# A Multilevel Network Peer Intervention Among Student Men Who Have Sex With Men Attending University: Protocol for an Implementation-Effectiveness Before-After Cohort Study

## TL;DR

This study tests an online peer-led program to reduce HIV and syphilis among student men who have sex with men in China.

## Contribution

The study introduces a multilevel internet-based peer intervention tailored for university student MSM in China.

## Key findings

- The intervention includes health education, counseling, and self-testing via online platforms.
- Baseline data collection began in April 2025 with 127 participants enrolled.
- Outcomes will assess changes in HIV/syphilis incidence and prevention behaviors.

## Abstract

The HIV prevalence among student men who have sex with men (MSM) in China is substantially higher than that in the general student population. However, targeted interventions for this vulnerable population remain limited. While digital technologies and peer-led approaches have shown promise in HIV prevention among MSM, their application in university settings is underexplored.

This study aims to evaluate the implementation and effectiveness of a multilevel, internet-based peer intervention model in reducing HIV and syphilis incidence, improving prevention behaviors, and increasing uptake of HIV-related services among student MSM attending university in Chengdu.

This prospective before-and-after self-controlled cohort study will evaluate the effectiveness of a 12-month internet-based intervention targeting university student MSM in Chengdu. A total of 484 HIV-negative student MSM among the MSM population will be recruited through WeChat and Blued. Trained student volunteers, supervised by community-based organization staff, will deliver monthly health education, one-on-one counseling, postexposure prophylaxis navigation, and HIV or sexually transmitted infection (STI) self-testing kits via secure online platforms. Participants will complete behavioral surveys and HIV/syphilis/hepatitis C virus/hepatitis B surface antigen self-tests at baseline, 6 months, and 12 months. Primary outcomes included changes in HIV and syphilis incidence rates; secondary outcomes included changes in sexual behaviors, HIV/STI testing frequency, preexposure prophylaxis/postexposure prophylaxis uptake, and knowledge improvement.

As of May 1, 2025, the intervention materials and training program have been finalized, and recruitment has begun. Enrollment of participants started in April 2025. By the end of April, 127 participants had completed baseline surveys and HIV/STI self-tests.

This study will provide empirical evidence on the feasibility and effectiveness of an internet-based peer intervention for student MSM.