Effect of a popular web drama video series on HIV and other sexually transmitted infection testing among gay, bisexual and other men who have sex with men in Singapore: a community-based, pragmatic, randomized controlled trial amidst the COVID-19 pandemic (Preprint)

BACKGROUND Gay, bisexual and other men who have sex with men (GBMSM) are at disproportionately higher risk of acquiring HIV and other sexually transmitted infections (STI). While HIV/STI testing rates among GBMSM are increasing worldwide, they remain suboptimal in a variety of settings. While many studies have attempted to evaluate the efficacy of a variety of community-based campaigns, including peer and reminder-based interventions on HIV/STI testing, however few have attempted to do so for a web drama series. OBJECTIVE This study evaluates the effectiveness of a popular web drama video series developed by a community-based organization in Singapore for GBMSM on HIV and other STI testing behaviors. METHODS The study is a pragmatic, randomized controlled trial to evaluate a popular web drama video series developed by a community-based organization in Singapore for GBMSM. A total of 300 HIV-negative, GBMSM men in Singapore aged 18 to 29 years old were recruited and block-randomized into the intervention (n=150) and control arms (n=150). Primary outcomes included changes in self-reported intention to test for, actual testing for, and regularity of testing for HIV, Syphilis, Chlamydia or Gonorrhoea, while secondary outcomes include changes in a variety of other knowledge-based and psychosocial measures at the end of the study period. RESULTS Overall, 125 out of 150 participants (83.3%) in the intervention arm completed the proof of completion survey, compared to 133 out of 150 participants (88.7%) in the control arm. We found statistically significant differences in self-reporting as a regular (at least yearly) tester for HIV (15.9% difference, 95%CI [3.2%, 28.6%]), as well as chlamydia or gonorrhoea (15.5% difference, 95%CI [4.2%, 26.9%]), indicating that the intervention had positively impacted these outcomes compared to the control condition. We also found statistically significant differences in participants’ intentions to test for HIV (16.6% difference, 95%CI [4.3%, 28.9%]), syphilis (14.8% difference, 95%CI [3.2%, 26.4%]), as well as chlamydia or gonorrhoea (15.4% difference, 95%CI [4.2%, 26.6%]), in the next three months, indicating that the intervention was effective in positively impacting intention for HIV and other STI testing among participants. CONCLUSIONS There are clear benefits for promoting intentions to test regularly and prospectively on a broad scale through this intervention. This intervention also has potential to reach GBMSM who may not have access to conventional HIV and other STI prevention messaging, which have typically been implemented at sex-on-premises venues, bars, clubs, and in sexual health settings frequented by GBMSM. When coupled with community or population-wide structural interventions, the overall impact on testing will likely be significant. CLINICALTRIAL Clinicaltrials.gov, NCT04021953 INTERNATIONAL REGISTERED REPORT RR2-http://dx.doi.org/10.1136/bmjopen-2019-033855