Abstract
BACKGROUND: Social app recruiting-based and peer-led testing strategies have been proven effective in increasing human immunodeficiency virus (HIV) testing among men who have sex with men (MSM), though their combination remains underevaluated. We aimed to assess the efficiency of a combined strategy named "standardly trained peer volunteer-led, social app recruiting-based HIV testing strategy using rapid testing kits" (SPARK). METHODS: Between March 2020 and December 2021, 177 trained peer volunteers tested 7256 eligible MSM testers. Volunteers primarily recruited testers to undergo HIV testing and counseling in social apps. Volunteers tested testers with HIV rapid antibody tests and interviewed testers while waiting for the results. Moreover, HIV testing data from other testing strategies, both pre- and postimplementation of SPARK, were collected to evaluate the capacity of SPARK to increase HIV testing. RESULTS: During this study, MSM testers underwent 10 441 HIV tests; HIV testing volume increased 3-fold from 2020 to 2021. On average, each volunteer recruited 40.99 testers and facilitated 58.99 HIV tests. After SPARK implementation, HIV tests in 2021 increased 1-fold compared with those in 2019; especially for rural MSM testers, the number of HIV tests performed in 2020 and 2021 increased to 2.86 and 5.85 times, respectively, that in 2019. In spatial analysis, most testers sought geographical proximity volunteers for testing; similarly, most testers recruited were from volunteers' own or nearby districts. More than 60% of HIV tests were performed outside of working hours on weekdays, regardless of whether the testers came from urban, periurban, or rural areas. CONCLUSIONS: SPARK, an MSM-friendly, geographically accessible, and time-flexible testing strategy, has the potential to promote HIV testing among MSM.