Abstract
BackgroundNotably, both international and local studies have found a high prevalence of sexually transmitted infections (STIs) and risky sexual behaviours, such as condomless anal sex, substance misuse in conjunction with sex (‘chemsex’) and group sex, among men who have sex with men (MSM) dating application (app) users. Although the use of dating apps is an emerging sexual risk factor, little effort has been expended on the promotion of safe sex and good sexual health among the users of those apps. Therefore, the aim of the proposed study is to develop and evaluate the effectiveness of an interactive web-based intervention in improving the sexual health of MSM dating app users in Hong Kong.MethodsA two-armed randomised controlled trial will be conducted. Chinese MSM dating app users will be recruited and randomly allocated into either the intervention (n = 200) or control group (n = 200). Subjects in the intervention group will receive the web-based intervention containing interactive content that (1) encourages a positive attitude towards consistent condom use and HIV/STI testing and negative attitude towards chemsex and group sex; (2) positions condom use and regular HIV/STI testing as normative; and (3) targets improved perceived self-efficacy concerning condom use and negotiation and HIV/STI testing. The control group will receive only web-based information without sexual health components. Subjects in both groups will be evaluated at baseline and three and 6 months after baseline. The primary outcome will be the frequency of condomless anal sex in the past 3 months.DiscussionThe proposed study will aid development of culturally relevant health promotion programmes aimed at minimising the potential harm of dating app use and promoting the sexual health of MSM dating app users. The web-based intervention, if found successful, will have important clinical and policy implications, as it can be adopted by the government and non-governmental organisations targeting MSM. Moreover, the proposed intervention can reach many MSM at relatively low cost, and thus has the potential to check the burgeoning HIV/STI epidemic among MSM in Hong Kong in a cost-effective manner.Trial registrationInternational standard randomized controlled trial number (ISRCTN) registry: ISRCTN16681863 registered on 28 April 2020.
Highlights
Both international and local studies have found a high prevalence of sexually transmitted infections (STIs) and risky sexual behaviours, such as condomless anal sex, substance misuse in conjunction with sex (‘chemsex’) and group sex, among men who have sex with men (MSM) dating application users
The proposed study will aid development of culturally relevant health promotion programmes aimed at minimising the potential harm of dating app use and promoting the sexual health of MSM dating app users
Another study on MSM dating app users in Hong Kong found that about 30% of participants had had more than three sexual partners, 25% had engaged in condomless anal sex with casual partners, 20% had had condomless anal sex with internal ejaculation, 15% had used alcohol in conjunction with sex in the past 6 months, 13% had had group sex, 8% had had chemsex [30]
Summary
Study design It is a two-armed non-blinded randomised control trial (RCT) design (with a 6-month follow-up period) will be adopted for this study. Control group The control group will participate in a web-based intervention with no sexual health information Participants in both groups will be afforded unlimited access to their allocated content over the 6-month study period, but that content will be available only to participants who log in with a registered email address and password. Frequency of condomless anal sex in the past 3 months is measured by a self-reported item at baseline, 3-month follow-up and 6-month follow-up. Frequency of group sex in the past 3 months is measured by a self-reported item at baseline, 3month follow-up and 6-month follow-up. Frequency of HIV testing in the past 3 months is measured by a self-reported item at baseline, 3month follow-up and 6-month follow-up. Frequency of STI testing in the past 3 months is measured by a self-reported item at baseline, 3month follow-up and 6-month follow-up. Model adequacy will be verified by examining the standardised residuals for normality and constant variance
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