Effectiveness and safety of community-led assisted partner service among HIV-diagnosed men who have sex with men: a multicentre, randomized controlled trial in China

Ze-Hao Ye; Fan Liu; Zhen-Xing Chu; Jun-Yi Duan; Jie Yang; Jia-Xin Zheng; Xiao-Yan Bi; Hai-Bo Ding; Yong-Jun Jiang; Jun-Jie Xu; Qing-Hai Hu; Hong Shang

doi:10.1016/j.lanwpc.2023.100772

Effectiveness and safety of community-led assisted partner service among HIV-diagnosed men who have sex with men: a multicentre, randomized controlled trial in China

Lancet Reg Health West Pac. 2023 May 16:36:100772. doi: 10.1016/j.lanwpc.2023.100772. eCollection 2023 Jul.

Authors

Ze-Hao Ye^{1

2

3

4

5}, Fan Liu^{1

2

3

4}, Zhen-Xing Chu^{1

2

3

4}, Jun-Yi Duan⁶, Jie Yang⁷, Jia-Xin Zheng⁸, Xiao-Yan Bi^{1

2

3

4}, Hai-Bo Ding^{1

2

3

4}, Yong-Jun Jiang^{1

2

3

4}, Jun-Jie Xu^{1

2

3

4}, Qing-Hai Hu^{1

2

3

4}, Hong Shang^{1

2

3

4}

Affiliations

¹ NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Centre for Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China.
² Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.
³ Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China.
⁴ Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
⁵ Ningbo Municipal Centre for Disease Control and Prevention, Ningbo, 315010, China.
⁶ Tian Yuan Studio, Beijing You'an Hospital, Beijing, 100069, China.
⁷ Shenlan Public Health Advisory Service Centre, Tianjin, 300122, China.
⁸ Yikang Social Work Service Centre, Shenbei New District, Shenyang, 110001, China.

Abstract

Background: No randomized controlled trials have involved established HIV-diagnosed men who have sex with men (MSM) diagnosed for more than 6 months into the assisted partner service (aPS). We compared voluntary aPS involving community-based organizations (CBOs) and HIV self-testing (aPSST) with regular partner service (rPS) in HIV-diagnosed MSM irrespective of diagnosis time.

Methods: In this unblinded, multicentre trial, we enrolled HIV-diagnosed MSM irrespective of diagnosis time in three cities in northern China. Index patients were randomly assigned to aPSST or rPS. Index patients in the aPSST group were additionally provided a comprehensive intervention package including HIV self-testing and CBO-based aPS compared with rPS group. The primary outcome was the number of index patients whose any sexual partner tested for HIV during the 6-month study. Completion of HIV testing was defined as sexual partners taking a clinic-based HIV test or HIV self-testing. Safety was assessed preliminary at the end of the 6-month follow-up. This study has been registered at chictr.org.cn (ChiCTR2000038784).

Findings: From March to December 2021, 325 of HIV-diagnosed MSM were enrolled (90⋅2% were established HIV-diagnosed MSM) and randomly assigned to receive aPSST (n = 167) or rPS (n = 158). At 6 months, 110 (65⋅9%) index patients in the aPSST group had at least one sexual partner tested for HIV compared with 50 (31⋅6%) in the rPS group (hazard ratio 2⋅86; 95% confidence interval 2⋅03-4⋅03; p < 0⋅001). No significant difference was observed in effects of aPSST on HIV testing promotion between established and newly HIV-diagnosed MSM. Self-reported harms were infrequently observed in both groups (approximately 2⋅0%).

Interpretation: Among HIV-diagnosed MSM regardless of diagnosis time, voluntary aPS involving CBOs and HIV self-testing was effective and safe for promoting partner HIV testing.

Funding: This work was supported by the Mega-Projects of National Science Research, the National Natural Science Foundation of China and the Liaoning Revitalization Talents Program, China.

Keywords: Assisted partner service; Community-based organization; HIV self-testing; Men who have sex with men.