Social Media Intervention Based on the Information-Motivation-Behavioral Skills Model Promotes HIV Testing and Reduces High-Risk Behaviors Among Men Who Have Sex With Men in Resource-Limited Settings in China: Randomized Controlled Trial

Clinical Snapshot

Key Findings

• P Value: All primary outcomes P<0.05

• Effect Size: HIV testing RR 1.739, HIV self-testing RR 2.306, consistent condom use RR 2.457

• Primary Outcome: HIV testing uptake significantly higher in intervention group

• Nnt Or Sensitivity: NNT not calculable from provided data, but substantial relative risk improvements suggest low NNT

• Confidence Interval: HIV testing 95% CI 1.110-2.730, HIV self-testing 95% CI 1.593-3.340, condom use 95% CI 1.636-3.690

Clinical Application

Requires social media platform access and video content development. Scalable intervention model Limited direct applicability due to different healthcare system, social media landscape, and cultural context. Australian MSM have better healthcare access through Medicare and PBS-subsidised PrEP MSM populations in resource-limited settings, potentially applicable to disadvantaged communities globally

Abstract

BACKGROUND: Social media intervention may enhance HIV prevention among men who have sex with men, but the effect of this intervention in resource-limited settings remains unclear. OBJECTIVE: This randomized controlled trial evaluated whether a social media intervention grounded in the information-motivation-behavioral skills (IMB) model could be beneficial for HIV prevention among men who have sex with men in resource-limited settings. METHODS: Participants were recruited in Nanning, China, between April 2023 and April 2024. Eligible participants were randomly assigned to either the social media intervention group or the routine HIV prevention services control group. Participants in the intervention group received a 3-month social media intervention, which included completing video-based tasks. Baseline surveys were conducted, followed by follow-up surveys every 3 months, for a total of 2 follow-ups. Outcomes included HIV testing uptake, high-risk behavior, AIDS-related knowledge, safe sex self-efficacy, and attitude. RESULTS: A total of 180 eligible men who have sex with men were enrolled (90 per group). Follow-up rates were 97.8% (88/90) and 95.5% (86/90) for the intervention and control groups, respectively. At the follow-ups, the intervention group demonstrated significantly higher uptake of HIV testing, a lower proportion of participants reporting high-risk sexual behaviors, and higher condom use self-efficacy compared to the control group (all P<.05). After controlling for sociodemographic variables, generalized estimating equations analysis revealed that the intervention group had significantly higher odds of HIV testing (risk ratio [RR] 1.739, 95% CI 1.110-2.730), HIV self-testing (RR 2.306, 95% CI 1.593-3.340), and consistent condom use (RR 2.457, 95% CI 1.636-3.690) than the control group. Cochran-Armitage trend tests within the intervention group revealed that with increasing intervention duration, both HIV testing and HIV self-testing significantly increased, while high-risk sexual behaviors significantly decreased (all P<.05). CONCLUSIONS: The social media intervention guided by the IMB model demonstrated a positive effect on expanding HIV testing coverage, reducing high-risk behavior, enhancing AIDS-related knowledge, and improving safer sex self-efficacy among men who have sex with men in resource-limited settings. These findings provide valuable guidance for future HIV prevention and control efforts targeting this population.

References

1. 1.Mai, H., Liu, J., Cheng, L., Liang, H., Cui, P., Yao, Q., Cao, Q., Zhang, H., Liao, W., He, S., Yang, X., Cen, P., & Huang, J. (2026). Social Media Intervention Based on the Information-Motivation-Behavioral Skills Model Promotes HIV Testing and Reduces High-Risk Behaviors Among Men Who Have Sex With Men in Resource-Limited Settings in China: Randomized Controlled Trial. *Journal of Medical Internet Research*, *28*(4), e84279. https://doi.org/10.2196/84279