1
|
Ignacio M, Garofalo R, Pearson C, Kuhns LM, Bruce J, Scott Batey D, Radix A, Belkind U, Hidalgo MA, Hirshfield S, Schnall R. Pilot feasibility trial of the MyPEEPS mobile app to reduce sexual risk among young men in 4 cities. JAMIA Open 2019; 2:272-279. [PMID: 31294422 PMCID: PMC6603441 DOI: 10.1093/jamiaopen/ooz008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/14/2019] [Accepted: 03/12/2019] [Indexed: 11/20/2022] Open
Abstract
Objectives Our study team adapted the MyPEEPS (Male Youth Pursuing Empowerment, Education, and Prevention around Sexuality) curriculum, an evidence-based human immunodeficiency virus (HIV) prevention intervention, from a face-to-face, group-based intervention to an individual-level mobile responsive web-based intervention to improve HIV risk behaviors in very young men, aged 13–18 years. Materials and methods In adapting the MyPEEPS intervention to mobile app, we used a series of methodologies, including expert panel reviews, weekly team meetings with the software development company, and conducted in-depth interviews with very young men. Following the iterative process, we conducted a 6-week pre–post feasibility pilot trial with 40 young men in Birmingham, AL; Chicago, IL; New York City, NY; and Seattle, WA. Primary outcomes of interest were uptake of the app, accessibility and satisfaction. Results Across all 4 sites, 62.5% (25/40) of participants completed all modules in the app in an average of 28.85 (SD 21.69) days. Participants who did not attend to the follow-up visit did not complete any of the app modules. Overall participants reported that the app was easy to use, useful and has the potential to improve their sexual health knowledge and behavior and awareness in risky contexts. Participants also highly rated the app, information and interface quality of the app. Discussion Lessons learned from the pilot included the need for reminder systems and providing anticipatory guidance about Internet connectivity when using the app. These changes will be incorporated into study procedures for our multisite trial. Conclusion Overall, participants found the app to be highly usable and have the potential to positively improve their sexual risk behavior.
Collapse
Affiliation(s)
- Matt Ignacio
- School of Social Work, Indigenous Wellness Research Institute, University of Washington, Seattle, Washington, USA
| | - Robert Garofalo
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital, Northwestern University, Chicago, Illinois, USA
| | - Cynthia Pearson
- School of Social Work, Indigenous Wellness Research Institute, University of Washington, Seattle, Washington, USA
| | - Lisa M Kuhns
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital, Northwestern University, Chicago, Illinois, USA
| | - Josh Bruce
- Birmingham AIDS Outreach, Birmingham, Alabama, USA
| | - D Scott Batey
- Department of Social Work, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Asa Radix
- Callen-Lorde Community Health Center, New York, New York, USA
| | - Uri Belkind
- Callen-Lorde Community Health Center, New York, New York, USA
| | - Marco A Hidalgo
- Children's Hospital of Los Angeles, Los Angeles, California, USA
| | - Sabina Hirshfield
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Rebecca Schnall
- School of Nursing, Columbia University, New York, New York, USA
| |
Collapse
|
2
|
Schnall R, Kuhns LM, Hidalgo MA, Powell D, Thai J, Hirshfield S, Pearson C, Ignacio M, Bruce J, Batey DS, Radix A, Belkind U, Garofalo R. Adaptation of a Group-Based HIV RISK Reduction Intervention to a Mobile App for Young Sexual Minority Men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2018; 30:449-462. [PMID: 30966769 PMCID: PMC7019210 DOI: 10.1521/aeap.2018.30.6.449] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
There is a dearth of evidence-based HIV prevention interventions for very young men who have sex with men (YMSM) ages 13-18 years, at high risk for HIV. We adapted the MyPEEPS intervention-an evidence-based, group-level intervention-to individual-level delivery by a mobile application. We used an expert panel review, in-depth interviews with YMSM (n = 40), and weekly meetings with the investigative team and the software development company to develop the mobile app. The expert panel recommended changes to the intervention in the following areas: (1) biomedical interventions, (2) salience of intervention content, (3) age group relevance, (4) technical components, and (5) stigma content. Interview findings reflected current areas of focus for the intervention and recommendations of the expert panel for new content. In regular meetings with the software development firm, guiding principles included development of dynamic content, while maintaining fidelity of the original curriculum and shortening intervention content for mobile delivery.
Collapse
Affiliation(s)
| | - Lisa M. Kuhns
- Ann & Robert H. Lurie Children’s Hospital, Division of Adolescent Medicine
| | | | | | - Jennie Thai
- Ann & Robert H. Lurie Children’s Hospital, Division of Adolescent Medicine
| | | | - Cynthia Pearson
- Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, WA
| | - Matt Ignacio
- Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, WA
| | - Josh Bruce
- Birmingham AIDS Outreach, Birmingham, AL
| | - D. Scott Batey
- Department of Social Work, University of Alabama at Birmingham, Birmingham, AL
| | - Asa Radix
- Callen-Lorde Community Health Center, New York
| | - Uri Belkind
- Callen-Lorde Community Health Center, New York
| | - Robert Garofalo
- Ann & Robert H. Lurie Children’s Hospital, Division of Adolescent Medicine
| |
Collapse
|
3
|
Hirshfield S, Grov C, Parsons JT, Anderson I, Chiasson MA. Social media use and HIV transmission risk behavior among ethnically diverse HIV-positive gay men: results of an online study in three U.S. states. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:1969-1978. [PMID: 26179596 DOI: 10.1007/s10508-015-0513-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 02/16/2015] [Accepted: 02/21/2015] [Indexed: 06/04/2023]
Abstract
Though Black and Hispanic men who have sex with men (MSM) are at an increased risk for HIV, few HIV risk reduction interventions that target HIV-positive MSM, and even fewer that use technology, have been designed to target these groups. Despite similar rates of social media and technology use across racial/ethnic groups, online engagement of minority MSM for HIV prevention efforts is low. Since minority MSM tend to have less representation in online HIV prevention studies, the goals of this online anonymous study of HIV-positive gay-identified men were to test the feasibility of conducting targeted recruitment by race/ethnicity and sexual orientation, to assess technology and social media use, and to assess global HIV transmission risk. In 2011, an anonymous online survey was conducted among 463 members of an HIV-positive personals website. Emails were sent to a subset of HIV-positive male members who self-identified as gay. While 57 % were White, substantial proportions of participants were Black (20 %) or Hispanic (18 %). Median age was 46 (range 18-79). Men who reported using 3 or more websites or apps to meet sex partners were significantly more likely to report anal intercourse (AOR 4.43, p < .001) and condomless anal sex (CAS) (AOR 2.70, p < .05) in the past 3 months. The only predictor of CAS with HIV-negative or unknown status partners was being under age 30 (AOR 3.38, p < .01). This study helped to inform online targeted recruitment techniques, access to technology and social media use, and sexual risk among a diverse sample of HIV-positive gay men. Efficacy trials of technology-based HIV prevention interventions targeting high-risk minority HIV-positive MSM are warranted.
Collapse
Affiliation(s)
- Sabina Hirshfield
- Research and Evaluation Unit, Public Health Solutions, 40 Worth Street, 5th Floor, New York, NY, 10013, USA,
| | | | | | | | | |
Collapse
|
4
|
Nöstlinger C, Nideröst S, Platteau T, Müller MC, Staneková D, Gredig D, Roulin C, Rickenbach M, Colebunders R. Sexual protection behavior in HIV-positive gay men: testing a modified information-motivation-behavioral skills model. ARCHIVES OF SEXUAL BEHAVIOR 2011; 40:817-827. [PMID: 20878223 DOI: 10.1007/s10508-010-9682-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Revised: 08/04/2010] [Accepted: 08/04/2010] [Indexed: 05/29/2023]
Abstract
This study on determinants of sexual protection behavior among HIV-positive gay men used the empirically tested information-motivation-behavioral skills (IMB) model. HIV-specific variables were added to the model to determine factors decisive for condom use with steady and casual partners. Data were collected using an anonymous, standardized self-administered questionnaire. Study participants were recruited at HIV outpatient clinics associated with the Eurosupport Study Group and the Swiss HIV Cohort Study. To identify factors associated with condom use, backward elimination regression analyses were performed. Overall, 838 HIV-infected gay men from 14 European countries were included in this analysis. About 53% of them reported at least one sexual contact with a steady partner; 62.5% had sex with a casual partner during the last 6 months. Forty-three percent always used condoms with steady partners and 44% with casual partners. High self-efficacy and subjective norms in favor of condom-use were associated with increased condom use with casual and steady partners, whereas feeling depressed was associated with decreased condom use with casual partners. Condoms were used less often with HIV-positive partners. Self-efficacy as an important behavioral skill to perform protection behavior was influenced by lower perceived vulnerability, higher subjective norms, and more positive safer sex attitudes. The IMB-model constructs appeared to be valid; however, not all the model predictors could be determined as hypothesized. Besides the original IMB constructs, HIV-specific variables, including sexual partners' serostatus and mental health, explained condom use. Such factors should be considered in clinical interventions to promote "positive prevention."
Collapse
Affiliation(s)
- Christiana Nöstlinger
- Department of Microbiology, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
| | | | | | | | | | | | | | | | | |
Collapse
|
5
|
|
6
|
O'Dell BL, Rosser BRS, Miner MH, Jacoby SM. HIV prevention altruism and sexual risk behavior in HIV-positive men who have sex with men. AIDS Behav 2008; 12:713-20. [PMID: 17985229 PMCID: PMC3433852 DOI: 10.1007/s10461-007-9321-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Accepted: 10/15/2007] [Indexed: 10/22/2022]
Abstract
An understanding of men's motivations to avoid risk behavior is needed to create efficacious HIV prevention programs for HIV-positive men who have sex with men (MSM). This study investigates the relationship between sexual risk behavior and HIV prevention altruism, which is defined as the values, motivations, and practices of caretaking towards one's sexual partners to prevent the transmission of HIV. In a sample of 637 HIV-positive MSM, HIV prevention altruism significantly protects against serodiscordant unprotected anal intercourse (SDUAI) in crude analysis, but not after adjustment for drug use and compulsive sexual behavior. HIV prevention altruism is also related to not engaging in anal intercourse, but is not related to serodisclosure to secondary partners. Lack of altruism appears related to sexual risk behavior in HIV-positive MSM, although other psychological and contextual factors play significant roles. The promotion of HIV prevention altruism may provide a formidable new direction for HIV prevention programs.
Collapse
Affiliation(s)
- Brennan L O'Dell
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S. Second Street, Suite 300, Minneapolis, MN 55454, USA.
| | | | | | | |
Collapse
|
7
|
Stall R. Efforts to Prevent HIV Infection That Target People Living with HIV/AIDS: What Works? Clin Infect Dis 2007; 45 Suppl 4:S308-12. [DOI: 10.1086/522555] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
8
|
Wolitski RJ, Parsons JT, Gómez CA, Purcell DW, Hoff CC, Halkitis PN. Prevention with gay and bisexual men living with HIV: rationale and methods of the Seropositive Urban Men's Intervention Trial (SUMIT). AIDS 2005; 19 Suppl 1:S1-11. [PMID: 15838188 DOI: 10.1097/01.aids.0000167347.77632.cd] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To provide a public health rationale for prevention with HIV-seropositive gay and bisexual men and to describe the methods of the Seropositive Urban Men's Intervention Trial (SUMIT). DESIGN A randomized intervention trial. METHODS Self-identified HIV-positive gay and bisexual men were recruited from community-based venues in New York City and San Francisco. Eligible participants completed an A-CASI baseline assessment, were asked to provide samples for sexually transmitted infection (STI) testing, and were randomly assigned to either a single-session intervention or a six-session enhanced intervention designed to reduce HIV transmission risk and promote serostatus disclosure. Participants who attended the first intervention session were assessed 3 and 6 months post-intervention. STI testing was offered at the 6-month assessment. RESULTS A total of 1168 self-identified HIV-seropositive gay and bisexual men completed the baseline assessment, and 1110 of these (95%) opted for STI testing. A total of 811 attended the first intervention session, of which 85% were assessed at 3 months and 90% were assessed at 6 months. Of those assessed at 6 months, 92% (670/729) provided a blood or urine sample for STI testing. CONCLUSION SUMIT demonstrates the feasibility and acceptability of prevention research with HIV-seropositive gay and bisexual men. The study provides new information about the sexual behavior, serostatus disclosure practices, and the efficacy of an intervention to reduce HIV transmission risk.
Collapse
Affiliation(s)
- Richard J Wolitski
- Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road (E-37), Atlanta, GA 30333, USA.
| | | | | | | | | | | |
Collapse
|