{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T06:02:41Z","timestamp":1780293761557,"version":"3.54.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HIV self-testing (HIVST) can help overcome barriers to clinic-based testing among men who have sex with men (MSM). Peer-led distribution through existing social networks may further extend reach and acceptability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Guided by the Consolidated Framework for Implementation Research (CFIR), this study evaluated a social network-based HIVST intervention in Australia, in which \u201ctest promoters\u201d distributed HIVST kits to friends and sexual partners, to identify facilitators and barriers to implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Online semi-structured interviews were conducted with 22 MSM, including both test promoters and recipients involved in social network-based HIVST distribution trial. Interviews explored perceptions of acceptability, feasibility, and contextual appropriateness. Data were thematically analysed using the CFIR framework to identify multilevel implementation determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants\u2019 mean age was 33.3\u202fyears (SD\u202f=\u202f8.2). Three interconnected enablers shaped successful implementation: (1) HIVST as an empowering, low-barrier testing option, enhancing privacy, convenience, and autonomy while mitigating stigma; (2) trust and peer credibility, which normalised test sharing and created culturally resonant pathways; and (3) collective responsibility for health, which sustained engagement and diffusion within MSM networks. HIVST\u2019s privacy, convenience, and autonomy enhanced motivation, while peer reassurance reduced procedural anxiety, particularly around finger-prick sampling among first-time or infrequent testers. However, participants also identified persistent barriers, including culturally rooted discomfort discussing HIV, fear of judgment, and the risk of excluding socially isolated or newly arrived individuals. Social network distribution reframed testing as an act of care and solidarity, mitigating stigma and fostering collective ownership. Participants recommended culturally tailored materials, non-invasive test options, and expanded digital platforms to strengthen inclusion and reach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Social network-based HIVST represents a feasible, acceptable, and culturally responsive strategy to expand testing among MSM in high-income settings. By leveraging relational trust and community solidarity rather than financial incentives, this model offers a scalable and equitable pathway to advance progress toward national and global HIV prevention targets.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1797893","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:27:38Z","timestamp":1780291658000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Leveraging social networks to expand HIV self-testing among culturally diverse MSM in Australia: insights from a CFIR-informed process evaluation"],"prefix":"10.3389","volume":"14","author":[{"given":"Ying","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University","place":["Melbourne, VIC, Australia"]},{"name":"Melbourne Sexual Health Centre, Bayside Health","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiming","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of North Carolina at Chapel Hill","place":["Chapel Hill, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Traeger","sequence":"additional","affiliation":[{"name":"Burnet Institute","place":["Melbourne, VIC, Australia"]},{"name":"School of Public Health and Preventive Medicine, Monash University","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith A.","family":"Dean","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland","place":["Brisbane, QLD, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric P. F.","family":"Chow","sequence":"additional","affiliation":[{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University","place":["Melbourne, VIC, Australia"]},{"name":"Melbourne Sexual Health Centre, Bayside Health","place":["Melbourne, VIC, Australia"]},{"name":"Melbourne School of Population and Global Health, The University of Melbourne","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University","place":["Melbourne, VIC, Australia"]},{"name":"Melbourne Sexual Health Centre, Bayside Health","place":["Melbourne, VIC, Australia"]},{"name":"Phase I Clinical Trial Research Ward, The Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi'an, Shaanxi, China"]},{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi\u2019an Jiaotong University Health Science Center","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl C.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Global HIV, Hepatitis and STI Programmes, World Health Organization","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Stoov\u00e9","sequence":"additional","affiliation":[{"name":"Burnet Institute","place":["Melbourne, VIC, Australia"]},{"name":"School of Public Health and Preventive Medicine, Monash University","place":["Melbourne, VIC, Australia"]},{"name":"Australian Research Centre in Sex, Health and Society, La Trobe University","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason J.","family":"Ong","sequence":"additional","affiliation":[{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University","place":["Melbourne, VIC, Australia"]},{"name":"Melbourne Sexual Health Centre, Bayside Health","place":["Melbourne, VIC, Australia"]},{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany R.","family":"Phillips","sequence":"additional","affiliation":[{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University","place":["Melbourne, VIC, Australia"]},{"name":"Melbourne Sexual Health Centre, Bayside Health","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"ref1","article-title":"Men Who Have Sex with Men (MSM)","year":"2021"},{"key":"ref2","article-title":"Global HIV & AIDS Statistics \u2014 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