AIDS and Behavior

, Volume 23, Issue 5, pp 1158–1165 | Cite as

Exploration of Implementation Patterns and Content from a Text-Based Outreach Intervention Clinical Trial for Newly Diagnosed, HIV-Positive MSM in Beijing, China

  • Angela Knudson
  • Sarah Shaw
  • Lu Yin
  • Dong Xiao
  • Han-Zhu Qian
  • Stephen Sullivan
  • Hongjie Liu
  • Yuhua Ruan
  • Yiming Shao
  • Sten H. Vermund
  • K. Rivet AmicoEmail author
Original Paper


The Multi-component HIV Intervention Packages for Chinese MSM (China MP3) project sought to facilitate engagement in care and initiation of antiretroviral therapy among newly HIV-diagnosed men who have sex with men in Beijing, China through the implementation of in-person peer-counseling (PC) and a weekly short message service (SMS)-based outreach text with as-needed follow-up during the first 12-months of living with HIV. Implementation of the interactive text-based intervention used a ‘ticket system’ to monitor and document responses to texted check-ins and PC follow-up. Using this tracking system, we characterized the 1521 tickets generated during the China-MP3 intervention across 184 intervention participants. A wide variety of topics were the focus of interactions prompted by texted outreach although most appeared to focus on issues related to ART and CD4 and viral load. Almost all participants engaged in at least one SMS-related discussion. Sending regular check-ins may offer unique opportunities to newly diagnosed MSM to ask questions or gather support between face-to-face visits.


Text messaging HIV China Sexual and gender minorities Peer counseling 



The authors acknowledge the contributions of the full China MP3 team and the participants who offered their time and insights for this project.


This work was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under Award Numbers R01AI094562 and R34AI091446. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with Ethical Standards

Conflict of interest

KRA had a grant with Gilead Sciences through the University of Michigan (completed 2017). No other authors have conflicts of interest with the work presented.

Ethical Approval

All research activities were approved by Vanderbilt University abd China CDC. The parent grant (China MP3) is registered with clinical trials (Clinical Trials NCT01904877).


  1. 1.
    Ministry of Health of the People’s Republic of China. 2012 China AIDS Response Progress Report. Unaids. 2012;1–70.[1].pdf.
  2. 2.
    UNAIDS. China Country Progress Report 2014. Geneva; 2014.Google Scholar
  3. 3.
  4. 4.
    Li X, Lu H, Cox C, Zhao Y, Xia D, Sun Y, et al. Changing the landscape of the HIV epidemic among MSM in China: results from three consecutive respondent-driven sampling surveys from 2009 to 2011. Biomed Res Int. 2014;2014:563517.Google Scholar
  5. 5.
    Huang M-B, Ye L, Liang B-Y, Ning C-Y, Roth W, Jiang J-J, et al. Characterizing the HIV/AIDS Epidemic in the United States and China. Int J Environ Res Public Health. 2015;13(1):30.CrossRefGoogle Scholar
  6. 6.
    Joint United Nations Programme on HIV/AIDS (UNAIDS). 90-90-90: An ambitious treatment target to help end the AIDS epidemic. 2014.
  7. 7.
    Mugavero MJ, Amico KR, Horn T, Thompson MA. The state of engagement in HIV care in the United States: from cascade to continuum to control. Clin Infect Dis. 2013;57(8):1164–71.CrossRefGoogle Scholar
  8. 8.
    Gardner EM, McLees MP, Steiner JF, Del Rio C, Burman WJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011;52(6):793–800.CrossRefGoogle Scholar
  9. 9.
    Mugavero MJ, Amico KR, Westfall AO, Crane HM, Zinski A, Willig JH, et al. Early retention in HIV care and viral load suppression: implications for a test and treat approach to HIV prevention. J Acquir Immune Defic Syndr. 2012;59(1):86–93.CrossRefGoogle Scholar
  10. 10.
    Jiang H, Lu F, He H, Zhang D, Zeng G, Xu P, et al. Acceptability status of early antiretroviral therapy among HIV-positive men who have sex with men. Zhonghua Yu Fang Yi Xue Za Zhi. China. 2013;47(9):843–7.Google Scholar
  11. 11.
    Liu Y, Ruan Y, Vermund SH, Osborn CY, Wu P, Jia Y, et al. Predictors of antiretroviral therapy initiation: a cross-sectional study among Chinese HIV-infected men who have sex with men. BMC Infect Dis. 2015;15:570.CrossRefGoogle Scholar
  12. 12.
    Zou H, Hu N, Xin Q, Beck J. Hiv testing among men who have sex with men in china: a systematic review and meta-analysis. AIDS Behav. 2012;16(7):1717–28.CrossRefGoogle Scholar
  13. 13.
    Zhang D, Lu H, Zhuang M, Wu G, Yan H, Xu J, et al. Enhancing HIV Testing and treatment among men who have sex with men in China: a pilot model with two-rapid tests, single blood draw session, and intensified case management in six cities in 2013. PLoS ONE. 2016;11(12):e0166812.CrossRefGoogle Scholar
  14. 14.
    Tao J, Li M, Qian H-Z, Wang L-J, Zhang Z, Ding H-F, et al. Home-based HIV testing for men who have sex with men in China: a novel community-based partnership to complement government programs. PLoS ONE. 2014;9(7):e102812.CrossRefGoogle Scholar
  15. 15.
    Liu Y, Osborn CY, Qian H-Z, Yin L, Xiao D, Ruan Y, et al. Barriers and facilitators of linkage to and engagement in HIV care among HIV-positive men who have sex with men in China: a qualitative study. AIDS Patient Care STDS. 2016;30(2):70–7.CrossRefGoogle Scholar
  16. 16.
    van der Kop ML, Karanja S, Thabane L, Marra C, Chung MH, Gelmon L, et al. In-depth Analysis of patient-clinician cell phone communication during the WelTel Kenya1 antiretroviral adherence trial. PLoS ONE. 2012;7(9):e46033.CrossRefGoogle Scholar
  17. 17.
    Lewis MA, Uhrig JD, Bann CM, Harris JL, Furberg RD, Coomes C, et al. Tailored text messaging intervention for HIV adherence: a proof-of-concept study. Heal Psychol. 2012;32(3):248–53.CrossRefGoogle Scholar
  18. 18.
    Xiao Y, Ji G, Tian C, Li H, Biao W, Hu Z. Acceptability and factors associated with willingness to receive short messages for improving antiretroviral therapy adherence in China. AIDS Care. 2014;26(8):952–8.CrossRefGoogle Scholar
  19. 19.
    Sabin L, Bachman DeSilva M, Vian T, Gill CJ, Zhong L, Cheng F, et al. Improving adherence to antiretroviral therapy through real-time feedback: the China adherence through technology study (CATS). 20th Int AIDS Conf July 20–25, 2014, Melbourne, Aust. 2014;69(5):2014.Google Scholar
  20. 20.
    Lester RT, Ritvo P, Mills EJ, et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet (Lond). 2010;376(9755):1838–45.CrossRefGoogle Scholar
  21. 21.
    Chiang N, Guo M, Amico KR, Atkins L, Lester RT. Interactive two-way mHealth interventions for improving medication adherence: an evaluation using the behaviour change wheel framework. Eysenbach G, ed. JMIR mHealth and uHealth. 2018;6(4):e87. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Angela Knudson
    • 1
  • Sarah Shaw
    • 1
  • Lu Yin
    • 2
    • 8
  • Dong Xiao
    • 3
  • Han-Zhu Qian
    • 2
    • 4
    • 9
  • Stephen Sullivan
    • 5
  • Hongjie Liu
    • 4
  • Yuhua Ruan
    • 6
  • Yiming Shao
    • 6
  • Sten H. Vermund
    • 2
    • 7
    • 9
  • K. Rivet Amico
    • 1
    Email author
  1. 1.Department of Health Behavior and Health Education, School of Public HealthUniversity of MichiganAnn ArborUSA
  2. 2.Vanderbilt Institute for Global HealthVanderbilt University Medical CenterNashvilleUSA
  3. 3.Chaoyang Chinese AIDS Volunteer GroupBeijingChina
  4. 4.Division of Epidemiology, Department of MedicineVanderbilt University Medical CenterNashvilleUSA
  5. 5.Department of Health Behavior and Biological Sciences, School of Nursing and the Center for Sexuality and Health DisparitiesUniversity of MichiganAnn ArborUSA
  6. 6.State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesChinese Center for Disease Control and PreventionBeijingChina
  7. 7.Division of Pediatric Infectious Diseases, Department of PediatricsVanderbilt University Medical CenterNashvilleUSA
  8. 8.Fuwai Hospital/Chinese Academy of Medical SciencesBeijingChina
  9. 9.Yale School of Public HealthNew HavenUSA

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