(P176) Can Oxytocin Measure the Recipient Warm Glow in Pay-It-Forward Interventions? Lessons from a Quasi-Experimental Study in Sexual Health Services

Tuesday, July 25, 2023

16:00 – 18:00 CST

Primary Presenter(s)

Gifty Marley, MMed, PhD (she/her/hers)

Post-doctoral Fellow
University of North Carlolina at Chapel Hill - Project China, Guangdong, China (People's Republic)

Co-author(s)

Rayner Tan, PhD

Postdoctoral Fellow
University of North Carolina Project-China, United States
Rayner Kay Jin Tan, PhD

Postdoctoral Fellow
University of North Carolina Project-China, United States
TW

Tong Wang

Sesh Global, United States
Christina Huon, MSc, MBBS (she/her/hers)

Graduate
Newcastle University, United Kingdom
QS

Qilei Sheng

Sesh Global, United States
MB

Maggie Byrne

Graduate Research Assistant
University of North Carolina at Chapel Hill
Rochester, New York, United States
RR

Rohit Ramaswamy

Cincinnati Children's Hospital Medical Center, United States
DW

Dan Wu, PhD

London School of Hygiene & Tropical Medicine, United States
WT

Weiming Tang

Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, United States
KG

Kurt Gray

UNC at Chapel Hill, United States
JT

Joseph D. Tucker

Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK, United States

Project: In a pay-it-forward approach, an individual receives a gift (i.e., STI testing) and then provides the person with an opportunity to give a gift to another person. Previous studies have shown that pay-it-forward interventions increase STI testing uptake.

Issue: The existing literature focuses on a recipient glow, defined as positive feelings or a sense of gratitude a recipient feels due to participating in prosocial behavior. Despite evidence supporting the pay-it-forward concept, the biological mechanism underpinning the recipient glow has not been investigated. We sought to operationalize and measure the recipient glow through oxytocin, one of the theorized biomarkers. Oxytocin is a hormone popularly associated with its effects on prosocial behaviors like trust, generosity, and affection. In a quasi-experimental study, we measured and compared salivary oxytocin concentrations between men who have sex with men (MSM) receiving free STI testing in a public STI clinic and MSM receiving STI testing through a pay-it-forward approach in a community-led clinic. Participants provided saliva samples using a passive drool method, before they received details about the source of funding for their test (baseline) and after undergoing STI testing. The saliva samples were stored at -80°C until processed. An ELISA was conducted using a commercially available oxytocin test kit, and oxytocin concentration was calculated using a microplate reader and standard curves.

Results: We recruited 48 participants (n=22 standard of care vs. n=26 pay-it-forward) with an mean age of 25.7 (SD=4.55). Most participants earned >737USD per month (n=28), had a bachelors/associate degree (n=36), and identified as gay (n=39). Prior to any intervention, participants in the pay-it-forward arm had a lower mean salivary oxytocin concentration (50.5 pg/mL) than participants in the standard of care arm (76.4 pg/mL). After accepting and undergoing STI testing, oxytocin concentrations decreased from baseline among 31 participants (mean = -20.8pg/mL). Although not statistically significant, the drop in oxytocin levels was smaller among participants receiving pay-it-forward ( -16.0pg/mL vs. -26.6pg/mL) than among standard-of-care participants.

Lessons Learned: Our data suggest that entering STI clinics and receiving testing is associated with decreases in salivary oxytocin. This has implications for designing public health interventions in STI clinics.