Promoting routine syphilis screening among men who have sex with men in China: study protocol for a randomised controlled trial of syphilis self-testing and lottery incentive

• Published in: BMC infectious diseases Vol. 20; no. 1; pp. 1 - 455
• Main Authors: Cheng, Weibin, Wang, Cheng, Tang, Weiming, Ong, Jason J, Fu, Hongyun, Marks, Michael, Smith, M. Kumi, Li, Changchang, Nie, Juan, Zhao, Peizhen, Zheng, Heping, Yang, Bin, Tucker, Joseph D
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 29.06.2020; BioMed Central; BMC
• Subjects: Clinical trials; Crowdsourcing; Digital imaging; Digital media; Disease control; Health aspects; Health promotion; HIV; Human immunodeficiency virus; Infectious diseases; Medical tests; MSM; Randomization; Screening; Self testing; Self tests; Self-test; Sexually transmitted diseases; Social networks; Social research; STD; Studies; Study Protocol; Syphilis; China
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-020-05188-z

Men who have sex with men (MSM) bear a high burden of syphilis infection. Expanding syphilis testing to improve timely diagnosis and treatment is critical to improve syphilis control. However, syphilis testing rates remain low among MSM, particularly in low- and middle-income countries. We describe the protocol for a randomised controlled trial (RCT) to assess whether provision of syphilis self-testing services can increase the uptake of syphilis testing among MSM in China. Four hundred forty-four high-risk MSM will be recruited online and randomized in a 1:1:1 ratio to (1) standard syphilis self-testing arm; (2) a self-testing arm program enhanced with crowdsourcing and a lottery-based incentive, and (3) a standard of care (control). Self-testing services include a free syphilis self-test kit through the mail at monthly intervals. Participants in the lottery incentive arm will additionally receive health promotion materials generated from an open crowdsourcing contest and be given a lottery draw with a 10% chance to win 100 RMB (approximately 15 US Dollars) upon confirmed completion of syphilis testing. Syphilis self-test kits have step-by-step instructions and an instructional video. This is a non-blinded, open-label, parallel RCT. Participants in each arm will be followed-up at three and 6 months through WeChat (a social media app like Facebook messenger). Confirmation of syphilis self-test use will be determined by requiring participants to submit a photo of the used test kit to study staff via secure data messaging. Both self-testing and facility-based testing will be ascertained by sending a secure photographic image of the completed kit through an existing digital platform. The primary outcome is the proportion of participants who tested for syphilis in the past 3 months. Trial registration