ORCID Profile
0000-0002-9026-707X
Current Organisation
University of North Carolina at Chapel Hill
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Publisher: Cold Spring Harbor Laboratory
Date: 31-10-2023
Publisher: JMIR Publications Inc.
Date: 02-03-2023
DOI: 10.2196/43772
Abstract: Regular chlamydia and gonorrhea testing are essential for key populations, such as female sex workers (FSWs). However, testing cost, stigma, and lack of access prevent FSWs in low- and middle-income countries from receiving chlamydia and gonorrhea testing. A social innovation to address these problems is “pay it forward,” where an in idual receives a gift (free testing) and then asks whether they would like to give a gift to another person in the community. This cluster randomized controlled trial examined the effectiveness and cost of the pay-it-forward strategy in increasing access to chlamydia and gonorrhea testing among FSWs in China. This trial integrated a pay-it-forward approach into a community-based HIV outreach service. FSWs (aged 18 years or older) were invited by an outreach team from 4 Chinese cities (clusters) to receive free HIV testing. The 4 clusters were randomized into 2 study arms in a 1:1 ratio: a pay-it-forward arm (offered chlamydia and gonorrhea testing as a gift) and a standard-of-care arm (out-of-pocket cost for testing: US $11). The primary outcome was chlamydia and gonorrhea test uptake, as ascertained by administrative records. We conducted an economic evaluation using a microcosting approach from a health provider perspective, reporting our results in US dollars (at 2021 exchange rates). Overall, 480 FSWs were recruited from 4 cities (120 per city). Most FSWs were aged ≥30 years (313/480, 65.2%), were married (283/480, 59%), had an annual income US $9000 (301/480, 62.7%), and had never been tested for chlamydia (401/480, 83.5%) or gonorrhea (397/480, 82.7%). Chlamydia and gonorrhea test uptake in the pay-it-forward and standard-of-care arms were 82% (197/240) and 4% (10/240), respectively, with an adjusted proportion difference of 76.7% (lower bound 95% CI 70.8%). All those who tested positive were referred to and received treatment at local sexually transmitted infection clinics. This finding was consistent when adjusting for marital status, income, inconsistent condom use during commercial sex in the last 3 months, and HIV testing history. Among 197 women who received tests in the pay-it-forward arm, 99 (50.3%) donated money, with a median donation of US $1.54 (IQR 0.77-1.54). The economic cost per person tested was US $568.71 for standard of care and US $43.20 for pay it forward. The pay-it-forward strategy has the potential to enhance chlamydia and gonorrhea testing for Chinese FSWs and may be useful for scaling up preventive services. Further implementation research is needed to inform the transition of pay-it-forward research into practice. Chinese Clinical Trial Registry ChiCTR2000037653 www.chictr.org.cn/showprojen.aspx?proj=57233
Publisher: BMJ
Date: 03-2020
DOI: 10.1136/BMJOPEN-2019-036098
Abstract: Internet search engine data have been widely used to monitor and predict infectious diseases. Existing studies have found correlations between search data and HIV/AIDS epidemics. We aimed to extend the literature through exploring the feasibility of using search data to monitor and predict the number of newly diagnosed cases of HIV/AIDS, syphilis and gonorrhoea in China. This paper used vector autoregressive model to combine the number of newly diagnosed cases with Baidu search index to predict monthly newly diagnosed cases of HIV/AIDS, syphilis and gonorrhoea in China. The procedures included: (1) keywords selection and filtering (2) construction of composite search index (3) modelling with training data from January 2011 to October 2016 and calculating the prediction performance with validation data from November 2016 to October 2017. The analysis showed that there was a close correlation between the monthly number of newly diagnosed cases and the composite search index (the Spearman’s rank correlation coefficients were 0.777 for HIV/AIDS, 0.590 for syphilis and 0.633 for gonorrhoea, p .05 for all). The R 2 were all more than 85% and the mean absolute percentage errors were less than 11%, showing the good fitting effect and prediction performance of vector autoregressive model in this field. Our study indicated the potential feasibility of using Baidu search data to monitor and predict the number of newly diagnosed cases of HIV/AIDS, syphilis and gonorrhoea in China.
Publisher: Elsevier BV
Date: 05-2020
Publisher: JMIR Publications Inc.
Date: 24-10-2022
Abstract: egular chlamydia and gonorrhea testing are essential for key populations, such as female sex workers (FSWs). However, testing cost, stigma, and lack of access prevent FSWs in low- and middle-income countries from receiving chlamydia and gonorrhea testing. A social innovation to address these problems is “pay it forward,” where an in idual receives a gift (free testing) and then asks whether they would like to give a gift to another person in the community. his cluster randomized controlled trial examined the effectiveness and cost of the pay-it-forward strategy in increasing access to chlamydia and gonorrhea testing among FSWs in China. his trial integrated a pay-it-forward approach into a community-based HIV outreach service. FSWs (aged 18 years or older) were invited by an outreach team from 4 Chinese cities (clusters) to receive free HIV testing. The 4 clusters were randomized into 2 study arms in a 1:1 ratio: a pay-it-forward arm (offered chlamydia and gonorrhea testing as a gift) and a standard-of-care arm (out-of-pocket cost for testing: US $11). The primary outcome was chlamydia and gonorrhea test uptake, as ascertained by administrative records. We conducted an economic evaluation using a microcosting approach from a health provider perspective, reporting our results in US dollars (at 2021 exchange rates). verall, 480 FSWs were recruited from 4 cities (120 per city). Most FSWs were aged ≥30 years (313/480, 65.2%), were married (283/480, 59%), had an annual income & US $9000 (301/480, 62.7%), and had never been tested for chlamydia (401/480, 83.5%) or gonorrhea (397/480, 82.7%). Chlamydia and gonorrhea test uptake in the pay-it-forward and standard-of-care arms were 82% (197/240) and 4% (10/240), respectively, with an adjusted proportion difference of 76.7% (lower bound 95% CI 70.8%). All those who tested positive were referred to and received treatment at local sexually transmitted infection clinics. This finding was consistent when adjusting for marital status, income, inconsistent condom use during commercial sex in the last 3 months, and HIV testing history. Among 197 women who received tests in the pay-it-forward arm, 99 (50.3%) donated money, with a median donation of US $1.54 (IQR 0.77-1.54). The economic cost per person tested was US $568.71 for standard of care and US $43.20 for pay it forward. he pay-it-forward strategy has the potential to enhance chlamydia and gonorrhea testing for Chinese FSWs and may be useful for scaling up preventive services. Further implementation research is needed to inform the transition of pay-it-forward research into practice. hinese Clinical Trial Registry ChiCTR2000037653 www.chictr.org.cn/showprojen.aspx?proj=57233
Location: United States of America
Location: United States of America
No related grants have been discovered for Weiming Tang.