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Now published in The Lancet

Contagious Kindness Through Pay-it-Forward Gonorrhea and Chlamydia Testing Among Men Who Have Sex with Men in China: A Pragmatic, Quasi-Experimental Study

30 Pages Posted: 25 Aug 2018

See all articles by Katherine T. Li

Katherine T. Li

Cornell University - Weill Cornell Medicine

Weiming Tang

University of North Carolina Project-China; Dermatology Hospital of Southern Medical University

Dan Wu

University of North Carolina (UNC) at Chapel Hill - Project-China

Wenting Huang

Emory University

Feng Wu

University of North Carolina (UNC) at Chapel Hill - Project-China

Amy Lee

University of North Carolina (UNC) at Chapel Hill - Project-China

Henry Feng

University of North Carolina (UNC) at Chapel Hill - Project-China

Stephen W. Pan

Xi'an Jiaotong-Liverpool University (XJTLU)

Larry Han

University of North Carolina (UNC) at Chapel Hill - Project-China

Vincent Mak

University of Cambridge - Cambridge Judge Business School

Ligang Yang

Southern Medical University - Dermatology Hospital

Joseph D. Tucker

University of North Carolina (UNC) at Chapel Hill - Division of Infectious Disease

More...

Abstract

Background: Chinese MSM rarely receive gonorrhea or chlamydia testing. The purpose of this pilot study was to evaluate a pay-it-forward strategy to increase gonorrhea/chlamydia testing among MSM.
Methods: We used a quasi-experimental pragmatic study to compare a pay-it-forward model to standard of care at two free HIV testing sites for MSM. A pay-it-forward gonorrhea/chlamydia dual testing program was implemented for three months, during which men were offered free testing and given the option of donating money toward testing for future participants. Both sites then switched to standard of care for two months, offering dual testing at the standard price of $24 USD. All men completed a survey reporting sociodemographic characteristics, sexual behaviors, and previous STD testing.
Findings: 408 men were included in this study. 203 men were offered pay-it-forward, and 205 were offered standard of care. Gonorrhea/chlamydia testing uptake was 53·7% (109/203) in the pay-it-forward group and 5·9% (12/205) in the standard of care group (aOR=19·74, 95%CI 10·03-38·85, p<0·001). This was a first gonorrhea or chlamydia test for 80% (97/121) and 86% (104/121) of total testers, respectively. 4% (5/121) were diagnosed with gonorrhea, and 12% (15/121) were diagnosed with chlamydia. 89% (97/109) of men in the pay-it-forward group donated any amount, and the mean contribution was $10 USD. Donations accrued through pay-it-forward supported 80% of the cost of testing.
Interpretation: Pay-it-forward may be a sustainable model for expanding integrated STD/HIV testing services among MSM in China.
Funding: National Institutes of Health, Southern Medical University Dermatology Hospital, Doris Duke Charitable Foundation
Conflict of Interest: JDT and WT are on the advisory board for SESH Global, which was involved in organizing the study. All other authors declare no competing interests
Ethical Approval Statement: Ethical approval for this study was obtained from the institutional review board at the University of North Carolina-Chapel Hill.

Keywords: MSM; China; gonorrhoea; chlamydia; screening; generosity

Suggested Citation

Li, Katherine T. and Tang, Weiming and Wu, Dan and Huang, Wenting and Wu, Feng and Lee, Amy and Feng, Henry and Pan, Stephen W. and Han, Larry and Mak, Vincent and Yang, Ligang and Tucker, Joseph D., Contagious Kindness Through Pay-it-Forward Gonorrhea and Chlamydia Testing Among Men Who Have Sex with Men in China: A Pragmatic, Quasi-Experimental Study (January 7, 2018). Available at SSRN: https://ssrn.com/abstract=3207927 or http://dx.doi.org/10.2139/ssrn.3207927

Katherine T. Li

Cornell University - Weill Cornell Medicine

1300 York Avenue
New York, NY 10065
United States

Weiming Tang

University of North Carolina Project-China ( email )

Guangzhou, 510095
China

Dermatology Hospital of Southern Medical University

Guangzhou
China

Dan Wu

University of North Carolina (UNC) at Chapel Hill - Project-China

NC
United States

Wenting Huang

Emory University

201 Dowman Drive
Atlanta, GA 30322
United States

Feng Wu

University of North Carolina (UNC) at Chapel Hill - Project-China

NC
United States

Amy Lee

University of North Carolina (UNC) at Chapel Hill - Project-China

NC
United States

Henry Feng

University of North Carolina (UNC) at Chapel Hill - Project-China

NC
United States

Stephen W. Pan

Xi'an Jiaotong-Liverpool University (XJTLU)

111 Renai Road, SIP
, Lake Science and Education Innovation District
Suzhou, JiangSu province 215123
China

Larry Han

University of North Carolina (UNC) at Chapel Hill - Project-China

NC
United States

Vincent Mak (Contact Author)

University of Cambridge - Cambridge Judge Business School ( email )

Trumpington Street
Cambridge, CB2 1AG
United Kingdom
+44 (0)1223 764295 (Phone)
+44 (0)1223 339701 (Fax)

Ligang Yang

Southern Medical University - Dermatology Hospital

China

Joseph D. Tucker

University of North Carolina (UNC) at Chapel Hill - Division of Infectious Disease ( email )