Background: Social media intervention may enhance HIV prevention among men who have sex with men, but the effect of this intervention in resource-limited settings remains unclear. Objective: This randomized controlled trial evaluated whether a social media intervention grounded in the information-motivation-behavioral skills (IMB) model could be beneficial for HIV prevention among men who have sex with men in resource-limited settings. Methods: Participants were recruited in Nanning, China, between April 2023 and April 2024. Eligible participants were randomly assigned to either the social media intervention group or the routine HIV prevention services control group. Participants in the intervention group received a 3-month social media intervention, which included completing video-based tasks. Baseline surveys were conducted, followed by follow-up surveys every 3 months, for a total of 2 follow-ups. Outcomes included HIV testing uptake, high-risk behavior, AIDS-related knowledge, safe sex self-efficacy, and attitude. Results: A total of 180 eligible men who have sex with men were enrolled (90 per group). Follow-up rates were 97.8% (88/90) and 95.5% (86/90) for the intervention and control groups, respectively. At the follow-ups, the intervention group demonstrated significantly higher uptake of HIV testing, a lower proportion of participants reporting high-risk sexual behaviors, and higher condom use self-efficacy compared to the control group (all
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