Table 2.

eHealth and HIV testing and linkage to care

Study	Country	Study design	Study Population Sample size (N=)	Technology mode	Purpose of study	Study description	Key outcomes of interest in this review	Results/Authors’ conclusions
SMS reminders to increase HIV testing and re-testing
Bourne et al. 2011	Australia	Cross-sectional	MSM I = 714 C = 1084 PI = 1753	SMS	Evaluate impact of SMS reminder system on HIV/STI re-testing rates	SMS testing reminders were sent 3–6 monthly for MSM considered high-risk based on self-reported sexual behaviour. Comparison of HIV/STI re-testing rates among 3 groups.	HIV re-testing rates	Significant increase HIV re-testing rates within 9 months, I (64%) vs. C (30%) (p < 0.001) and I (64%) vs. PI (31%) (p < 0.001). SMS group was 4.4 times more likely to re-test than Control (95% CI 3.5 to 5.5, p < 0.001); SMS group was 3.1 times more likely to re-test than PI group (95% CI 2.5 to 3.8, p < 0.001).
Instant messaging to promote HIV testing
Zou et al. 2013	China	Cross-sectional	MSM N = 429	Instant messaging	Explore the feasibility of using internet outreach to encourage MSM to get tested for HIV	Two trained MSM volunteers promoted VCT using active (instant messaging, chat rooms, mobile phone, email) and passive (website banner ads) methods. Those who came for testing completed a survey and HIV/syphilis tests.	HIV testing uptake Motivation for seeking HIV testing Response to internet outreach	Instant messaging was the most effective mode for HIV testing promotion (1:4 men). The email was the least effective (1:140 men). Active internet outreach recruited younger MSM (X2 = 11.400, p = 0.001), never tested for HIV (X2 = 4.281, p = 0.039), tested less often (X2 = 5.638, p = 0.018). Note: Internet effective in encouraging testing but a confounding factor of financial reward.
Social media campaigns to increase HIV testing in MSM
Cheng et al. 2016	China	Cross-sectional	MSM Primary outcome N = 22,282 Secondary outcomes N = 999	Internet Social media	Evaluate impact of integrated service including internet based prevention services, online-to-offline line service linkage and offline one-stop shop service	Three project components: (1) internet-based prevention services to facilitate HIV prevention; (2) online-to-offline service linkage-online appointments for MSM for HIV testing; and (3) offline one-stop shop service-HIV testing and linkage to care for PLHIV	Primary outcome: HIV testing uptake Secondary outcomes: linkage to and retention in care	Six years of project implementation, the project accounted for 80% of total HIV tests (22,282/26,884) and new HIV diagnoses (999/1218) among MSM in Guangzhou. Of the 999 HIV-positive diagnoses, 948 (95%) linked to care services, while 891 (94%) of those linked were successfully retained in care.
Ko et al. 2013	Taiwan	Cross-sectional	MSM N = 1037	Social media	Evaluate the effectiveness of iPOL in disseminating information about HIV, increasing the frequency of HIV testing, and reducing risky behaviours	The iPOLs actively disseminated HIV-related information via the Facebook social networking website and discussed and responded to questions from Internet-using MSM. MSM who visited the intervention or control website were surveyed after 6 months.	Frequency of online discussion or accessing information about HIV Incidence of HIV testing and condom use	MSM who visited intervention website were more likely to have HIV tests within 6 months (43.89% vs. 22.31%, p < 0.001); consistently use condoms during anal sex with online sex partners (34.15% vs. 26.19%, p = 0.004); receive HIV-related information (25.49% vs.10.47%, p < 0.001); discuss HIV issues with others (41.88% vs. 23.79%, p < 0.001); review articles about HIV (90.58% vs.79.73%, p < 0.001); and be asked about or discuss HIV-related questions (51.11% vs. 31.78%, p < 0.001) than those on the control website.
Web-based health promotion to increase HIV testing
Minas et al. 2012	Australia	Cross-sectional	MSM Various sample size as multiple methods of evaluation	Website	Evaluation of a communication strategy to improve the awareness and appropriate use of nPEP	The communication strategy included: • development of nPEP information pamphlet for distribution through gay websites • nPEP resources (aimed at people at risk of acquiring HIV) and the Western Australia nPEP guidelines aimed at HCWs available on Western Australia AIDS Council website • 24 h nPEP phone line	Immediate outcomes: • Access and use of nPEP information • Awareness of nPEP among MSM and HCWs Ultimate outcomes: • nPEP treatment practice and follow up testing	Significant increase in the proportion of clients tested for HIV at 3 to 4 months after the initial visit (38.8% in 2002–2005 to 51.9% in 2008–2010, p = 0.023). No increase in clients tested at six to seven month after the initial visit.
Pedrana et al. 2012	Australia	Cross-sectional	MSM N = 295	Social marketing campaign	Evaluate the impact of a social marketing campaign in 2008–2009 aimed to increase health-seeking behaviour and STI testing and enhance HIV/STI knowledge in gay men	Impact evaluation of “Drama Downunder” health promotion campaign, by surveying online sample of gay men and analysing HIV and other STI testing data from high case load clinics before, during and after the campaign.	HIV/STI testing	Compared with the pre-campaign period, 17% increase in HIV testing rate (p < 0.01) were observed during the initial campaign period and 27% increase (p < 0.01) during the continued campaign period.
Wilkinson et al. 2016	Australia	Cohort	MSM N = 242	Social marketing campaign	Evaluate impact of campaign on HIV sexual health testing	Impact evaluation of social marketing campaign, by surveying online sample of MSM and analysing HIV and other STI testing data from Victorian Primary Care Network for Sentinel Surveillance HIV network before, during and after the campaign.	HIV/STI testing among MSM	Though increasing HIV/STI testing trends were observed for MSM pre and post marketing period, there was insufficient evidence to significantly attribute impact exclusively to the campaign.