A mixed-methods study on the acceptability of using eHealth for HIV prevention and sexual health care among men who have sex with men in China.
BACKGROUND
Human immunodeficiency virus (HIV) infection disproportionately affects men who have sex with men (MSM). Over half of all HIV-positive MSM in China may not know their HIV status. Mobile phones and Web interventions (eHealth) are underutilized resources that show promise for supporting HIV education, testing, and linkage to care.


OBJECTIVE
This mixed-methods study among MSM in China assessed technology utilization and eHealth acceptability for sexual health care.


METHODS
We conducted in-depth interviews and an online survey. Qualitative analyses informed the development of the Internet survey, which was administered through two popular MSM websites. Bivariate and multivariate analysis assessed characteristics of MSM interested in eHealth for sexual health care.


RESULTS
The qualitative sample included MSM across a range of ages, education, marital status, sexuality, and HIV testing experience. Qualitative findings included the importance of the Internet as the primary source of information about sexual health, HIV and other sexually transmitted diseases (STDs), use of the Internet to enable HIV testing opportunities by facilitating connections with both the gay community and health care providers, and mixed perceptions regarding the confidentiality of eHealth tools for sexual health. Among the Internet sample (N=1342), the average age was 30.6 years old, 82.81% (1098/1342) were single, and 53.42% (711/1331) had completed college. In the past 3 months, 38.66% (382/988) had condomless sex and 60.53% (805/1330) self-reported having ever tested for HIV. The majority of men owned computers (94.14%, 1220/1296) and mobile phones (92.32%, 1239/1342), which many had used to search for HIV/STD information and testing sites. In multivariate analysis, interest in using computers or mobile phones to support their sexual health care was associated with being a student, prior use of computers or mobile phones to search for general health information, prior use of computers or mobile phones to search for HIV/STD information, and confidentiality concerns.


CONCLUSIONS
MSM in this sample had high utilization of technology and interest in eHealth despite confidentiality concerns. Future eHealth interventions can thoughtfully and creatively address these concerns as a priority for successful implementation.
['Muessig|Kathryn E|KE|http://orcid.org/0000-0002-8522-3240', 'Bien|Cedric H|CH|http://orcid.org/0000-0003-0182-5680', 'Wei|Chongyi|C|http://orcid.org/0000-0002-4424-5523', 'Lo|Elaine J|EJ|http://orcid.org/0000-0003-1957-5296', 'Yang|Min|M|http://orcid.org/0000-0001-6745-1429', 'Tucker|Joseph D|JD|http://orcid.org/0000-0003-2804-1181', 'Yang|Ligang|L|http://orcid.org/0000-0002-6775-8970', 'Meng|Gang|G|http://orcid.org/0000-0003-1067-6007', 'Hightow-Weidman|Lisa B|LB|http://orcid.org/0000-0002-2421-923X']
D000328:Adult D040421:Cell Phone D002681:China D015658:HIV Infections D018451:Homosexuality, Male D006801:Humans D020407:Internet D008297:Male D008875:Middle Aged D010342:Patient Acceptance of Health Care D060728:Reproductive Health D012749:Sexually Transmitted Diseases D017216:Telemedicine
HIV men who have sex with men China Internet sexually transmitted diseases AIDS mixed method