This is a randomized controlled trial which will evaluate dual gonorrhea/chlamydia test uptake and other outcomes in men who have sex with men (MSM) in three trial arms - 1) a pay-it-forward testing arm, 2) a pay-what-you-want testing arm, and 3) standard of care arm.
At both of the program sites, MSM partaking in HIV and syphilis testing will be offered dual gonorrhea/chlamydia testing. First, all men will be provided a brief (5 minute) introduction to gonorrhea and chlamydia testing using a pamphlet. Program organizers will then explain the pay-it-forward program to each man separately. Briefly, men will be told that the hospital list price of gonorrhea and chlamydia testing was 150 RMB ($24 USD), but previous men attending the clinic had donated money to cover the cost of his test. Thus, each man could receive a free gonorrhea and chlamydia test, then decide whether to donate money (pay-it-forward) for future men to receive the same option. Men will be assured that donating is completely optional and advised to pay any amount that is feasible for them. Each man's gonorrhea and chlamydia test fees will be covered by a combination of the initial funding pool from the program organizers and the donations from previous participants. Men will also be shown a postcard with a message written by a previous pay-it-forward contributor. Messages will contain information encouraging men to be tested/slogans to promote sexual health and testing (i.e. taking ownership of their health). They will be told that they could also write a postcard message for a future participant. Men will then decide whether or not to receive combined urine gonorrhea/chlamydia testing. Program organizers will inform participants of their test results via WeChat. Patients with positive test results will be counseled and directed to the WeChat page of designated hospitals where they could make an appointment to receive treatment and follow-up.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
301
Participants will be offered a gift of free gonorrhea and chlamydia testing made available by donations from previous testers, and asked whether they would like to donate money (pay-it-forward) for future men to receive the same option.
Participants will be offered gonorrhoea and chlamydia testing and told that they can decide and pay any desired amount after receiving the test.
Southern Medical University
Guangzhou, Guangdong, China
Zhitong Guangzhou LGBT Center
Guangzhou, Guangdong, China
BlueD Danlan Happy Testing Office
Beijing, China
Number of Participants Who Received the Dual Gonorrhea/Chlamydia Testing
Dual gonorrhea/chlamydia test uptake as assessed by administrative records in each arm.
Time frame: During enrollment visit, an approximate total of 1.5 hours
Number of Participants Tested Positive for Gonorrhea
The number of men who tested positive for gonorrhea through this study. Samples were collected either from urine or rectum.
Time frame: During enrollment visit, an approximate total of 1.5 hours
Number of Participants Tested Positive for Chlamydia
The is the number of men who tested positive for chlamydia through this study
Time frame: During enrollment visit, an approximate total of 1.5 hours
Cost Per Test
Cost per test, defined as the cost associated with respective interventions (development, start-up, implementation, intervention) per individual who reported testing for gonorrhea and chlamydia following the intervention; economic test and financial cost are reported separately.
Time frame: During enrollment visit, an approximate total of 1.5 hours
Cost Per Diagnosis
Cost per diagnosis, defined as the cost associated with respective interventions (development, start-up, implementation, intervention) per individual who tested positive for gonorrhea and/or chlamydia following the intervention. Cost using economic cost and financial cost were respectively reported.
Time frame: During enrollment visit, an approximate total of 1.5 hours
Number of Participants Reporting Community Engagement Activities
Number of participants who reported yes/no to specific questions on the awareness of and/or participation in MSM-related causes, organizations, or community events
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Time frame: During enrollment visit, an approximate total of 1.5 hours
Community Connectedness Scale Scores
Community connectedness scales include six statements and Likert scale response ranging from 1= Strongly disagree, 2= Agree, 3= Disagree, and 4= Strongly agree. For each scale item, the range spans across 1 to 4, with higher score indicating more agreement with the statement and potentially higher community connectedness.
Time frame: During enrollment visit, an approximate total of 1.5 hours
Social Cohesion Scale Scores
Social cohesion is a scale made of seven statements and Likert response to them ranging from 1= strongly disagree, 2 = disagree, 3 = agree, and 4= strongly agree. Those questions asked about the feelings of being able to depend on a larger MSM community (i.e., tongzhi circle, gay online networks or groups). For each item, the range spans across 1 to 4. For items 1 to 5, the higher score, the more agreement with the statement and potentially the higher social cohesion. Item 6 and 7 are reversely scored, meaning that the higher the score, the lower social cohesion potentially.
Time frame: During enrollment visit, an approximate total of 1.5 hours