The efficacy of using online narratives in changing HIV risk perceptions and behaviours among men who have sex with men in Hong Kong

ISRCTN	ISRCTN14109784
DOI	https://doi.org/10.1186/ISRCTN14109784
Protocol serial number	RGC Ref No.14612615
Sponsor	the Research Grants Council of Hong Kong
Funder	the Research Grants Council of Hong Kong

Submission date: 28/08/2018
Registration date: 27/09/2018
Last edited: 01/12/2022

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Infections and Infestations

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Plain English summary of protocol

Background and study aims
Human immunodeficiency virus (HIV) is a major public health threat causing heavy social and medical costs. Although the prevalence of HIV in Hong Kong has been fairly stable over the past few years, the proportion of HIV cases attributed to unprotected homosexual and bisexual contacts have increased drastically. Behavioural interventions are needed to address the HIV burden among men who sex with men (MSM). Narrative persuasion (providing information in a story format) is proposed as a promising health communication approach to promote behavioural changes, but few studies have explored its efficacy in addressing HIV prevention.
This study, the HeHe Talks project, aims to investigate how well the narrative messages work in terms of reducing HIV risk behaviors among MSM in Hong Kong.

Who can participate?
Males aged 18 years or older who have engaged in anal sex with another man in the past 6 months, use the internet at least once per week, are able to read Chinese and are either HIV negative or status unknown

What does the study involve?
Participants will be randomly allocated to the intervention condition or the control one. All participants will watch six HIV prevention-themed videos on the study website, which are made available sequentially weekly. For the intervention group, the videos contain both narrative and didactic messages; whereas for the control group, the videos contain the didactic ones only.

What are the possible benefits and risks of participating?
The benefit of taking part is that participants will learn more about HIV prevention and may have a reduction in their HIV risk behaviours as a result. They will receive supermarket coupons as the compensation for their participation. There are no known risks to participants taking part in this study. Completing the intervention videos and evaluation surveys may cause fatigue among some participants.

Where is the study run from?
AIDS Concern Health Service Center, Hong Kong

When is the study starting and how long is it expected to run for?
May 2016 to October 2018

Who is funding the study?
General Research Funds by the Research Grant Council of Hong Kong

Who is the main contact?
Dr. Phoenix Kit-han, MO
phoenix.mo@cuhk.edu.hk

Contact information

Dr Phoenix Kit-han Mo
Scientific

Room 508, School of Public Health, Prince of Wales Hospital, Shatin, N.T., Hong Kong
Hong Kong
NA
Hong Kong

Study information

Primary study design	Interventional
Study design	Interventional single-centre two-arm single-blind randomised controlled trial
Secondary study design	Randomised controlled trial
Study type	Participant information sheet
Scientific title	Efficacy of the narrative persuasion intervention in changing HIV risk perceptions and behaviours among men who have sex with men in Hong Kong: an online randomised controlled trial
Study acronym	HeHe Talks
Study objectives	The aim of this study is to test the efficacy of online narratives in changing HIV risk perceptions and behaviors among men who have sex with men (MSM) in Hong Kong using a randomised controlled trial design. The specific objectives are as below: 1. To examine the efficacy of an online intervention involving narrative and didactic information about HIV prevention in reducing unprotected anal intercourse, increasing HIV/STI risk perceptions, improving condom social norms, increasing HIV testing behaviors, and increasing intentions to use condom and intentions to receive HIV testing among MSM, compared to the control group who will only receive online didactic information about HIV prevention. 2. To examine the information processing mechanisms underlying the potential efficacy of the intervention information.
Ethics approval(s)	Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee, 03/06/2014, reference number: 2014.274-T
Health condition(s) or problem(s) studied	HIV prevention
Intervention	Participants will be randomly allocated to the intervention group or the control group using the web-based tool Research Randomizer. The multiple-session intervention will last for 6 weeks and both groups will be provided with six HIV-themed videos on the study website, which are made available sequentially weekly. For the intervention group, the videos contain both narrative and didactic messages; whereas for the control group, the videos contain the didactic ones only. Firsthand stories will be elicited from eligible MSM peers with diverse behavioral patterns and experiences of HIV/STI infection to generate collective narrative messages under six themes related to HIV prevention. Theme-equivalent didactic messages will then be developed accordingly. For the intervention group, the information will be related to reducing unprotected anal intercourse, increasing HIV/STI risk perceptions, improving condom social norms, increasing HIV testing behaviors, and increasing intentions to use condom and intentions to receive HIV testing among MSM. Efficacy outcomes will be measured at baseline (T0), post-intervention (T1) and six-month follow-up (T2).
Intervention type	Behavioural
Primary outcome measure(s)	The following will be measured through an online self-administered survey (The HIV Preventive Behavior Survey) on the study website: 1. Unprotected anal intercourse: the frequency of condom use in both receptive and insertive anal sex with different types of sex partners (regular and non-regular partners) in the past 3 months at T0, during the intervention period at T1, and during the follow-up period at T2; and whether they had used a condom in the last sex encounter with the different types of sex partners. 2. HIV testing: whether they have taken part in HIV testing in the past six months at T0, during the intervention period at T1, and during the follow-up period at T2
Key secondary outcome measure(s)	The following will be measured through an online self-administered survey (The HIV Preventive Behavior Survey) on the study website: 1. Cognitive correlates of behavioural outcomes, assessed at the baseline (T0), during the intervention period at T1 and during the follow-up period at T2: 1.1. Intention to use a condom 1.2. Perceived behavioural control over condom use 1.3. Condom social norms 1.4. Attitudes towards condom use 1.5. Risk perceptions about HIV/STIs 1.6. Self-efficacy about condom use 1.7. Intention to be tested for HIV 2. Measures of information processing mechanisms, assessed during the intervention period at T1 and during the follow-up period at T2: 2.1. Argument-based cognitive responses 2.2. Narrative responses
Completion date	31/10/2018

Eligibility

Participant type(s)	Other
Age group	Adult
Lower age limit	18 Years
Sex	Male
Target sample size at registration	236
Key inclusion criteria	1. Male 2. Aged 18 years or older 3. Self-reported to have engaged in anal sex with another man in the past 6 months 4. Self-reported as a regular internet use (use the internet at least once per week) 5. Able to read Chinese
Key exclusion criteria	Diagnosed as HIV positive prior to enrolment
Date of first enrolment	01/09/2017
Date of final enrolment	15/03/2018

Locations

Countries of recruitment

Hong Kong

Study participating centre

AIDS Concern Health Service Center

Flat B, 3/F, Fu Lee Commercial Building, 14 – 20 Pilkem Street, Jordan, Kowloon
Hong Kong
NA
Hong Kong

Results and Publications

Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not expected to be made available
IPD sharing plan	The datasets generated during and/or analysed during the current study are not expected to be made available due to the confidentiality agreement made between the research team and MSM participants to address the ethical concern.

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Abstract results	p384	23/08/2022	01/12/2022	No	No
Other publications	Intervention development	16/09/2021	27/04/2022	Yes	No
Participant information sheet	Participant information sheet	11/11/2025	11/11/2025	No	Yes
Protocol file			01/12/2022	No	No
Study website	Study website	11/11/2025	11/11/2025	No	Yes

Additional files

35680 HeHeTalks Protocol.pdf: Protocol file

Editorial Notes

01/12/2022: The following changes were made to the trial record:
1. Uploaded protocol (not peer-reviewed) as an additional file.
2. Publication reference added.
27/04/2022: The following changes have been made:
1. The intention to publish date has been changed from 31/12/2018 to 31/12/2022 and the Publication and dissemination plan has been updated to reflect this change.
2. Publication reference added.