Delivery of WeChat-Based HIV Result e-Reports in Social Networks for Recruitment of High-Risk Population: Baseline Data From a Cluster Randomized Controlled Trial.

BACKGROUND: Disclosure of infectious disease status to social network peers can facilitate reaching and early detection among high-risk populations. In this era of social media, globally, HIV/AIDS represents a high burden of infectious disease. Thus, delivery of an HIV result e-report via social media presents a new approach that has the potential to improve contact with and enrollment of the high-risk population in research studies and routine practice. OBJECTIVE: This study explores the effectiveness and associated factors of a recruitment strategy (ie, WeChat-based HIV e-report delivery in social networks) on the enrollment of men who have sex with men (MSM) for an HIV testing intervention study. METHODS: This was an enrollment result analysis of an ongoing cluster randomized controlled trial (RCT) aiming to promote HIV testing among MSM. Recruitment of potential participants was based on the unit of an egocentric social network, which includes 1 core member (an offline tested ego as the recruiter) and several network members (online alters as network associates). Alters' enrollment and alters' transformation to ego-recruiters (alter-ego) were measured as outcomes. Recruitment outcomes were compared between the exchangeable and regular e-report groups of the RCT. Associated factors of both outcomes were also investigated, including sociodemographic characteristics, health behaviors, social network characteristics, e-report types, and online delivery information. Binary outcomes were modeled using logistic models, with Firth correction for rare events. Qualitative interviews were conducted to understand facilitators and barriers in detail for alter-ego as the subsequent wave's recruiter. RESULTS: The e-report of 1157 egos who tested offline were delivered to 5165 alters in 3 recruitment waves; eventually, 1162 eligible alters enrolled in this RCT (response rate: 22.5%). In the exchangeable e-report group, 544 egos recruited 467 alters, of which 35 alters transformed to alter-egos (7.5%), whereas in the regular e-report group, 613 egos recruited 695 alters, of which 40 alters transformed to alter-egos (5.8%). Alters' enrollment at first wave was associated with a higher number of e-reports being forwarded by the egos. Alters' transformation to alter-egos for the subsequent wave was associated with the exchangeable e-report, higher income, being a Guangzhou resident, unprotected anal intercourse, preferring self-testing, and viewing senders' e-reports frequently. Qualitative interviews revealed that the lack of awareness of e-reports' function and inadequate access to e-reports at offline testing facilities were major barriers to alters' transformation to offline ego-recruiters. CONCLUSIONS: The delivery of e-report was feasible in MSM social network, and the success and sustainability of online recruitment depended on high levels of familiarity among MSM with the digital tool. The HIV e-report exchange mechanism might promote MSM to test HIV offline to get their own e-report for exchange in the community. The e-report provides an innovative recruitment method with great potential to trace direct contacts for infectious diseases studies.

Correction: WeChat-Based HIV e-Report, a New Approach for HIV Serostatus Requests and Disclosures Among Men Who Have Sex With Men: Prospective Subgroup Analysis of a Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/44513.].

WeChat-Based HIV e-Report, a New Approach for HIV Serostatus Requests and Disclosures Among Men Who Have Sex With Men: Prospective Subgroup Analysis of a Randomized Controlled Trial

BACKGROUND: Requesting and disclosing HIV serostatus is associated with a reduction in HIV transmission among men who have sex with men (MSM). However, the reliability of common methods for HIV serostatus request and disclosure is inadequate. Validated approaches for requesting and disclosing HIV serostatus are necessary. OBJECTIVE: The objective of this study was to investigate the use of the HIV e-report as authentic evidence of HIV serostatus among the MSM community in Guangzhou, China. Additionally, the study aimed to explore its correlation with HIV serostatus requesting and disclosure receiving behavior. METHODS: This study is a subgroup analysis of a cluster randomized controlled trial (RCT) that enrolled 357 participants during the first year. Participants in this RCT were recruited from the WeChat-based HIV testing service miniprogram developed by Guangzhou Center for Disease Control and Prevention, China. Participants completed web-based questionnaires at baseline and at the month 3 follow-up, which covered sociodemographic characteristics, HIV-related information, HIV serostatus requests, receiving HIV serostatus disclosures, and HIV e-report usage. Univariate and multivariate logistic regressions were used for data analysis. RESULTS: The WeChat-based HIV e-report was available in Guangzhou when the RCT project started. At the month 3 follow-up, 32.2% (115/357) of participants had their own HIV e-reports, and 37.8% (135/357) of them had received others' HIV e-reports. In all, 13.1% (27/205) and 10.5% (16/153) of participants started to use HIV e-reports to request the HIV serostatus from regular and casual male sex partners, respectively. Moreover, 27.3% (42/154) and 16.5% (18/109) of the regular and casual male sex partners, respectively, chose HIV e-reports to disclose their HIV serostatus. Compared to MSM who did not have HIV e-reports, those who had HIV e-reports and stated, "I had had my own HIV e-report(s) but hadn't sent to others" (multivariate odds ratio 2.71, 95% CI 1.19-6.86; P=.02) and "I had had my own HIV e-reports and had sent to others" (multivariate odds ratio 2.67, 95% CI 1.07-7.73; P=.048) were more likely to request HIV serostatus from their partners. However, no factor was associated with receiving an HIV serostatus disclosure from partners. CONCLUSIONS: The HIV e-report has been accepted by the MSM community in Guangzhou and could be applied as a new optional approach for HIV serostatus requests and disclosures. This innovative intervention could be effective in promoting infectious disease serostatus disclosure among the related high-risk population. TRIAL REGISTRATION: ClinicalTrials.gov NCT03984136; https://clinicaltrials.gov/show/NCT03984136. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12879-021-06484-y.

miR-106b-5p induces immune imbalance of Treg/Th17 in immune thrombocytopenic purpura through NR4A3/Foxp3 pathway.

BACKGROUND: Immune imbalance of regulatory T cells (Treg)/T helper 17 cells (Th17) contributes to the development of immune thrombocytopenic purpura (ITP). The dysregulation of miRNAs is important in the development of ITP. However, the role of miR-106b-5p in Treg/Th17 imbalance remains unknown in ITP. MATERIALS AND METHODS: Peripheral blood was collected from patients with ITP and healthy controls, and CD4 + T cells were further isolated. miR-106b-5p, nuclear receptor subfamily 4 group A member 3 (NR4A3), forkhead box protein 3 (Foxp3), IL-17A, and TGF-ß expressions were detected by qRT-PCR, western blot, or ELISA. The effect of miR-106b-5p on NR4A3 was detected by dual-luciferase reporter gene assay. RESULTS: Compared with healthy controls, miR-106b-5p was elevated in peripheral blood of patients with ITP, and NR4A3 expression was decreased. sh-NR4A3 significantly decreased Foxp3 and TGF-ß expressions, indicating that NR4A3 may regulate Treg differentiation via Foxp3. Additionally, NR4A3 was identified to be a target of miR-106b-5p, and miR-106b-5p was able to negatively modulate NR4A3 expression. Moreover, we found miR-106b-5p induced immune imbalance of Treg/Th17 through NR4A3. In vivo experiments revealed that silencing miR-106b-5p promoted Treg differentiation and increased the number of platelets, suggesting the relief of ITP. CONCLUSION: miR-106b-5p regulated immune imbalance of Treg/Th17 in ITP through the NR4A3/Foxp3 pathway.