{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:59:48Z","timestamp":1790805588093,"version":"4.1.0"},"reference-count":11,"publisher":"BMJ","issue":"5","funder":[{"name":"Dermatology Hospital of Southern Medical University"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,10,6]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Individuals with risk-loving attitudes may be more likely to participate in high-risk sex and gambling. We investigated whether a lottery-based financial incentive to have a negative syphilis test may attract Chinese men who have sex with men (MSM) who practised risky sexual behaviours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In July 2018, a national online cross-sectional survey was conducted in China. We collected information on willingness to participate in a lottery-based financial incentive where men were eligible if they tested negative for syphilis, and the minimum prize that would attract them to participate. We used a validated risk attitude scale which asked about the willingness to take risks in six domains, ranging from 0 (avoids taking risk) to 10 (fully prepared to take risks). To avoid multicollinearity, we used principal components analysis to create a \u2018risk attitude index\u2019. Bivariable and multivariable logistic regression explored factors associated with willingness to test negative for syphilis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>699 MSM enrolled with a median age of 26 years (IQR: 23\u201330). 70% self-identified as gay and 52% reported ever testing for syphilis. 64% stated they were likely or very likely to test for syphilis linked with a lottery-based incentive. The median desired amount for the lottery had an expected value of \u00a510 (US$1.50, IQR: \u00a55\u2013\u00a530). Men who had greater odds of willingness to participate in the lottery-based incentive were those scoring highest on the risk attitude index (adjusted OR (AOR) 2.6, 95%\u2009CI 1.5 to 4.3), those reporting more than one sexual partner in the last 3\u2009months (AOR 1.7, 95%\u2009CI 1.2 to 2.4), those who had not used condoms during their last sex (AOR 1.5, 95%\u2009CI 1.0 to 2.2) and those who ever had group sex (AOR 1.5, 95%\u2009CI 1.0 to 2.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Chinese MSM with higher risk attitudes and who reported riskier sexual behaviours indicated greater interest in the concept of a lottery-based incentive for syphilis testing. A lottery-based incentive may be a promising strategy for promoting condom use among risk-loving men.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2019-054072","type":"journal-article","created":{"date-parts":[[2019,10,25]],"date-time":"2019-10-25T21:18:14Z","timestamp":1572038294000},"page":"355-357","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Risk attitudes, risky sexual behaviours and willingness to test negative for syphilis using lottery-based financial incentives among Chinese men who have sex with men"],"prefix":"10.1136","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-7403","authenticated-orcid":false,"given":"Jason J","family":"Ong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Chang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HongYun","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8376-8079","authenticated-orcid":false,"given":"Juan","family":"Nie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9026-707X","authenticated-orcid":false,"given":"Weiming","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"WeiBin","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5861-8100","authenticated-orcid":false,"given":"M Kumi","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7585-4743","authenticated-orcid":false,"given":"Michael","family":"Marks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8000-9969","authenticated-orcid":false,"given":"Cheng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Tucker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,25]]},"reference":[{"key":"2024092304150688000_96.5.355.1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0143304","article-title":"Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting","volume":"10","author":"Newman","year":"2015","journal-title":"PLoS One"},{"key":"2024092304150688000_96.5.355.2","doi-asserted-by":"crossref","DOI":"10.1186\/1741-7015-9-111","article-title":"The epidemic of sexually transmitted infections in China: implications for control and future perspectives","volume":"9","author":"Chen","year":"2011","journal-title":"BMC Med"},{"key":"2024092304150688000_96.5.355.3","unstructured":"Thaler R . Nudge: improving decisions about health wealth and happiness. Penguin, 2012."},{"key":"2024092304150688000_96.5.355.4","doi-asserted-by":"publisher","DOI":"10.1257\/app.20160469"},{"key":"2024092304150688000_96.5.355.5","doi-asserted-by":"crossref","unstructured":"Wang C , Cheng W , Li C , et al . Syphilis self-testing: a nationwide pragmatic study among men who have sex with men in China. Clin Infect Dis 2019.doi:10.1093\/cid\/ciz603","DOI":"10.1093\/cid\/ciz603"},{"key":"2024092304150688000_96.5.355.6","doi-asserted-by":"crossref","unstructured":"Ding XH , Hartog J , Sun YZ . Can we measure individual risk attitudes in a survey? IZA Discussion Paper 2010;4807.","DOI":"10.2139\/ssrn.1570425"},{"key":"2024092304150688000_96.5.355.7","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czl029"},{"key":"2024092304150688000_96.5.355.8","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-013-0588-8"},{"key":"2024092304150688000_96.5.355.9","doi-asserted-by":"publisher","DOI":"10.2307\/1914185"},{"key":"2024092304150688000_96.5.355.10","doi-asserted-by":"publisher","DOI":"10.1257\/aer.89.1.103"},{"key":"2024092304150688000_96.5.355.11","doi-asserted-by":"publisher","DOI":"10.1023\/A:1007850605129"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2019-054072","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T11:15:45Z","timestamp":1727090145000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2019-054072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,25]]},"references-count":11,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,7,16]]},"published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1136\/sextrans-2019-054072"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2019-054072","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,25]]}}}