Web-supported social network testing for HIV among men who have sex with men with a migration background: Protocol for a mixed methods pilot study

Eline Op De Coul*, Chantal Den Daas, Ralph Spijker, Titia Heijman, Marvin De Vos, Hannelore Götz, Koenraad Vermey, Wim Zuilhof, Jossy Van Den Boogaard, Udi Davidovich, Freke Zuure

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Background: Of newly diagnosed HIV positive men who have sex with men (MSM) in the Netherlands, 29% have a non-Western migration background (MSM-NW). Among MSM-NW, HIV positivity rates are high (0.8%-2.0%), as is the proportion of late stage infections (39%). Factors such as HIV and sexual orientation-related stigma may form barriers for timely testing. Innovative approaches for HIV testing are needed to better reach MSM-NW. Social network testing (SNT) for HIV is an evidence-supported approach where peer recruiters identify persons (network associates) who could benefit from testing in their social or sexual networks. Web-supported SNT might be particularly promising for reaching people who may not be reached by regular care. Objective: The purpose of this paper is to describe the design of our pilot PREVENT (Peer-Empowered Voluntary Extended Network Testing). In this pilot, we will explore whether SNT using HIV self-tests is feasible and acceptable among MSM-NW in the Netherlands and whether it reaches those who were never or not recently tested for HIV (>1 year ago). Methods: The project aims to include 50 to 60 MSM and MSM-NW peers who will distribute 4 to 5 oral HIV self-tests each aiming to reach 200 network associates (NAs). Enrollment of peers includes 4 steps: (1) fostering interest in becoming a peer by health care professionals at sexual health clinics, HIV treatment clinics, and community settings; (2) sending peer contact information to the peer coordinator; (3) registering peers and giving program instructions by the peer coordinator and referring to the Web-based training at time2test; and (4) receiving precoded HIV self-tests for distribution in the peers' networks. NAs who receive the self-test will log in with their test package code in the time2test application for step-by-step test instructions. After testing is complete, NAs receive tailored follow-up information depending on their test result. Results: Between January and May 2019, 10 STI clinics and 7 HIV treatment clinics started recruiting peers. Results of the PREVENT pilot are expected in December 2020. Conclusions: This is the first Web-supported peer-driven SNT pilot using HIV self-tests in the Netherlands and one of the first in Europe. Implementation is considered successful if it reaches MSM-NW who were never or not recently tested for HIV. Additionally, it may encourage conversations within the networks about risk behavior and barriers to HIV testing, potentially contributing to the Joint United Nations Programme on HIV/AIDS goal of zero HIV infections.

Original languageEnglish
Article numbere14743
Number of pages11
JournalJMIR Research Protocols
Issue number2
Early online date17 May 2019
Publication statusPublished - 10 Feb 2020

Bibliographical note

The PREVENT project is funded by Aidsfonds (grants P-22603 and P-35609) as a high-risk high-gain project. We also thank the following people for their contributions: from Aidsfonds–Soa Aids Nederland, Suzan Bergh, Hanna Bos, Tatiana Mouhebati, and Marieke van den Borne; from the National Institute for Public Health and the Environment, Birgit van Benthem; from Amsterdam Public Health Service, Anders Boyd and Adriaan Tempert; from Utrecht University, John de Wit; from Maastricht University, Nicole Dukers; from Trial Data Solutions, Gerben Rienk Visser. The time2test website was developed by Tjuna


  • Community-based testing
  • HIV
  • HIV self-testing
  • Men who have sex with men (MSM)
  • Social network testing (SNT)


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