Pay-it-forward RCT for Gonorrhea and Chlamydia Testing

University of North Carolina (UNC)

Status: Completed

Conditions: Gonorrhea Male; Chlamydia;M

Treatments: Other: Pay-what-you-want; Other: Pay-it-forward

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03741725

18-2142

R01AI114310 (U.S. NIH Grant/Contract)

5P30AG034420-10 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This is a randomized controlled trial which will evaluate dual gonorrhea/chlamydia test uptake and other outcomes in men who have sex with men (MSM) in three trial arms - 1) a pay-it-forward testing arm, 2) a pay-what-you-want testing arm, and 3) standard of care arm.

Full description

At both of the program sites, MSM partaking in HIV and syphilis testing will be offered dual gonorrhea/chlamydia testing. First, all men will be provided a brief (5 minute) introduction to gonorrhea and chlamydia testing using a pamphlet. Program organizers will then explain the pay-it-forward program to each man separately. Briefly, men will be told that the hospital list price of gonorrhea and chlamydia testing was 150 RMB ($24 USD), but previous men attending the clinic had donated money to cover the cost of his test. Thus, each man could receive a free gonorrhea and chlamydia test, then decide whether to donate money (pay-it-forward) for future men to receive the same option. Men will be assured that donating is completely optional and advised to pay any amount that is feasible for them. Each man's gonorrhea and chlamydia test fees will be covered by a combination of the initial funding pool from the program organizers and the donations from previous participants. Men will also be shown a postcard with a message written by a previous pay-it-forward contributor. Messages will contain information encouraging men to be tested/slogans to promote sexual health and testing (i.e. taking ownership of their health). They will be told that they could also write a postcard message for a future participant.

Men will then decide whether or not to receive combined urine gonorrhea/chlamydia testing. Program organizers will inform participants of their test results via WeChat. Patients with positive test results will be counseled and directed to the WeChat page of designated hospitals where they could make an appointment to receive treatment and follow-up.

Enrollment: 301 patients

Sex: Male

Ages: 16 to 99 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• born biologically male
• age 16 years or older
• report previous anal sex with another man
• willing to provide mobile phone number for results notification

Exclusion criteria

• tested for both gonorrhoea and chlamydia in the past 12 months with no high-risk sexual behavior following testing
• previous participation in pay-it-forward program

Trial design

Primary purpose: Screening

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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301 participants in 3 patient groups

Pay-it-forward

Experimental group

Description:

First, participants will be provided a brief introduction to gonorrhea and chlamydia testing. Then, participants will be offered a gift of free gonorrhea and chlamydia testing made available by donations from previous testers, and asked whether they would like to donate money (pay-it-forward) for future men to receive the same option.

Treatment:

Other: Pay-it-forward

Pay-what-you-want

Experimental group

Description:

First, participants will be provided a brief introduction to gonorrhea and chlamydia testing. Then, participants will be offered gonorrhoea and chlamydia testing and told that they can decide and pay any desired amount after receiving the test.

Treatment:

Other: Pay-what-you-want

Standard of care

No Intervention group

Description:

First, participants will be provided a brief introduction to gonorrhea and chlamydia testing. Then, participants will be offered gonorrhoea and chlamydia testing at the standard patient price.