Abstract
BACKGROUND: Men who have sex with men (MSM) remain significantly affected by HIV/AIDS due to high-risk sexual behaviors. The adoption rate of preventive measures like pre-exposure prophylaxis (PrEP) use and HIV testing among MSM is insufficient in China, which requires more effective prevention strategies. OBJECTIVE: This study aims to evaluate the feasibility and effectiveness of an Information-Motivation-Behavioral Skills (IMB) model-based digital health intervention in promoting healthy behaviors and reducing high-risk activities among MSM in China. METHOD: A real-world exploratory study in a naturalistic setting without strict control over participants' daily behaviors was conducted using the Blued platform (a popular online geosocial networking platform in China) to deliver the self-developed IMB-based intervention materials to MSM in 3 cities in China, with 3 additional cities as the controls. A questionnaire including items on healthy behavior adoption was administered pre- and post-intervention and finally generated an unmatched pseudo-panel dataset. Multiple logistic regression, linear regression, and structural equation modeling analyses were used to examine the association between the IMB model and outcomes. The χ(2) test, Fisher's exact test, and two-sample independent t-test were utilized to identify potential confounders for further adjustment, and were applied in both the intention-to-treat (ITT) and as-treated (AT) analyses to explore the effectiveness of the intervention. RESULTS: Post-intervention, the intervention group showed a significant increase in HIV testing rates and PrEP awareness compared to the control group. The willingness to use oral PrEP was also improved. The intervention materials were favorably received, with most of the MSM perceiving the form and content of these materials as useful and attractive. CONCLUSION: The IMB model-based digital health intervention effectively increased HIV testing rates and PrEP awareness among MSM. The high acceptance of the intervention materials suggests that such digital platforms can be a cost-effective strategy for HIV prevention in hard-to-reach populations.