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Financing STI testing among men in China: A mixed-methods study of pay-it-forward monetary donations
1University of North Carolina at Chapel Hill Project-China, Guangzhou, China.
Plos One
|February 13, 2026
Summary
Donating to support sexual transmitted infection (STI) testing is influenced by donor characteristics, perceived risk, and organizational transparency. Clear communication and feedback enhance trust and participation in pay-it-forward STI testing programs.
Area of Science:
- Public Health
- Health Economics
- Behavioral Science
Background:
- Underfunded sexual transmitted infection (STI) testing services necessitate innovative funding strategies.
- The pay-it-forward model encourages donations to fund STI testing for others.
- This study analyzes factors influencing monetary donations within a pay-it-forward intervention for men in China.
Purpose of the Study:
- To explore factors influencing monetary donations in a pay-it-forward STI testing program.
- To identify donor, recipient, and organizational factors affecting donation behavior.
- To inform strategies for enhancing participation in STI testing initiatives.
Main Methods:
- Secondary analysis of data from a randomized controlled trial (RCT) involving 800 men.
- Convergent parallel mixed-methods design integrating RCT data and semi-structured interviews.
- Logistic regression for quantitative analysis and thematic analysis for qualitative insights, guided by charitable triad theory.
Main Results:
- 19% of participants made monetary donations, averaging $3.88 USD.
- Donor characteristics (age, gender, prior testing) and ability to visualize recipients influenced donations.
- Organizational transparency, clear messaging, and perceived STI risk motivated donations; recipient income did not significantly impact donation behavior.
Conclusions:
- Key drivers for donations in pay-it-forward programs include donor-specific factors, perceived risk, and organizational attributes.
- Enhancing trust through transparent fund allocation and real-time donor feedback is crucial for increasing participation.
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