{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:10:45Z","timestamp":1791357045503,"version":"4.3.1"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n HIV self-testing (HIVST) with online real-time support by human administrators (HIVST-OIC) is an evidence-based HIV intervention for men who have sex with men (MSM) but requires intensive resources to implement.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate whether a novel HIVST service using a chatbot to deliver online real-time instruction and counseling support (HIVST-chatbot) is noninferior to the HIVST-OIC in increasing HIVST uptake and counseling support for MSM.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n A partially blinded, parallel-group, and noninferiority randomized clinical trial was conducted between April 16, 2023, and May 31, 2024, in Hong Kong, China. Eligible participants were Hong Kong\u2013based, Chinese-speaking MSM 18 years or older who reported anal intercourse with men in the past 6 months and had access to WhatsApp. Participants were recruited via gay venues, online recruitment, and peer referrals and then randomized to the HIVST-chatbot or HIVST-OIC groups. Both intention-to-treat (ITT) and complete case analyses were performed. The noninferiority margin was set at 10 percentage points.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Standard-of-care pretest and posttest counseling was delivered by a chatbot for the HIVST-chatbot group and by trained human administrators in the HIVST-OIC group. Both groups received free HIVST kits.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcomes included self-reported HIVST uptake and receiving any counseling support along with HIVST, validated by the research team.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 531 participants (mean [SD] age, 34.8 [9.3] years) were randomized to either the HIVST-chatbot (n\u2009=\u2009266) or HIVST-OIC (n\u2009=\u2009265) groups. In ITT analysis, the HIVST-chatbot was noninferior to the HIVST-OIC in increasing HIVST uptake (216 [81.2%] vs 227 [85.7%]; proportion difference, \u22124.5 percentage points; 95% CI, \u22129.8 to 0.8 percentage points; 1-sided\n P<\/jats:italic>\n \u2009=\u2009.10) and proportion of HIVST users who received counseling support (197 [91.2%] vs 142 [62.6%]; proportion difference, 28.7 percentage points; 95% CI, 22.5 to 34.8 percentage points; 1-sided\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) at month 6. The HIVST-chatbot was more cost-effective than HIVST-OIC.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this randomized clinical trial, the HIVST-chatbot was noninferior to the HIVST-OIC in increasing HIVST uptake and counseling among HIVST users. These results suggest that the HIVST-chatbot might be an alternative to the evidence-based HIVST-OIC service for MSM.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrial.gov Identifier:\n NCT05796622<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.44821","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T16:31:02Z","timestamp":1764001862000},"page":"e2544821","source":"Crossref","is-referenced-by-count":16,"title":["Chatbot-Delivered Real-Time Support to Improve HIV Self-Testing Rates"],"prefix":"10.1001","volume":"8","author":[{"given":"Siyu","family":"Chen","sequence":"first","affiliation":[{"name":"Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuk-yuen","family":"Yu","sequence":"additional","affiliation":[{"name":"Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Health and Physical Education, Education University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Yau","sequence":"additional","affiliation":[{"name":"AIDS Concern, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Ng","sequence":"additional","affiliation":[{"name":"AIDS Concern, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingpeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Musketeers Foundation Institute of Data Science, University of Hong Kong, Hong Kong SAR, China"},{"name":"Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhao","family":"Ni","sequence":"additional","affiliation":[{"name":"School of Nursing, Yale University, New Haven, Connecticut"},{"name":"Centre for Interdisciplinary Research on AIDS (CIRA), Yale University, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh Cuong","family":"Duong","sequence":"additional","affiliation":[{"name":"School of Population Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenghua","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Health and Physical Education, Education University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phoenix K. 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