NCT05723263

Pay-it-forward Gonorrhea and Chlamydia Testing Among Men in China

Completed NA Results posted Last updated 3 December 2025

What this trial tests

NA trial testing Standard Pay-it-forward in Gonorrhea in 1,200 participants. Completed in 30 September 2024.

Timeline

1 April 2023

Primary endpoint
15 July 2024

30 September 2024

Quick facts

Lead sponsor	University of North Carolina, Chapel Hill
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	none
Primary purpose	health services research
Enrollment	1,200
Start date	1 April 2023
Primary completion	15 July 2024
Estimated completion	30 September 2024
Sites	1 location across China

Drugs / interventions tested

• Standard Pay-it-forward
• Community Engaged Pay-it-forward
• Control arm

Conditions studied

• Gonorrhea — all drugs for Gonorrhea →
• Chlamydia — all drugs for Chlamydia →

Sponsor

University of North Carolina, Chapel Hill

Who can join

18 and older, male only, with Gonorrhea or Chlamydia. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Number of Participants Testing for Gonorrhea and Chlamydia Primary · During enrollment visit

Defined as the number of eligible participants who accepted and provided laboratory samples for gonorrhea and chlamydia PCR testing out of the total number of eligible participants recruited across the three study arms.

Group	Value	95% CI
Community-Engaged Pay-It-Forward	390
Standard Pay-It-Forward	361
Control	12

Donation Amount Secondary · Baseline

The response was defined as the total amount of money donated by participants in the pay-it-forward group to support testing for other participants. Self-reported via a self-administered survey and validated in donation receipt records.

Group	Value	95% CI
Community-Engaged Pay-It-Forward	225.16	± 37.53
Standard Pay-It-Forward	382.61	± 63.77

Number of Participants Who Test Positive for Gonorrhea Secondary · Within 2 weeks of enrollment

The response rate was defined as the number of participants who tested positive for gonorrhea out of the total number of participants tested for gonorrhea. Test results were obtained from validated laboratory diagnosis reports based on polymerase chain reaction (PCR) testing.

Group	Value	95% CI
Community-Engaged Pay-It-Forward	10
Standard Pay-It-Forward	12
Control	1

Number of Participants Who Test Positive for Chlamydia Secondary · Within 2 weeks of recruitment

The response rate was defined as the number of participants who tested positive for chlamydia out of the total number of participants who tested for chlamydia. Test results were obtained from validated laboratory diagnosis reports based on PCR testing.

Group	Value	95% CI
Community-Engaged Pay-It-Forward	35
Standard Pay-It-Forward	58
Control	0

Cost Per Test Per Individual Secondary · Baseline - During enrollment visit

The costs per test individual consist of the direct costs of PCR tests for gonorrhea and chlamydia for each individual tested at baseline. For the intervention arms, the estimate was calculated as the total direct cost paid to the laboratory minus the total amount donated by pay-it-forward arm participants in that intervention arm, divided by the total number of participants tested in that arm. The average exchange rate for the US dollar (USD) to RMB on March 31, 2025, was 1 USD = 7.22 RMB. Control arm participants paid the standard cost of 150 RMB (\~20.18 USD) each for dual PCR testing at t

Group	Value	95% CI
Community Engaged Pay-it-forward	14.10	± 0.41
Standard Pay-it-forward	13.61	± 0.75
Control Arm	20.18	± 0

Mean Self Reported Gratitude Score Secondary · During enrollment visit

The response rate was the average self-rated gratitude towards and about the pay-it-forward intervention. This was scored using a 10-item adapted gratitude survey on a 5-level Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). Possible average scores ranged from 1 (lowest level of gratitude) to 7 (highest level of gratitude).

Group	Value	95% CI
Community-Engaged Pay-It-Forward	5.81	± 1.04
Standard Pay-It-Forward	6.21	± 0.84

Mean Self Reported Community Engagement Score Secondary · Baseline

The response rate was the average self-rated community engagement with the local and/or LGBTQ community before participating in the study, scored using a validated tool assessed on a 6-item Likert scale. Possible average scores ranged from 0 (no community engagement) to 6 (high community engagement)

Group	Value	95% CI
Community-Engaged Pay-It-Forward	0.21	± 0.29
Standard Pay-It-Forward	0.27	± 0.31
Control	0.32	± 0.34

Mean Community Connectedness and Cohesion Score Secondary · Baseline

The response rate was defined as the average self-rated community engagement score using a validated 11-item scale rated on a 4-level Likert scale. Possible average scores ranged from 1 (low community connectedness and cohesion) to 4 (high community connectedness and cohesion)

Group	Value	95% CI
Community Engaged Pay-it-forward	3.27	± 0.67
Standard Pay-it-forward	3.02	± 0.72
Control Arm	2.66	± 0.83

Internalized Homophobia and Self-identification Secondary · Baseline

The response rate was the average self-rated internalized homophobia and self-identification score assessed using a validated 9-item survey rated on a 1-5 Likert scale. Possible average scores ranged from 1 (low self-identification and high internalized homophobia) to 5 (high self-identification and low internalized homophobia)

Group	Value	95% CI
Community-Engaged Pay-It-Forward	3.61	± 0.89
Standard Pay-It-Forward	3.34	± 0.95
Control	3.44	± 0.84

Gonorrhea and Chlamydia Testing Uptake by Clinic Type Secondary · During enrollment visit

Stratifies gonorrhea/chlamydia testing uptake between participants recruited in community-led clinics versus public STI clinics across the three intervention arms.

Group	Value	95% CI
Community-engaged Pay-It-Forward	199
Standard Pay-It-Forward	164
Control	1
Community-engaged Pay-It-Forward	191
Standard Pay-It-Forward	197
Control	11
Community-engaged Pay-It-Forward	10
Standard Pay-It-Forward	39
Control	388

Gonorrhea and Chlamydia Testing Uptake by Sexual Orientation Secondary · During enrollment visit

Stratifies gonorrhea/chlamydia testing uptake between MSM and non-MSM participants across the three intervention arms.

Group	Value	95% CI
Community-engaged Pay-It-Forward	194
Standard Pay-It-Forward	193
Control	1
Community-engaged Pay-It-Forward	196
Standard Pay-It-Forward	168
Control	11
Community-engaged Pay-It-Forward	10
Standard Pay-It-Forward	39
Control	388

Gonorrhea and Chlamydia Testing Uptake by Age Group Secondary · During enrollment visit

Stratifies gonorrhea/chlamydia testing uptake between participants aged 30 years and below and those above 30 years across the three intervention arms.

Group	Value	95% CI
Community-engaged Pay-It-Forward	143
Standard Pay-It-Forward	178
Control	4
Community-engaged Pay-It-Forward	247
Standard Pay-It-Forward	183
Control	8
Community-engaged Pay-It-Forward	10
Standard Pay-It-Forward	39
Control	388

Sponsor's own description

PIONEER is a three-arm, programmatic cluster randomized controlled trial (RCT) to compare effectiveness of three implementation strategies, followed by a mixed-methods implementation evaluation study

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

1. Pay-it-forward gonorrhea and chlamydia testing among men who have sex with men and male STD patients in China: the PIONEER pragmatic, cluster randomized controlled trial protocol.
   Marley G, Tan RKJ, Wu D, Wang T, et al · · 2023 · cited 6× · PMID 37337181 · DOI 10.1186/s12889-023-16095-8
2. Financing STI testing among men in China: A mixed-methods study of pay-it-forward monetary donations.
   Liu Y, Zhou K, Li L, Salma G, et al · · 2026 · PMID 41686825 · DOI 10.1371/journal.pone.0342595