Background: Rates of HIV are increasing among the estimated 330,000 men who have sex with men (MSM) in Vietnam. Face-to-face outreach only reaches a fraction of at-risk MSM. A 2015 USAID/PATH Healthy Markets (HM) study found that 98% of MSM surveyed across four provinces regularly used Facebook, and preferred social media as a source of HIV and health information. HM and MSM leaders co-created a fun, sex-positive HIV prevention and service awareness, trust, and uptake campaign?“My Future, My Choice”?that utilized a Facebook community (Rainbow Village), online influencers trained as HIV lay testers, and an HIV service booking application (I Reserve), to allow for a measurable online-to-offline HIV testing-treatment cascade.
Methods: Three techniques were applied to characterize the online-to-offline cascade in Ho Chi Minh City (HCMC) and Hanoi from 2016-2017 (18 months):
1) an online Facebook user survey;
2) a rapid survey assessing MSM self-reported motivation for HIV testing when they presented for an HIV test;
3) results from online peer influencers and I Reserve app, applying an HIV testing-treatment cascade analysis.
Results: By December 2017, Rainbow Village had over 232,000 members; 88% were aged 25 or over and 70% were HCMC/Hanoi residents. The Facebook user study (n=424) found 50% of respondents visited Rainbow Village at least once a week, 75% were not in contact with HIV outreach workers/peers, and 38% self-assessed at substantial HIV risk. The rapid survey on primary HIV testing motivators (n=3,989) found that 35% stated online content as the reason for testing, 8% of whom tested HIV-positive?compared to 5% of those motivated by face-to-face peer interactions/referrals. Among 2,454 people reached by online peer influencers or the I Reserve app, 73% tested, 11% of whom were HIV-diagnosed and enrolled in treatment (100%). This compares to an overall 6% HIV positivity yield among MSM seeking HIV lay or self-testing.
Conclusions: Online interventions effectively reach MSM who may never be contacted through conventional face-to-face peer outreach, and are more effective in reaching higher risk MSM. Online strategies should be further scaled and adapted alongside face-to-face interventions to reach more diverse segments of at-risk MSM.

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