Development and Validation of a Personalized Social Media Platform–Based HIV Incidence Risk Assessment Tool for Men Who Have Sex With Men in China

Background Personalized risk assessments can help medical providers determine targeted populations for counseling and risk reduction interventions. Objective The objective of this study was to develop a social media platform–based HIV risk prediction tool for men who have sex with men (MSM) in China based on an independent MSM cohort to help medical providers determine target populations for counseling and risk reduction treatments. Methods A prospective cohort of MSM from Shenyang, China, followed from 2009 to 2016, was used to develop and validate the prediction model. The eligible MSM were randomly assigned to the training and validation dataset, and Cox proportional hazards regression modeling was conducted using predictors for HIV seroconversion selected by the training dataset. Discrimination and calibration were performed, and the related nomogram and social media platform–based HIV risk assessment tool were constructed. Results The characteristics of the sample between the training dataset and the validation dataset were similar. The risk prediction model identified the following predictors for HIV seroconversion: the main venue used to find male sexual partners, had condomless receptive or insertive anal intercourse, and used rush poppers. The model was well calibrated. The bootstrap C-index was 0.75 (95% CI 0.65-0.85) in the training dataset, and 0.60 (95% CI 0.45-0.74) in the validation dataset. The calibration plots showed good agreement between predicted risk and the actual proportion of no HIV infection in both the training and validation datasets. Nomogram and WeChat-based HIV incidence risk assessment tools for MSM were developed. Conclusions This social media platform–based HIV infection risk prediction tool can be distributed easily, improve awareness of personal HIV infection risk, and stratify the MSM population based on HIV risk, thus informing targeted interventions for MSM at greatest risk for HIV infection.

[1]  S. Leuba,et al.  The Effect of Using Geosocial Networking Apps on the HIV Incidence Rate Among Men Who Have Sex With Men: Eighteen-Month Prospective Cohort Study in Shenyang, China , 2018, Journal of medical Internet research.

[2]  S. Vermund,et al.  Risk Prediction Score for HIV Infection: Development and Internal Validation with Cross-Sectional Data from Men Who Have Sex with Men in China , 2018, AIDS and Behavior.

[3]  Bolin Cao,et al.  Social Media Engagement and HIV Testing Among Men Who Have Sex With Men in China: A Nationwide Cross-Sectional Survey , 2017, Journal of medical Internet research.

[4]  Weiming Tang,et al.  Will Gay Sex–Seeking Mobile Phone Applications Facilitate Group Sex? A Cross-Sectional Online Survey among Men Who Have Sex with Men in China , 2016, PloS one.

[5]  Weiming Tang,et al.  Gay mobile apps and the evolving virtual risk environment: a cross-sectional online survey among men who have sex with men in China , 2016, Sexually Transmitted Infections.

[6]  Ning Wang,et al.  HIV incidence and associated risk factors in men who have sex with men in Mainland China: an updated systematic review and meta-analysis. , 2016, Sexual health.

[7]  W. Mcfarland,et al.  Comparing Samples of Men Who Have Sex with Men Recruited Online and in Venues, Jiangsu Province, China, 2013. , 2016, LGBT health.

[8]  Zhao Wang,et al.  WeChat: a new clinical teaching tool for problem-based learning , 2016, International journal of medical education.

[9]  N. Ko,et al.  Seeking sex partners through the internet and mobile phone applications among men who have sex with men in Taiwan , 2016, AIDS care.

[10]  David Thompson,et al.  On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. , 2015, The New England journal of medicine.

[11]  S. Little,et al.  Development and validation of the San Diego Early Test Score to predict acute and early HIV infection risk in men who have sex with men. , 2015, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[12]  J. Bernhardt,et al.  Behavioral Functionality of Mobile Apps in Health Interventions: A Systematic Review of the Literature , 2015, JMIR mHealth and uHealth.

[13]  Jin Wang,et al.  Establishment and assessment of a nomogram for predicting the individual prognosis of osteosarcoma , 2015 .

[14]  M. Emch,et al.  HIV Self-Testing Among Online MSM in China: Implications for Expanding HIV Testing Among Key Populations , 2014, Journal of acquired immune deficiency syndromes.

[15]  G. Fegan,et al.  Evaluation of an empiric risk screening score to identify acute and early HIV-1 infection among MSM in Coastal Kenya , 2013, AIDS.

[16]  Shuzhuo Li,et al.  Same-Sex Sexual Behaviors Among Male Migrants in a Context of Male “Marriage Squeeze” , 2012, American journal of men's health.

[17]  L. Ling,et al.  [Study on the infectious risk model of AIDS among men who have sex with men in Guangzhou]. , 2012, Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi.

[18]  C. Grov.  HIV Risk and Substance Use in Men Who Have Sex with Men Surveyed in Bathhouses, Bars/Clubs, and on Craigslist.org: Venue of Recruitment Matters , 2012, AIDS and Behavior.

[19]  Victoria L. Crittenden,et al.  We're all connected: The power of the social media ecosystem , 2011 .

[20]  C. Beckwith,et al.  Low perceived risk and high HIV prevalence among a predominantly African American population participating in Philadelphia's Rapid HIV testing program. , 2011, AIDS patient care and STDs.

[21]  T. Menza,et al.  Prediction of HIV Acquisition Among Men Who Have Sex With Men , 2009, Sexually transmitted diseases.

[22]  E. Steyerberg.  Clinical Prediction Models , 2008, Statistics for Biology and Health.

[23]  L. Torian,et al.  Perceptions of Lifetime Risk and Actual Risk for Acquiring HIV Among Young Men Who Have Sex with Men , 2007, AIDS and Behavior.

[24]  E. Vittinghoff,et al.  Sexual Risk, Nitrite Inhalant Use, and Lack of Circumcision Associated With HIV Seroconversion in Men Who Have Sex With Men in the United States , 2005, Journal of acquired immune deficiency syndromes.

[25]  M. Ashton,et al.  An outbreak no longer: factors contributing to the return of syphilis in Greater Manchester , 2003, Sexually transmitted infections.

[26]  T. Flanigan,et al.  Internet sex-seeking leads to acute HIV infection: a report of two cases , 2003, International journal of STD & AIDS.

[27]  M. McFarlane,et al.  Soliciting sex on the Internet: what are the risks for sexually transmitted diseases and HIV? , 2000, Sexually transmitted diseases.

[28]  J. Klausner,et al.  Tracing a syphilis outbreak through cyberspace. , 2000, JAMA.

[29]  E. D. Nelson,et al.  Popping and snorting volatile nitrites: a current fad for getting high. , 1978, The American journal of psychiatry.

[30]  Rui Sun,et al.  Establishment and Validation of Prognostic Nomograms for Endemic Nasopharyngeal Carcinoma. , 2016, Journal of the National Cancer Institute.

[31]  M. Lyons,et al.  Derivation and validation of the Denver Human Immunodeficiency Virus (HIV) risk score for targeted HIV screening. , 2012, American journal of epidemiology.