{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T03:32:13Z","timestamp":1770348733679,"version":"3.49.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"the national natural science foundation of china","doi-asserted-by":"crossref","award":["no. 81903371"],"award-info":[{"award-number":["no. 81903371"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>HIV self-testing (HIVST), especially the secondary distribution of HIVST (SD-HIVST) initiated by sexual health influencers (SHIs), has been recognized as an effective strategy in promoting HIV testing, especially among men who have sex with men (MSM). This quasi-experimental study aimed to evaluate whether SHIs identified through the ensemble machine learning approach can distribute more HIVST than those who identified by the empiricalscale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We will recruit eligible adults (\u226518\u2009years old) who were assigned male gender at birth, and willing to participate in potential SD-HIVST online. Participants will be assigned randomly to two groups (scale group or machine learning group), followed by a separate process of SHI identification based on the group assignment. After identification, all index participants (defined as identified SHIs who are verbally consented to participate in SD-HIVST or who directly order HIVST kits) will follow the same procedure for SD-HIVST acquisition and distribution. Index participants can order HIVST online and distribute them to members within their social networks (defined as alters) in-person or virtually through a personalized peer referral link. Once a unique alter uploads a photographed test result to the platform, both the alter and the corresponding index participant will receive a fixed incentive of 3 USD. The index MSM can order up to five HIVST in the first three months and ten HIVST in the following three months. Each index participant will need to complete a baseline survey at the first-time ordering and one to two follow-upbased on the times of ordering,, three months after ordering. This trial will be comparing 1) the mean number of alters motivated by each index participant in each group and 2) the mean number of newly-tested alters motivated by each index participant in each group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In promoting the efficacy of identifying SHIs for SD-HIVST, our study has the potential to enhance testing coverage, particularly among marginalized individuals and those who are reluctant to for HIV and other sexually transmitted infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>We registered the study on the Chinese Clinical Trial Registry website on 4th November 2021, with registration number<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.chictr.org.cn\/showproj.aspx?proj=63068\">ChiCTR2000039632<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12889-021-11817-2","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T19:06:39Z","timestamp":1632855999000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Effectiveness of sexual health influencers identified by an ensemble machine learning model in promoting secondary distribution of HIV self-testing among men who have sex with men in China: study protocol for a quasi-experimental trial"],"prefix":"10.1186","volume":"21","author":[{"given":"Ying","family":"Lu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxin","family":"Ni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qianyun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengshi","family":"Jing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanzi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wencan","family":"Dai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph D.","family":"Tucker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongbo","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liqun","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9026-707X","authenticated-orcid":false,"given":"Weiming","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,9,28]]},"reference":[{"key":"11817_CR1","unstructured":"UNAIDS. 90\u201390-90: An ambitious treatment target to help end the AIDS epidemic. [Internet]. Geneva; 2014. Available from: https:\/\/www.unaids.org\/en\/resources\/documents\/2017\/90-90-90"},{"issue":"3","key":"11817_CR2","doi-asserted-by":"publisher","first-page":"100133","DOI":"10.1016\/j.xinn.2021.100133","volume":"2","author":"J Yu","year":"2021","unstructured":"Yu J, Hu S. On the ultimate finishing line of the human genome project. Innovation. 2021;2(3):100133. https:\/\/doi.org\/10.1016\/j.xinn.2021.100133.","journal-title":"Innovation."},{"issue":"1","key":"11817_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12879-016-1904-5","volume":"16","author":"S Tang","year":"2016","unstructured":"Tang S, Tang W, Meyers K, Chan P, Chen Z, Tucker JD. HIV epidemiology and responses among men who have sex with men and transgender individuals in China: a scoping review. BMC Infect Dis. 2016;16(1):1\u20138. https:\/\/doi.org\/10.1186\/s12879-016-1904-5.","journal-title":"BMC Infect Dis"},{"issue":"1","key":"11817_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/srep31081","volume":"6","author":"Q Qin","year":"2016","unstructured":"Qin Q, Tang W, Ge L, Li D, Mahapatra T, Wang L, et al. Changing trend of HIV, syphilis and hepatitis C among men who have sex with men in China. Sci Rep. 2016;6(1):1\u201310. https:\/\/doi.org\/10.1038\/srep31081.","journal-title":"Sci Rep"},{"issue":"6","key":"11817_CR5","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1007\/s11904-019-00471-4","volume":"16","author":"Z Wu","year":"2019","unstructured":"Wu Z, Chen J, Scott SR, McGoogan JM. History of the HIV epidemic in China. Curr HIV\/AIDS Rep. 2019;16(6):458\u201366. https:\/\/doi.org\/10.1007\/s11904-019-00471-4.","journal-title":"Curr HIV\/AIDS Rep."},{"issue":"5","key":"11817_CR6","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1111\/j.1468-1293.2011.00974.x","volume":"13","author":"EPF Chow","year":"2012","unstructured":"Chow EPF, Wilson DP, Zhang L. The rate of HIV testing is increasing among men who have sex with men in China. HIV Med. 2012;13(5):255\u201363. https:\/\/doi.org\/10.1111\/j.1468-1293.2011.00974.x.","journal-title":"HIV Med"},{"key":"11817_CR7","volume-title":"HIV testing is an important entry point for HIV treatment, prevention, care, and support services","author":"M Sidib\u00e9","year":"2018","unstructured":"Sidib\u00e9 M. HIV testing is an important entry point for HIV treatment, prevention, care, and support services. Geneva: UNAIDS; 2018. p. 16"},{"issue":"6","key":"11817_CR8","doi-asserted-by":"publisher","first-page":"e241","DOI":"10.1016\/S2352-3018(17)30023-1","volume":"4","author":"MS Jamil","year":"2017","unstructured":"Jamil MS, Prestage G, Fairley CK, Grulich AE, Smith KS, Chen M, et al. Effect of availability of HIV self-testing on HIV testing frequency in gay and bisexual men at high risk of infection (FORTH): a waiting-list randomized controlled trial. Lancet HIV. 2017;4(6):e241\u201350. https:\/\/doi.org\/10.1016\/S2352-3018(17)30023-1.","journal-title":"Lancet HIV."},{"issue":"11","key":"11817_CR9","doi-asserted-by":"publisher","first-page":"e611","DOI":"10.1016\/S2352-3018(18)30244-3","volume":"5","author":"W Tang","year":"2018","unstructured":"Tang W, Wu D. Opportunities and challenges for HIV self-testing in China. Lancet HIV. 2018;5(11):e611\u20132. https:\/\/doi.org\/10.1016\/S2352-3018(18)30244-3.","journal-title":"Lancet HIV"},{"key":"11817_CR10","unstructured":"World Health Organization. Consolidated guidelines on HIV testing services [Internet]. Geneva; 2015. Available from: http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/179870\/9789241508926_eng.pdf;jsessionid=38D96D45D7D9A6AB16BDF837EADD59C0?sequence=1"},{"issue":"3","key":"11817_CR11","doi-asserted-by":"publisher","first-page":"e0174629","DOI":"10.1371\/journal.pone.0174629","volume":"12","author":"S Maman","year":"2017","unstructured":"Maman S, Murray KR, Mavedzenge SN, Oluoch L, Sijenje F, Agot K, et al. A qualitative study of secondary distribution of HIV self-test kits by female sex workers in Kenya. PLoS One. 2017;12(3):e0174629. https:\/\/doi.org\/10.1371\/journal.pone.0174629.","journal-title":"PLoS One"},{"issue":"11","key":"11817_CR12","doi-asserted-by":"publisher","first-page":"e0208191","DOI":"10.1371\/journal.pone.0208191","volume":"13","author":"AT Choko","year":"2018","unstructured":"Choko AT, Nanfuka M, Birungi J, Taasi G, Kisembo P, Helleringer S. A pilot trial of the peer-based distribution of HIV self-test kits among fishermen in Bulisa. Uganda PLOS ONE. 2018;13(11):e0208191. https:\/\/doi.org\/10.1371\/journal.pone.0208191.","journal-title":"Uganda PLOS ONE"},{"issue":"1","key":"11817_CR13","doi-asserted-by":"publisher","first-page":"e0227741","DOI":"10.1371\/journal.pone.0227741","volume":"15","author":"S Okoboi","year":"2020","unstructured":"Okoboi S, Lazarus O, Castelnuovo B, Nanfuka M, Kambugu A, Mujugira A, et al. Peer distribution of HIV self-test kits to men who have sex with men to identify undiagnosed HIV infection in Uganda: a pilot study. PLoS One. 2020;15(1):e0227741. https:\/\/doi.org\/10.1371\/journal.pone.0227741.","journal-title":"PLoS One"},{"issue":"4","key":"11817_CR14","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1097\/QAI.0000000000001838","volume":"79","author":"A Gichangi","year":"2018","unstructured":"Gichangi A, Wambua J, Mutwiwa S, Njogu R, Bazant E, Wamicwe J, et al. Impact of HIV Self-Test Distribution to Male Partners of ANC Clients: Results of a Randomized Controlled Trial in Kenya. J Acquir Immune Defic Syndr 1999. 2018;79(4):467.","journal-title":"J Acquir Immune Defic Syndr 1999"},{"key":"11817_CR15","first-page":"81","volume":"220","author":"RC Shelton","year":"2019","unstructured":"Shelton RC, Lee M, Brotzman LE, Crookes DM, Jandorf L, Erwin D, et al. Use of social network analysis in the development, dissemination, implementation, and sustainability of health behavior interventions for adults: A systematic review. Soc Sci Med 1982. 2019;220:81\u2013101.","journal-title":"Soc Sci Med 1982"},{"issue":"6","key":"11817_CR16","doi-asserted-by":"publisher","first-page":"e24303","DOI":"10.2196\/24303","volume":"23","author":"N Yang","year":"2021","unstructured":"Yang N, Wu D, Zhou Y, Huang S, He X, Tucker J, et al. Sexual health influencer distribution of HIV\/syphilis self-tests among men who have sex with men in China: secondary analysis to inform community-based interventions. J Med Internet Res. 2021;23(6):e24303. https:\/\/doi.org\/10.2196\/24303.","journal-title":"J Med Internet Res"},{"issue":"2","key":"11817_CR17","doi-asserted-by":"publisher","first-page":"168","DOI":"10.2105\/AJPH.81.2.168","volume":"81","author":"JA Kelly","year":"1991","unstructured":"Kelly JA, St Lawrence JS, Diaz YE, Stevenson LY, Hauth AC, Brasfield TL, et al. HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis. Am J Public Health. 1991;81(2):168\u201371. https:\/\/doi.org\/10.2105\/AJPH.81.2.168.","journal-title":"Am J Public Health"},{"issue":"2","key":"11817_CR18","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1080\/09540120410001640986","volume":"16","author":"JA Kelly","year":"2004","unstructured":"Kelly JA. Popular opinion leaders and HIV prevention peer education: resolving discrepant findings, and implications for the development of effective community programmes. AIDS Care. 2004;16(2):139\u201350. https:\/\/doi.org\/10.1080\/09540120410001640986.","journal-title":"AIDS Care"},{"issue":"9719","key":"11817_CR19","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1016\/S0140-6736(10)60232-2","volume":"375","author":"BM Mathers","year":"2010","unstructured":"Mathers BM, Degenhardt L, Ali H, Wiessing L, Hickman M, Mattick RP, et al. HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage. Lancet. 2010;375(9719):1014\u201328. https:\/\/doi.org\/10.1016\/S0140-6736(10)60232-2.","journal-title":"Lancet"},{"issue":"Suppl 1","key":"11817_CR20","first-page":"151","volume":"113","author":"CA Latkin","year":"1998","unstructured":"Latkin CA. Outreach in natural settings: the use of peer leaders for HIV prevention among injecting drug users\u2019 networks. Public Health Rep. 1998;113(Suppl 1):151.","journal-title":"Public Health Rep"},{"issue":"1","key":"11817_CR21","doi-asserted-by":"publisher","first-page":"100003","DOI":"10.1016\/j.xinn.2020.04.003","volume":"1","author":"H Liao","year":"2020","unstructured":"Liao H, Zhang L, Marley G, Tang W. Differentiating COVID-19 response strategies. Innovation. 2020;1(1):100003. https:\/\/doi.org\/10.1016\/j.xinn.2020.04.003.","journal-title":"Innovation"},{"key":"11817_CR22","first-page":"2021.04.19.2125","volume":"20","author":"F Jing","year":"2021","unstructured":"Jing F, Ye Y, Zhou Y, Ni Y, Yan X, Lu Y, et al. Identification of Key Influencers for Secondary Distribution of HIV Self-Testing among Chinese MSM: A Machine Learning Approach. medRxiv. 2021;20:2021.04.19.21255584.","journal-title":"medRxiv"},{"issue":"1","key":"11817_CR23","doi-asserted-by":"publisher","first-page":"e10171","DOI":"10.2196\/10171","volume":"21","author":"D Wu","year":"2019","unstructured":"Wu D, Tang W, Lu H, Zhang TP, Cao B, Ong JJ, et al. Leading by example: web-based sexual health influencers among men who have sex with men have higher HIV and syphilis testing rates in China. J Med Internet Res. 2019;21(1):e10171. https:\/\/doi.org\/10.2196\/10171.","journal-title":"J Med Internet Res"},{"issue":"1","key":"11817_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12889-020-09048-y","volume":"20","author":"Y Lu","year":"2020","unstructured":"Lu Y, Ni Y, Li X, He X, Huang S, Zhou Y, et al. Monetary incentives and peer referral in promoting the digital network-based secondary distribution of HIV self-testing among men who have sex with men in China: study protocol for a three-arm randomized controlled trial. BMC Public Health. 2020;20(1):1\u20138. https:\/\/doi.org\/10.1186\/s12889-020-09048-y.","journal-title":"BMC Public Health"},{"key":"11817_CR25","doi-asserted-by":"publisher","first-page":"ciaa825","DOI":"10.1093\/cid\/ciaa825","volume":"26","author":"D Wu","year":"2020","unstructured":"Wu D, Zhou Y, Yang N, Huang S, He X, Tucker J, et al. Social media-based secondary distribution of HIV\/syphilis self-testing among Chinese men who have sex with men. Clin Infect Dis Off Publ Infect Dis Soc Am. 2020;26:ciaa825.","journal-title":"Clin Infect Dis Off Publ Infect Dis Soc Am"},{"key":"11817_CR26","doi-asserted-by":"crossref","unstructured":"Zhou Y, Lu Y, Ni Y, Wu D, He X, Ong J, et al. Monetary Incentives and Peer Referral in Promoting Digital Network-Based Secondary Distribution of HIV Self-Testing Among Men Who Have Sex With Men in China: A Three-Arm Randomized Controlled Trial. SSRN Electron J [Internet]. 2021 [cited 2021 Jul 8]; Available from: https:\/\/www.ssrn.com\/abstract=3795303","DOI":"10.2139\/ssrn.3795303"},{"issue":"1","key":"11817_CR27","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1186\/s12889-020-08540-9","volume":"20","author":"D Wu","year":"2020","unstructured":"Wu D, Yang E, Huang W, Tang W, Xu H, Liu C, et al. Homoprejudiced violence among Chinese men who have sex with men: a cross-sectional analysis in Guangzhou China. BMC Public Health. 2020;20(1):400. https:\/\/doi.org\/10.1186\/s12889-020-08540-9.","journal-title":"BMC Public Health"},{"issue":"9","key":"11817_CR28","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","volume":"16","author":"K Kroenke","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606\u201313. https:\/\/doi.org\/10.1046\/j.1525-1497.2001.016009606.x.","journal-title":"J Gen Intern Med"},{"issue":"1","key":"11817_CR29","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1207\/s15327752jpa5801_17","volume":"58","author":"HR Winefield","year":"1992","unstructured":"Winefield HR, Winefield AH, Tiggemann M. Social support and psychological well-being in Young adults: the multi-dimensional support scale. J Pers Assess. 1992;58(1):198\u2013210. https:\/\/doi.org\/10.1207\/s15327752jpa5801_17.","journal-title":"J Pers Assess"},{"issue":"4","key":"11817_CR30","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/0277-9536(88)90273-0","volume":"27","author":"SJ Neuling","year":"1988","unstructured":"Neuling SJ, Winefield HR. Social support and recovery after surgery for breast cancer: frequency and correlates of supportive behaviors by family, friends, and surgeon. Soc Sci Med. 1988;27(4):385\u201392. https:\/\/doi.org\/10.1016\/0277-9536(88)90273-0.","journal-title":"Soc Sci Med"},{"issue":"5","key":"11817_CR31","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1007\/s11904-020-00524-z","volume":"17","author":"J Pagkas-Bather","year":"2020","unstructured":"Pagkas-Bather J, Young LE, Chen Y-T, Schneider JA. Social network interventions for HIV transmission elimination. Curr HIV\/AIDS Rep. 2020;17(5):450\u20137. https:\/\/doi.org\/10.1007\/s11904-020-00524-z.","journal-title":"Curr HIV\/AIDS Rep"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-021-11817-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-021-11817-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-021-11817-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T17:35:48Z","timestamp":1673372148000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-021-11817-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,28]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["11817"],"URL":"https:\/\/doi.org\/10.1186\/s12889-021-11817-2","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,28]]},"assertion":[{"value":"25 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 September 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical review of biomedical research has been obtained from the Ethics Committee of Dermatology Hospital of Southern Medical University (no. 2019020) before study enrollment. All participants will be required to provide signed online consents.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that we have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1772"}}