@文章{信息:doi/10.2196/46514，作者=“关子志与陈，钟佩琪与黄，杨山与李水山”，标题=“基于社交网络的层次化——男男性行为者艾滋病自我检测方法的实施:横断面研究”，期刊=“J Med Internet Res”，年=“2023”，月=“4”，日=“26”，卷=“25”，页=“e46514”，关键词=“社区检测服务;横断面研究;艾滋病自测;艾滋病毒检测;艾滋病毒;实现级联;与男性发生性关系的男性;社交网络;病毒传播"，摘要="背景:艾滋病毒检测是实现到2030年终结艾滋病流行的快车道目标战略的基石。自我测试已被证明是男男性行为者(MSM)的有效健康干预措施。 While social network--based approaches for distributing HIV self-tests are recommended by the World Health Organization, their implementation consists of multiple steps that need to be properly evaluated. Objective: This study aimed to assess the implementation cascade of a social network--based HIV self-test approach for reaching MSM who had never undergone testing in Hong Kong. Methods: This is a cross-sectional study. Seed MSM participants were recruited through different web-based channels, who in turn invited their peers to participate in this study. A web-based platform was set up to support the recruitment and referral process. Participants could request for an oral fluid or a finger-prick HIV self-test, with or without real-time support, after completing a self-administered questionnaire. Referrals could be made upon uploading the test result and passing the web-based training. Characteristics of participants completing each of these steps and their preferences for the type of HIV self-test were evaluated. Results: A total of 463 MSM were recruited, including 150 seeds. Participants recruited by seeds were less likely to have previously been tested for HIV (odds ratio [OR] 1.80, 95{\%} CI 1.06-3.04, P=.03) and have lower confidence in performing self-tests (OR 0.66, 95{\%} CI 0.45-0.99, P=.045). Almost all (434/442, 98{\%}) MSM who completed the questionnaire requested a self-test, of whom 82{\%} (354/434) had uploaded their test results. Participants requesting support were new to self-testing (OR 3.65, 95{\%} CI 2.10-6.35, P<.001) and less confident in carrying out the self-test correctly (OR 0.35, 95{\%} CI 0.22-0.56, P<.001). More than half (216/354, 61{\%}) of the eligible participants initiated the referral process by attempting the web-based training with a passing rate of 93{\%} (200/216). They were more likely to have sought sex partners (OR 2.20, 95{\%} CI 1.14-4.25, P=.02), especially through location-based networking apps (OR 2.13, 95{\%} CI 1.31-3.49, P=.002). They also gave higher usability scores along the implementation cascade (median 81 vs 75, P=.003). Conclusions: The social network approach was effective in diffusing HIV self-tests in the MSM community and reaching nontesters. Support and option to choose a preferable type of self-test are essential to address users' individual needs when delivering HIV self-tests. A positive user experience throughout the processes along the implementation cascade is vital to transform a tester into a promoter. Trial Registration: ClinicalTrials.gov NCT04379206; https://clinicaltrials.gov/ct2/show/NCT04379206 ", issn="1438-8871", doi="10.2196/46514", url="//www.mybigtv.com/2023/1/e46514", url="https://doi.org/10.2196/46514", url="http://www.ncbi.nlm.nih.gov/pubmed/37099364" }