. ResultsRecruitment and enrollment of participants started in April 2023. ConclusionsThis study will generate important research and policy implications regarding chatbot use in HIVST services. If HIVST-chatbot is proven noninferior to HIVST-OIC, it can be easily integrated into existing HIVST services in Hong Kong, given its relatively low resource requirements for implementation and maintenance. HIVST-chatbot can potentially overcome the barriers to using HIVST. Therefore, the coverage of HIV testing, the level of support, and the linkage to care for MSM HIVST users will be increased. Trial RegistrationClinicalTrial.gov NCT05796622; https://clinicaltrials.gov/ct2/show/NCT05796622 International Registered Report Identifier (IRRID)PRR1-10.2196/48447https://www.researchprotocols.org/2023/1/e48447
spellingShingle Siyu Chen
Qingpeng Zhang
Chee-kit Chan
Fuk-yuen Yu
Andrew Chidgey
Yuan Fang
Phoenix K H Mo
Zixin Wang
Evaluating an Innovative HIV Self-Testing Service With Web-Based, Real-Time Counseling Provided by an Artificial Intelligence Chatbot (HIVST-Chatbot) in Increasing HIV Self-Testing Use Among Chinese Men Who Have Sex With Men: Protocol for a Noninferiority Randomized Controlled Trial
JMIR Research Protocols
title Evaluating an Innovative HIV Self-Testing Service With Web-Based, Real-Time Counseling Provided by an Artificial Intelligence Chatbot (HIVST-Chatbot) in Increasing HIV Self-Testing Use Among Chinese Men Who Have Sex With Men: Protocol for a Noninferiority Randomized Controlled Trial
title_full Evaluating an Innovative HIV Self-Testing Service With Web-Based, Real-Time Counseling Provided by an Artificial Intelligence Chatbot (HIVST-Chatbot) in Increasing HIV Self-Testing Use Among Chinese Men Who Have Sex With Men: Protocol for a Noninferiority Randomized Controlled Trial
title_fullStr Evaluating an Innovative HIV Self-Testing Service With Web-Based, Real-Time Counseling Provided by an Artificial Intelligence Chatbot (HIVST-Chatbot) in Increasing HIV Self-Testing Use Among Chinese Men Who Have Sex With Men: Protocol for a Noninferiority Randomized Controlled Trial
title_full_unstemmed Evaluating an Innovative HIV Self-Testing Service With Web-Based, Real-Time Counseling Provided by an Artificial Intelligence Chatbot (HIVST-Chatbot) in Increasing HIV Self-Testing Use Among Chinese Men Who Have Sex With Men: Protocol for a Noninferiority Randomized Controlled Trial
title_short Evaluating an Innovative HIV Self-Testing Service With Web-Based, Real-Time Counseling Provided by an Artificial Intelligence Chatbot (HIVST-Chatbot) in Increasing HIV Self-Testing Use Among Chinese Men Who Have Sex With Men: Protocol for a Noninferiority Randomized Controlled Trial
title_sort evaluating an innovative hiv self testing service with web based real time counseling provided by an artificial intelligence chatbot hivst chatbot in increasing hiv self testing use among chinese men who have sex with men protocol for a noninferiority randomized controlled trial
url https://www.researchprotocols.org/2023/1/e48447
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