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Financing STI testing among men in China: A mixed-methods study of pay-it-forward monetary donations

Title: Financing STI testing among men in China: A mixed-methods study of pay-it-forward monetary donations
Authors: Liu, Ye; Zhou, Ke; Li, Lan; Salma, Gayed; Fitzpatrick, Thomas; Marley, Gifty; Zhu, Zixuan; Tang, Weiming; Tucker, Joseph D.
Source: PLOS One, 21(2)
Publisher Information: PLOS
Publication Year: 2026
Collection: Carolina Digital Repository (UNC - University of North Carolina)
Subject Terms: gamification; frailty; postoperative delirium; hypotension; NHANES; well-being; sense of belonging; Pakistani family; rescucitation; infections; quality control; Celecoxib; Família; Percutaneous cholecystostomy; Clinical decision-making; sexual arousal; federated analysis; refusal to participate; T2DM; nitrous oxide sedation; Resolved computational fluid dynamics; diagnostic techniques and procedures; cancer-specific survival; proficiency testing scheme; feelings; vertically integrated health system; Brain organoid; parenting knowledge; claims data; Translational neurogenetics
Description: Aim Many STI testing services are underfunded. Pay-it-forward is a strategy to support STI testing that asks participants to donate money to spur others to receive STI testing. To explore factors influencing monetary donations, we performed a secondary analysis of data from a randomized controlled trial that evaluated a pay-it-forward strategy to increase STI testing among men in China. Methods We used a convergent parallel mixed-methods design to analyze data from the RCT and semi-structured interviews. Correlates of monetary donations were identified using logistic regression. Interview responses were analyzed using thematic analysis using charitable triad theory to explore donor, recipient, and organizational factors influencing donation behavior. Results A total of 800 men received the pay-it-forward intervention. Overall, 139/718 (19%) made monetary donations, with a mean amount of 3.88 USD. The total value of all donations was 539.4 USD. At the donor level, donation behavior was associated with individual characteristics such as age, gender, and prior testing history. Donors who could identify with or visualize future recipients were also more likely to donate money. At the recipient level, income was not significantly associated with donation. At the organizational level, transparency and clear messaging enhanced trust and facilitated donations. An increased perceived risk of STI infection also motivated donations. Conclusion Our findings highlight key factors driving donations in a pay-it-forward program. Transparent fund allocation and real-time donor feedback can enhance trust and participation. Clinical trial registration ClinicalTrials.gov NCT05723263.
Document Type: article in journal/newspaper
Language: unknown
Relation: https://cdr.lib.unc.edu/downloads/5x21tz17g?file=thumbnail; https://cdr.lib.unc.edu/downloads/5x21tz17g
DOI: 10.17615/my62-0n03
Availability: https://doi.org/10.17615/my62-0n03; https://cdr.lib.unc.edu/downloads/5x21tz17g?file=thumbnail; https://cdr.lib.unc.edu/downloads/5x21tz17g
Rights: http://rightsstatements.org/vocab/InC/1.0/ ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.5804243F
Database: BASE