Peer-led online communities effective in increasing HIV self-testing among MSM of color

Reviewed by Emily Henderson, B.Sc.Feb 28 2022

A new University of California, Irvine-led study, called the HOPE (Harnessing Online Peer Education) HIV study, revealed that using peer-led online communities was successful in increasing HIV self-testing and reducing alcohol consumption among Latinx and African American MSM (men who have sex with men).

Published today in the Journal of AIDS, the study involved a total of 900 HIV negative and/or serostatus unknown Los Angeles-based MSM subjects, who participated in a 12-week intervention between December 2016 and September 2020. The intervention was conducted via Facebook and led by peer leaders trained in HOPE, which involves the psychology of how you change people's attitudes and behaviors. Of the participants, 68.9 percent were Latinx, 16 percent were African American and 7.4 percent were White.

We randomly assigned participants to intervention through peer-led Facebook groups designed to build trust and deliver HIV testing information. Participants in control groups were assigned to groups without peer leaders. What we found, was that compared to control group participants, our intervention group participants were significantly more likely to accept the offer for the HIV self-testing kit, report having taken an HIV self-test within the past three months, and report drinking fewer glasses of alcohol in an average week."

Sean Young, PhD, Associate Professor, UCI School of Medicine and UCI School of Informatics, Information and Computer Sciences

The HOPE HIV study was designed to test the effectiveness of using peer-led online communities to increase HIV self-testing, by changing social norms and testing whether Latinx and African American MSM who receive peer-delivered HIV prevention information over Facebook Groups, compared to control Facebook Groups without peer leaders, are more likely to request an HIV self-testing kit and report decreased risk behaviors.

Our results are exciting because they take proven behavior change approaches and apply them to online communities and social media, by using the HOPE online community intervention. Because HOPE is an online approach to behavior change, it may be a highly cost-effective platform for scaling health behavior change among MSM of color and other communities with health disparities."

Latinx and African Americans in Los Angeles, California have high rates of both prevalent HIV cases and new diagnoses. Cases have primarily occurred among MSM who currently account for more than 80 percent of all new diagnoses in the city. Approximately one in nine HIV positive individuals in Los Angeles are estimated to be unaware of their infection.

Novel strategies are needed to increase HIV prevention and testing efforts among Latinx and African American MSM. Innovative programs, like the HOPE program, have proven successful in reaching diverse audiences and underserved communities.

The Harnessing Online Peer Education (HOPE) intervention program is a peer-led online community-based behavior change intervention, and one example of a theoretical framework, called the Adaptive Behavioral Components (ABC) theory for technology-based interventions. The goals of this theory are to guide high-level development for digital health technology–based interventions; help interventionists consider, plan for, and adapt to potential barriers that may arise during longitudinal interventions; and provide a framework to potentially help increase consistency of findings among digital technology intervention studies.

This work was funded by the National Institute of Mental Health.