{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T14:00:44Z","timestamp":1770300044208,"version":"3.49.0"},"reference-count":30,"publisher":"CSIRO Publishing","issue":"1","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Secondary distribution of HIV self-testing can expand testing among men who have sex with men. A parent quasi-experimental trial found that sexual health influencers (SHIs) identified by a machine-learning model achieved greater peer uptake than those identified by an empirical scale, but the factors driving distribution effectiveness remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary analysis of the parent trial (ChiCTR2000039632) in five provinces in southern China. Participants were randomized to either the empirical scale or machine-learning identification arm, and SHIs were then selected within each arm. The current analysis included 196 SHIs with complete follow up. Effective distribution was defined as motivating at least one peer to test. Predictor variables captured sociodemographic, behavioral and network characteristics. Multivariable Poisson LASSO models with multiple imputation and cross-validation estimated adjusted incidence rate ratios (aIRRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 196 SHIs (mean age\u00a028\u00a0years), 46.9% achieved effective distribution. A total of 286 unique peers returned verified HIV self-testing results, of whom 118 (41.3%) were first-time testers. Peer HIV testing was associated with stronger awareness of peers\u2019 HIV status (aIRR\u00a01.31; 95% CI 1.16\u20131.48) and more active sharing of HIV information (aIRR\u00a01.28; 95% CI 1.10\u20131.50). SHIs who had been accompanied during their own HIV test recruited more newly tested peers (aIRR\u00a01.94; 95% CI 1.12\u20133.37).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data have implications for secondary distribution of HIV self-test kits and suggest the need for capacity strengthening related to peer engagement in HIV self-testing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh25214","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T01:27:16Z","timestamp":1767922036000},"source":"Crossref","is-referenced-by-count":0,"title":["Optimizing machine learning-based identification of sexual health influencers for HIV self-testing distribution among men who have sex with men in China: a secondary analysis of a quasi-experimental trial"],"prefix":"10.1071","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8251-2478","authenticated-orcid":true,"given":"Qian","family":"Zou","sequence":"first","affiliation":[{"name":"ASchool of Public Health, Nanjing Medical University, Nanjing, China."},{"name":"BUniversity of North Carolina Project - China, Guangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhou","sequence":"additional","affiliation":[{"name":"CZhuhai Center for Disease Control and Prevention, Zhuhai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye","family":"Zhang","sequence":"additional","affiliation":[{"name":"ASchool of Public Health, Nanjing Medical University, Nanjing, China."},{"name":"BUniversity of North Carolina Project - China, Guangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0415-5467","authenticated-orcid":true,"given":"Dan","family":"Wu","sequence":"additional","affiliation":[{"name":"ASchool of Public Health, Nanjing Medical University, Nanjing, China."},{"name":"BUniversity of North Carolina Project - China, Guangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"BUniversity of North Carolina Project - China, Guangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengshi","family":"Jing","sequence":"additional","affiliation":[{"name":"BUniversity of North Carolina Project - China, Guangzhou, China."},{"name":"DFaculty of Data Science, City University of Macau, Taipa, Macao SAR, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Fan","sequence":"additional","affiliation":[{"name":"BUniversity of North Carolina Project - China, Guangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"He","sequence":"additional","affiliation":[{"name":"EZhuhai Xutong Voluntary Services Center, Zhuhai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2804-1181","authenticated-orcid":true,"given":"Joseph D.","family":"Tucker","sequence":"additional","affiliation":[{"name":"BUniversity of North Carolina Project - China, Guangzhou, China."},{"name":"FFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9026-707X","authenticated-orcid":true,"given":"Weiming","family":"Tang","sequence":"additional","affiliation":[{"name":"ASchool of Public Health, Nanjing Medical University, Nanjing, China."},{"name":"BUniversity of North Carolina Project - China, Guangzhou, China."},{"name":"GSouthern Medical University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"2026020418112515600_R1","unstructured":"Global HIV & AIDS statistics \u2014 Fact sheet. 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