BACKGROUND: Gonorrhea and chlamydia are common among Chinese men who have sex with men (MSM), but testing rates are low. We developed a pay-it-forward program where men receive a free gonorrhea/chlamydia test and can then donate toward future participants' tests. This study aims to investigate drivers of testing uptake and donation using a mixed methods approach. METHODS: We used a sequential explanatory design to explore drivers of testing uptake and donation unique to pay-it-forward through a quantitative cross-sectional survey and a qualitative thematic analysis of semistructured interviews. We collected data on sociodemographics and perceived benefits of pay-it-forward among men offered the pay-it-forward interventionand analyzed testing uptake and donations using descriptive statistics and logistic regression. We then conducted 30 semistructured interviews with men and coded interview data to identify themes. RESULTS: Three hundred and one MSM were offered pay-it-forward and 55% (165/301) received gonorrhea/chlamydia testing. Ninety-one percent (150 of 165) donated any amount with a mean of 58.31 ± 53.39 RMB (US $8.61 ± 7.88), or 39% of the standard price of gonorrhea/chlamydia testing. Getting tested was not associated with income, but donations were higher in the highest income bracket (adjusted odds ratio, 7.12; 95% confidence interval, 1.61-31.52). Fifty-eight percent (94 of 162) selected "more MSM can get tested," and 54% (88 of 162) selected "I can help someone else" as benefits of pay-it-forward. Qualitative themes for drivers of testing and donation included flexible pricing, generosity and reciprocity, and MSM community identity. CONCLUSIONS: Quantitative and qualitative results suggest that this pay-it-forward program may increase gonorrhea/chlamydia testing by reducing cost barriers, leveraging generosity and reciprocity, and mobilizing community altruism.
BACKGROUND: Gonorrhea and chlamydia are common among Chinese men who have sex with men (MSM), but testing rates are low. We developed a pay-it-forward program where men receive a free gonorrhea/chlamydia test and can then donate toward future participants' tests. This study aims to investigate drivers of testing uptake and donation using a mixed methods approach. METHODS: We used a sequential explanatory design to explore drivers of testing uptake and donation unique to pay-it-forward through a quantitative cross-sectional survey and a qualitative thematic analysis of semistructured interviews. We collected data on sociodemographics and perceived benefits of pay-it-forward among men offered the pay-it-forward interventionand analyzed testing uptake and donations using descriptive statistics and logistic regression. We then conducted 30 semistructured interviews with men and coded interview data to identify themes. RESULTS: Three hundred and one MSM were offered pay-it-forward and 55% (165/301) received gonorrhea/chlamydia testing. Ninety-one percent (150 of 165) donated any amount with a mean of 58.31 ± 53.39 RMB (US $8.61 ± 7.88), or 39% of the standard price of gonorrhea/chlamydia testing. Getting tested was not associated with income, but donations were higher in the highest income bracket (adjusted odds ratio, 7.12; 95% confidence interval, 1.61-31.52). Fifty-eight percent (94 of 162) selected "more MSM can get tested," and 54% (88 of 162) selected "I can help someone else" as benefits of pay-it-forward. Qualitative themes for drivers of testing and donation included flexible pricing, generosity and reciprocity, and MSM community identity. CONCLUSIONS: Quantitative and qualitative results suggest that this pay-it-forward program may increase gonorrhea/chlamydia testing by reducing cost barriers, leveraging generosity and reciprocity, and mobilizing community altruism.
Authors: Jane Goudge; James Akazili; John Ataguba; August Kuwawenaruwa; Josephine Borghi; Bronwyn Harris; Anne Mills Journal: Health Policy Plan Date: 2012-03 Impact factor: 3.344
Authors: Katherine T Li; Weiming Tang; Dan Wu; Wenting Huang; Feng Wu; Amy Lee; Henry Feng; Stephen W Pan; Larry Han; Vincent Mak; Ligang Yang; Joseph D Tucker Journal: Lancet Infect Dis Date: 2019-01 Impact factor: 25.071
Authors: Kyle T Bernstein; Julia L Marcus; Giuliano Nieri; Susan S Philip; Jeffrey D Klausner Journal: J Acquir Immune Defic Syndr Date: 2010-04-01 Impact factor: 3.731
Authors: Tiange P Zhang; Fan Yang; Weiming Tang; Marcus Alexander; Laura Forastiere; Navin Kumar; Katherine Li; Fei Zou; Ligang Yang; Guodong Mi; Yehua Wang; Wenting Huang; Amy Lee; Weizan Zhu; Peter Vickerman; Dan Wu; Bin Yang; Nicholas A Christakis; Joseph D Tucker Journal: Infect Dis Poverty Date: 2019-08-16 Impact factor: 4.520
Authors: Anne Sung; Tiange P Zhang; Wenting Huang; Weiming Tang; Marcus Alexander; Laura Forastiere; Navin Kumar; Brian J Hall; Yusuf Ransome; Kevin D Dieckhaus; Dan Wu; Joseph D Tucker; Fan Yang Journal: Sex Transm Dis Date: 2022-06-08 Impact factor: 3.868