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Table 2 eHealth and HIV testing and linkage to care

From: Using eHealth to engage and retain priority populations in the HIV treatment and care cascade in the Asia-Pacific region: a systematic review of literature

Study Country Study design Study Population Sample size (N=) Technology mode Purpose of study Study description Key outcomes of interest in this review Results/Authors’ conclusions
SMS reminders to increase HIV testing and re-testing
Bourne et al. 2011 Australia Cross-sectional MSM
I = 714
C = 1084
PI = 1753
SMS Evaluate impact of SMS reminder system on HIV/STI re-testing rates SMS testing reminders were sent 3–6 monthly for MSM considered high-risk based on self-reported sexual behaviour.
Comparison of HIV/STI re-testing rates among 3 groups.
HIV re-testing rates Significant increase HIV re-testing rates within 9 months, I (64%) vs. C (30%) (p < 0.001) and I (64%) vs. PI (31%) (p < 0.001).
SMS group was 4.4 times more likely to re-test than Control (95% CI 3.5 to 5.5, p < 0.001); SMS group was 3.1 times more likely to re-test than PI group (95% CI 2.5 to 3.8, p < 0.001).
Instant messaging to promote HIV testing
Zou et al. 2013 China Cross-sectional MSM
N = 429
Instant messaging Explore the feasibility of using internet outreach to encourage MSM to get tested for HIV Two trained MSM volunteers promoted VCT using active (instant messaging, chat rooms, mobile phone, email) and passive (website banner ads) methods.
Those who came for testing completed a survey and HIV/syphilis tests.
HIV testing uptake
Motivation for seeking HIV testing
Response to internet outreach
Instant messaging was the most effective mode for HIV testing promotion (1:4 men). The email was the least effective (1:140 men).
Active internet outreach recruited younger MSM (X2 = 11.400, p = 0.001), never tested for HIV (X2 = 4.281, p = 0.039), tested less often (X2 = 5.638, p = 0.018).
Note: Internet effective in encouraging testing but a confounding factor of financial reward.
Social media campaigns to increase HIV testing in MSM
Cheng et al. 2016 China Cross-sectional MSM
Primary outcome N = 22,282
Secondary outcomes N = 999
Social media
Evaluate impact of integrated service including internet based prevention services, online-to-offline line service linkage and offline one-stop shop service Three project components:
(1) internet-based prevention services to facilitate HIV prevention; (2) online-to-offline service linkage-online appointments for MSM for HIV testing; and (3) offline one-stop shop service-HIV testing and linkage to care for PLHIV
Primary outcome: HIV testing uptake
Secondary outcomes: linkage to and retention in care
Six years of project implementation, the project accounted for 80% of total HIV tests (22,282/26,884) and new HIV diagnoses (999/1218) among MSM in Guangzhou.
Of the 999 HIV-positive diagnoses, 948 (95%) linked to care services, while 891 (94%) of those linked were successfully retained in care.
Ko et al. 2013 Taiwan Cross-sectional MSM
N = 1037
Social media Evaluate the effectiveness of iPOL in disseminating information about HIV, increasing the frequency of HIV testing, and reducing risky behaviours The iPOLs actively disseminated HIV-related information via the Facebook social networking website and discussed and responded to questions from Internet-using MSM.
MSM who visited the intervention or control website were surveyed after 6 months.
Frequency of online discussion or accessing information about HIV
Incidence of HIV testing and condom use
MSM who visited intervention website were more likely to have HIV tests within 6 months (43.89% vs. 22.31%, p < 0.001); consistently use condoms during anal sex with online sex partners (34.15% vs. 26.19%, p = 0.004); receive HIV-related information (25.49% vs.10.47%, p < 0.001); discuss HIV issues with others (41.88% vs. 23.79%, p < 0.001); review articles about HIV (90.58% vs.79.73%, p < 0.001); and be asked about or discuss HIV-related questions (51.11% vs. 31.78%, p < 0.001) than those on the control website.
Web-based health promotion to increase HIV testing
Minas et al. 2012 Australia Cross-sectional MSM
Various sample size as multiple methods of evaluation
Website Evaluation of a communication strategy to improve the awareness and appropriate use of nPEP The communication strategy included:
• development of nPEP information pamphlet for distribution through gay websites
• nPEP resources (aimed at people at risk of acquiring HIV) and the Western Australia nPEP guidelines aimed at HCWs available on Western Australia AIDS Council website
• 24 h nPEP phone line
Immediate outcomes:
• Access and use of nPEP information
• Awareness of nPEP among MSM and HCWs
Ultimate outcomes:
• nPEP treatment practice and follow up testing
Significant increase in the proportion of clients tested for HIV at 3 to 4 months after the initial visit (38.8% in 2002–2005 to 51.9% in 2008–2010, p = 0.023).
No increase in clients tested at six to seven month after the initial visit.
Pedrana et al. 2012 Australia Cross-sectional MSM
N = 295
Social marketing campaign Evaluate the impact of a social marketing campaign in 2008–2009 aimed to increase health-seeking behaviour and STI testing and enhance HIV/STI knowledge in gay men Impact evaluation of “Drama Downunder” health promotion campaign, by surveying online sample of gay men and analysing HIV and other STI testing data from high case load clinics before, during and after the campaign. HIV/STI testing Compared with the pre-campaign period, 17% increase in HIV testing rate (p < 0.01) were observed during the initial campaign period and 27% increase (p < 0.01) during the continued campaign period.
Wilkinson et al. 2016 Australia Cohort MSM
N = 242
Social marketing campaign Evaluate impact of campaign on HIV sexual health testing Impact evaluation of social marketing campaign, by surveying online sample of MSM and analysing HIV and other STI testing data from Victorian Primary Care Network for Sentinel Surveillance HIV network before, during and after the campaign. HIV/STI testing among MSM Though increasing HIV/STI testing trends were observed for MSM pre and post marketing period, there was insufficient evidence to significantly attribute impact exclusively to the campaign.