About

Jonathan Lio is an Associate Professor of Medicine at the University of Chicago. He serves as Associate Director of the Wuhan University Medical Education Reform Project (WUMER) and Co-Director of the International Medical Educators Program (IMEP). His work has involved developing high-quality residency training programs in China, responding to the country's national standardization of residency education, and leading Wuhan University’s creation of one of the first competency-based medical education frameworks for residency training in China. Since 2019, IMEP has trained and mentored over 80 clinician-educators across China, equipping them with skills in curriculum design, teaching strategies, and methods, resulting in educational innovations, teaching awards, scholarly publications, and leadership roles. Dr. Lio has been invited to speak at national residency training conferences across China and has advised the China Medical Board Consortium of Elite Hospitals for Residency Training. At the University of Chicago, he is a member of the Faculty Steering Committee for the Beijing Center, promoting academic exchange and collaboration between the United States and China.

Research topics

• Computer Science
• Artificial Intelligence
• Medicine
• Nursing
• Surgery
• Psychology
• Mathematics education
• Internal medicine
• Family medicine
• Gastroenterology
• Pedagogy

Selected publications

• The safety and tolerability of oral TDF/FTC as pre-exposure prophylaxis among men who have sex with men in China: a prospective cohort study

  BMC Infectious Diseases · 2026-05-21

  articleOpen access

  BACKGROUND: Pre-exposure prophylaxis (PrEP) has been demonstrated as an effective strategy for preventing HIV infection. However, multiple barriers contribute to its suboptimal uptake in China, with drug safety being a shared concern for both clinicians and patients. This study aimed to assess the safety and tolerability of oral tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) for PrEP in a real-world setting in China. METHODS: An open-label, prospective cohort study was conducted between September 2021 and September 2024 in Wuhan and Guangzhou, China. PrEP-eligible men who have sex with men (MSM) were enrolled, participants were prescribed TDF/FTC as PrEP and followed up for 12 months. Adverse events (AEs) were self-reported, and participants underwent regular monitoring for HIV, syphilis, liver and kidney function during follow-up. RESULTS: A total of 1,138 participants enrolled and initiated PrEP, with 1,045 completing at least one follow-up visit. Seven participants were diagnosed with HIV infection, yielding an HIV incidence rate of 0.8 per 100 person-years (95% CI: 0.2-1.4). A total of 62 participants self-reported 106 AEs, the majority of which were grade 1, with no serious AEs observed. Participants reported a significantly higher AE incidence with daily PrEP than on-demand PrEP (14.7 per 100 person-years vs. 9.3 per 100 person-years, P < 0.05). Additionally, 128 episodes of serum creatinine (SCr) and 701 episodes of liver enzyme abnormalities were recorded, and mild elevations in ALT, AST, and SCr were significantly more frequent among participants taking the daily regimen. Significant ALT elevations were observed from the 1st month to the 9th month follow-up, while SCr elevations occurred predominantly in the 1st month. CONCLUSIONS: Both daily and on-demand PrEP regimens with TDF/FTC are safe and well tolerated for the prevention of HIV among Chinese MSM. On-demand PrEP with fewer AEs and comparable effectiveness provides an alternative HIV prevention strategy for Chinese MSM in real-world settings. TRIAL REGISTRATION: The study is registered in Clinical Trial databases in China (ChiCTR2100048981, July 19, 2021) and the US (NCT04754139, February 11, 2021).

  PublisherDOI

• A Co-Created Digital Intervention to Improve Oral PrEP Adherence Among Men Who Have Sex with Men in China: A Stepped-Wedge Randomized Trial in China

  SSRN Electronic Journal · 2026-01-01

  preprintOpen access
  PublisherDOI

• Group competition mechanism in surgical robot training: a randomized controlled trial

  BMC Medical Education · 2025-10-24

  articleOpen access

  BACKGROUND: Limited training equipment and instructors at training centers cannot fulfill the simultaneous training required of numerous trainees. Optimizing the training organization can improve the training efficiency and trainee performance to enhance the overall training effectiveness. This study aims to evaluate the effectiveness and feasibility of group competition mechanism under peer evaluation during robot training. METHODS: A randomized controlled trial was conducted with 60 robotic-naive medical students, divided into two groups: independent training and team-based learning with a competitive element. Both groups performed Pick-and-Place (PP), Match-Board-2 (MB), and Thread-the-Rings-1 (TR) tasks on a dV-Trainer robot simulator. Training scores were automatically recorded to construct learning curves and calculate scoring efficiencies, which were compared between the two groups. RESULTS: Compared with the conventional training group, the group utilizing the group competition training format demonstrated significantly higher average operational scores, scoring efficiency, and learning curves (P < 0.05). In addition, the group competition mode demonstrates a higher performance in cultivating the trainees' satisfactory operational habits (P < 0.001). CONCLUSIONS: Based on task-reporting strategies guided by peer evaluation, the group competition mechanism is a novel and effective model for improving robot simulator training. This method holds promise as an effective tool for the surgical education of practicing surgeons and clinical medical students.

  PublisherOA PDFDOI

• Impact of Peer Referral on Pre-Exposure Prophylaxis Adherence and Persistence Among Men Who Have Sex with Men: A Cohort Study in China

  AIDS and Behavior · 2025-02-10 · 2 citations

  article
  PublisherDOI

• Community-engaged mHealth intervention to increase uptake of HIV pre-exposure prophylaxis (PrEP) among gay, bisexual and other men who have sex with men in China: study protocol for a pilot randomised controlled trial

  UNC Libraries · 2025-04-29

  articleOpen access

  INTRODUCTION: The large number of key populations in China who would benefit from HIV pre-exposure prophylaxis (PrEP) in the context of limited health system capacity and public awareness will pose challenges for timely PrEP scale-up, suggesting an urgent need for innovative and accessible interventions. This study aims to develop and pilot test a theory-informed, tailored mobile phone intervention that was codeveloped by young gay men, HIV clinicians and public health researchers to increase engagement in PrEP education and initiation among Chinese gay, bisexual and other men who have sex with men (GBMSM), who bear a disproportionate burden of HIV infections and remain underserved in the healthcare system. METHODS AND ANALYSIS: This two-phase study includes a formative assessment using in-depth interviews (N=30) and a 12-week experimental pilot study using a two-arm randomised controlled trial design (N=70). The primary intervention is delivered through a WeChat-based mini-app (a program built into a Chinese multipurpose social media application) developed by young GBMSM from a 2019 crowdsourcing hackathon. Using mixed methods, we will further investigate the specific needs and concerns among GBMSM in terms of using PrEP as an HIV prevention strategy, how their concerns and PrEP use behaviours may change with exposure to the mini-app intervention during the study period and how we can further refine this intervention tool to better meet GBMSM's needs for broader implementation. ETHICS AND DISSEMINATION: This study and its protocols have been reviewed and approved by the Institutional Review Boards of the University of North Carolina at Chapel Hill, USA (19-3481), the Guangdong Provincial Dermatology Hospital, China (2020031) and the Guangzhou Eighth People's Hospital, China (202022155). Study staff will work with local GBMSM community-based organisations to disseminate the study results to participants and the community via social media, workshops and journal publications. TRIAL REGISTRATION NUMBER: The study was prospectively registered on clinicaltrials.gov (NCT04426656) on 11 June 2020.

  PublisherDOI

• Co-creation using crowdsourcing to promote PrEP adherence in China: study protocol for a stepped-wedge randomized controlled trial

  UNC Libraries · 2025-05-01

  articleOpen access
  PublisherDOI

• Daily PrEP and event-driven PrEP adherence for men who have sex with men in China

  Sexual Health · 2025-12-03

  article

  BACKGROUND: The HIV incidence among Chinese men who have sex with men (MSM) has still been high over the past decade. Despite HIV pre-exposure prophylaxis (PrEP) being an effective prevention strategy, few studies have examined PrEP uptake and adherence in China. This study examined PrEP initiation and adherence among Chinese MSM enrolled in a multi-site PrEP demonstration trial. METHODS: Three-month data for this study were drawn from a PrEP demonstration project in Guangzhou and Wuhan, China. The project aimed to increase the engagement of MSM in China for HIV/STI screening, HIV risk reduction, and PrEP initiation and adherence through the use of a mobile phone app and community engagement with crowdsourcing of messages and study images. Part of the intervention was the provision of tenofovir/emtricitabine as PrEP through two types of modalities: (1) once-daily oral dose (Daily-PrEP), or (2) event-driven dose (i.e. the 2 + 1 + 1 approach, Event-Driven PrEP). The outcome of interest was PrEP adherence, defined as missing fewer than five pills in the past 30 days for Daily PrEP, and no missed doses for the Event-Driven PrEP regimen. Univariate and multivariate logistic regressions were conducted for data analyses. RESULTS: A total of 927 individuals started PrEP, with follow-up data available for 650 people (70%) after 3 months. There were 593 men with a median age of 30 years (range 21-61 years) in this study. Of those people, 341 reported taking Daily-PrEP, and 93% (317/341) reported missing fewer than five pills in the past 30 days. Among 252 participants who reported taking the Event-Driven PrEP regimen, 61.5% (155/252) reported full adherence. Daily-PrEP users were more likely to report good adherence than Event-Driven PrEP users (OR 7.28, P < 0.0001, 95% CI: 4.28-12.39). CONCLUSION: We observed a higher adherence to daily PrEP compared with Event-Driven PrEP among a sample of MSM in China. Further research is needed to examine long-term PrEP adherence among MSM in China.

  PublisherDOI

• HIV pre-exposure prophylaxis re-initiation among men who have sex with men: a multi-center cohort study in China

  Sexual Health · 2025-03-16 · 2 citations

  articleOpen access

  Background Data on persistent use of HIV pre-exposure prophylaxis (PrEP) is limited among Chinese men who have sex with men (MSM). This study aimed to explore factors associated with the re-initiation of PrEP among Chinese MSM from a longitudinal PrEP demonstration trial. Methods A multi-center cohort study was conducted in Guangzhou and Wuhan, China (September 2021-2024), providing 1134 MSM participants with a 12-month dosage of tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) as oral PrEP. Following the trial, a subgroup of participants were invited to complete a 3-month post-trial follow-up survey. These participants were categorized on the basis of self-reported PrEP use patterns into (1) continued PrEP use, (2) discontinued without re-initiation, and (3) re-initiated after discontinuation. Log-binomial regression models were used to assess factors associated with PrEP re-initiation. Results Out of 408 participants who completed the 3-month post-trial follow-up survey, 70.1% (n =286/408) reported discontinuing PrEP, and 50.7% (n =145/286) of those who discontinued subsequently re-initiated PrEP. Participants who had concurrent sexual partnerships (adjusted risk ratio [aRR]=1.47, 95% CI: 1.11-1.96), used drugs during sex (aRR=1.34, 95% CI: 1.09-1.65), or lived alone (aRR=1.29, 95% CI: 1.03-1.61) were more likely to re-initiate PrEP. The Likert scale analysis indicated that perceived partner influence, specifically the expectation of condomless sex, played a significant role in re-initiation decisions (P =0.03). Conclusion Individuals engaging in higher-risk behaviors are more likely to re-initiate PrEP, highlighting the dynamic nature of risk perception. Future interventions should focus on promoting both re-initiation and consistent condom use, emphasizing partner-related dynamics and substance use as key factors in PrEP decisions among MSM.

  PublisherOA PDFDOI

• A theoretical perspective on professional identity

  Medical Teacher · 2024-10-16

  article
  PublisherDOI

• When educators are locked down: transitioning an international faculty development program from in-person to online during the COVID-19 pandemic in China

  MedEdPublish · 2023-08-10

  articleOpen access1st authorCorresponding

  <ns3:p> <ns3:italic>Introduction</ns3:italic> : The COVID-19 pandemic forced international faculty development programs in medical education to forgo in-person activities and transition to online learning. We sought to examine changes in international medical educators’ evaluations of our faculty development program as it transitioned due to the pandemic. </ns3:p> <ns3:p> <ns3:italic>Methods</ns3:italic> : We compared survey responses from participants in our International Medical Educators Program between 2019 (in-person) and 2020 (online). The 43-item survey addressed aspects such as program evaluation and self-assessment of curriculum development and teaching skills. We analyzed data using t-tests to compare means and chi-square test for categorical variables and performed thematic analysis of open-ended responses. </ns3:p> <ns3:p> <ns3:italic>Results</ns3:italic> : We found that trainees in both cohorts rated the program highly with regard to overall program quality and self-assessed learning outcomes, but the 2019 group reported stronger relationships with peers and instructors. Some scores for self-assessed outcomes were lower for the 2020 class, but no statistically significant differences were found in pre- and post- training scores between the two cohorts. Four themes emerged from the feedback: positive program utility, IMEP as an example of good curriculum design, timing issues, and online learning environment challenges. </ns3:p> <ns3:p> <ns3:italic>Discussion</ns3:italic> : Despite pandemic challenges, the transition to online faculty development was favorably evaluated, with high confidence in the applicability of learned skills. Future efforts should focus on fostering community and optimizing interaction times to enhance learning experiences. The study contributes insights for global medical education communities in pandemic circumstances. </ns3:p>

  PublisherDOI

Frequent coauthors

• Renslow Sherer

  University of Chicago

  22 shared

• Hongmei Dong

  University of Chicago

  10 shared

• Basil A. Ali

  University Hospitals of Cleveland

  9 shared

• Hyo Jung Tak

  University of Nebraska Medical Center

  9 shared

• Farhan Dadani

  University of Nebraska Medical Center

  9 shared

• John D. Yoon

  University of Chicago

  9 shared

• Joseph D. Tucker

  9 shared

• Yanping Duan

  Hong Kong Baptist University

  9 shared

Labs

• Jonathan Lio LabPI

Education

• M.D.

  Loma Linda University

  2011

• Other

  Johns Hopkins University

  2014

Awards & honors

• Chinese Medical Association Top 100 Excellent Papers on Medi…
• China Medical Doctor Association Faculty Steering Committee…
• First Place Abstract China Medical Education Research and Re…
• Johns Hopkins Lay Health Educator Program (2012 - 2013)
• Varner J. Johns Award Loma Linda University (2011)