Developing and Pilot Testing a Mobile Phone-Based HIV/STI Prevention Intervention

开发和试点测试基于手机的艾滋病毒/性传播感染预防干预措施

• 批准号: 8467323
• 负责人: JOHN BARTON JEMMOTT
• 金额: $ 54.46万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-27 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8467323
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adopted; African; African American; Age; Age-Years; Anus; Attention; Behavior; Behavior Therapy; Belief; Car Phone; Centers for Disease Control and Prevention (U.S.); Client; Communities; Computer Assisted; Control Groups; Educational workshop; Focus Groups; Funding; HIV; HIV Infections; HIV/STD; Health Promotion; Human immunodeficiency virus test; Incidence; Individual; Intervention; Intervention Studies; Interview; Life; Literature; Longevity; Mediating; Newly Diagnosed; Ownership; Participant; Patient Self-Report; Pattern; Pilot Projects; Population; Prevention; Preventive Intervention; Process; Public Health; Publishing; Randomized; Randomized Controlled Trials; Reporting; Research; Risk; Risk Reduction; Safe Sex; Screening procedure; Sex Behavior; Sexual Partners; Solid; Subgroup; Target Populations; Technology; Testing; Text; Time; Treatment Efficacy; Unsafe Sex; Vagina; base; behavior change; condoms; consistent condom use; cost effective; design; effective intervention; efficacy testing; follow-up; health disparity; innovation; intervention effect; man; men; men who have sex with men; primary outcome; response; secondary outcome; sex; sex risk; social cognitive theory; tool; trend; usability; AIDS prevention; AIDS/HIV problem; Accounting; Address; Adopted; African; African American; Age; Age-Years; Anus; Attention; Behavior; Behavior Therapy; Belief; Car Phone; Centers for Disease Control and Prevention (U.S.); Client; Communities; Computer Assisted; Control Groups; Educational workshop; Focus Groups; Funding; HIV; HIV Infections; HIV/STD; Health Promotion; Human immunodeficiency virus test; Incidence; Individual; Intervention; Intervention Studies; Interview; Life; Literature; Longevity; Mediating; Newly Diagnosed; Ownership; Participant; Patient Self-Report; Pattern; Pilot Projects; Population; Prevention; Preventive Intervention; Process; Public Health; Publishing; Randomized; Randomized Controlled Trials; Reporting; Research; Risk; Risk Reduction; Safe Sex; Screening procedure; Sex Behavior; Sexual Partners; Solid; Subgroup; Target Populations; Technology; Testing; Text; Time; Treatment Efficacy; Unsafe Sex; Vagina; base; behavior change; condoms; consistent condom use; cost effective; design; effective intervention; efficacy testing; follow-up; health disparity; innovation; intervention effect; man; men; men who have sex with men; primary outcome; response; secondary outcome; sex; sex risk; social cognitive theory; tool; trend; usability

DESCRIPTION (provided by applicant): This proposal is submitted in response to the alarming rates of HIV among young African American men who have sex with men (MSM). The CDC recently reported that between 2006 and 2009, HIV incidence was stable among all populations in the US except young MSM. The overall increase in incidence among young MSM was driven by a 48% increase in HIV infections among young African American MSM. The broad, long-term objective of this research is to identify strategies to reduce the rates of HIV in young African American MSM. This research will take advantage of the men's avid use of mobile phone technology to deliver an innovative intervention to change their sexual risk behavior. The Specific Aims are to: 1) develop an interactive mobile phone-based HIV/STI risk-reduction intervention that is acceptable and feasible to be implemented with African American MSM ages 18 to 24 years; 2) develop an acceptable and feasible text-messaging adjunctive strategy designed to increase its efficacy; 3) pilot test the efficacy of the HIV/STI risk-reductio intervention compared with an attention-control intervention in increasing the proportion of men who report consistent condom use during anal and vaginal intercourse; and 4) pilot test whether the efficacy of the HIV/STI risk-reduction compared with the control intervention is enhanced among men randomized to the tailored text-messaging adjunctive intervention as compared with other men. African American men ages 18 to 24 years who report having anal intercourse with a man in the 2 months prior to screening will be eligible to participate. The intervention and adjunctive strategy will be developed using an iterative process involving focus groups, input from a community advisory board, usability testing, and small-scale pilot testing. Evidence of potential efficacy will be based on a pilot randomized controlled trial involving 180 men with 6-month follow-up. Men will be randomly assigned to the HIV/STI risk-reduction or an attention-control intervention. In addition, they will be randomly assigned to receive or not receive intervention-specific, individually tailored text messages. The approach draws on social cognitive theory and the applicant's Preliminary Studies with the target population. Self-reported consistent condom use, other sexual behaviors, HIV testing, and variables hypothesized to mediate intervention efficacy will be collected via audio-computer-assisted self-interviewing. The use of a mobile phone technology for intervention would allay participants' concerns about revealing their sexual involvement with men by virtue of participating in a group or workshop intervention. If current trends in smartphone use continue, this research has the potential to produce a cost-effective intervention that local, state, or national organizations might offer to their young African American MSM clients. The proposed research has great public health significance because although young African American MSM have some of the highest rates of HIV in the US, there is a paucity of efficacious HIV/STI interventions tailored to them. PUBLIC HEALTH RELEVANCE: Men who have sex with men (MSM) continue to account for the largest number of new HIV cases in the US, and the rates of newly diagnosed HIV in young African American MSM are especially high, rivaling those in many sub-Saharan African nations. Yet, no published randomized controlled trial has tested HIV/STI risk-reduction interventions for young African American MSM. These men are avid users of mobile phones, and if current trends in smartphone ownership continue, the potential product of this research, if successful, might be a cost-effective intervention that local, state, or national organizations can offer to thir young African American MSM clients.

描述（由申请人提供）：该提案是针对与男性发生性关系的年轻非裔美国人（MSM）的艾滋病毒率提高的。疾病预防控制中心最近报道说，在2006年至2009年之间，除年轻MSM以外，在美国所有人群中，艾滋病毒的发病率均稳定。年轻MSM的总体发病率增加是由于年轻非裔美国人MSM的艾滋病毒感染增加了48％。这项研究的广泛，长期目标是确定降低艾滋病毒率的策略 年轻的非裔美国人MSM。这项研究将利用男性对手机技术的狂热使用来提供创新的干预措施来改变其性风险行为。具体目的是：1）开发一种基于交互式手机的艾滋病毒/STI风险降低干预措施，可与18至24岁的非洲裔美国MSM实施可接受且可行的； 2）制定一种可接受且可行的文本消息辅助策略，旨在提高其功效； 3）试验测试HIV/STI风险还原干预的功效，而注意力控制干预措施增加了在肛门和阴道性交期间报告避孕套一致使用的男性的比例； 4）试点测试与其他男性相比，随机分配到量身定制的文本消息辅助干预的男性中，HIV/STI风险降低与对照干预相比的疗效是否得到增强。 18至24岁的非裔美国人报告在筛查前的两个月与一名男子进行肛交将有资格参加。干预和辅助策略将使用涉及焦点小组的迭代过程，社区顾问委员会的投入，可用性测试和小规模的试点测试制定。潜在疗效的证据将基于一项试验随机对照试验，涉及180名有6个月随访的男性。男性将被随机分配到HIV/STI风险降低或注意力控制干预措施中。此外，它们将被随机分配为接收或未接收特定于干预的，单独定制的文本消息。该方法借鉴了社会认知理论以及申请人与目标人群的初步研究。自我报告的一致的避孕套使用，其他性行为，HIV测试以及假设介导干预功效的变量将通过音频计算机辅助的自我访问来收集。使用手机技术进行干预将使参与者担心通过参加小组或研讨会干预，揭示他们与男人的性爱。如果智能手机使用中当前的趋势继续存在，这项研究有可能进行具有成本效益的干预措施，该干预措施本地，州或国家组织可能会为其年轻的非裔美国人MSM客户提供。拟议的研究具有很大的公共卫生意义，因为尽管年轻的非裔美国人MSM在美国的艾滋病毒率是最高的艾滋病毒率最高，但对他们量身定制的有效艾滋病毒/性传播感染措施很少。 公共卫生相关性：与男性发生性关系的男性（MSM）继续说明美国新的HIV病例数量最多，在非裔美国人MSM中，新诊断的HIV率尤其很高，与许多撒哈拉以南非洲国家的艾滋病毒相抗衡。 然而，尚未发表的随机对照试验对非裔美国人MSM的HIV/STI降低风险干预进行了测试。这些人是手机的狂热用户，如果智能手机所有权的当前趋势仍在继续，那么这项研究的潜在产品（如果成功）可能是一项经济有效的干预措施，当地，州或国家组织可以为年轻的非裔美国人MSM客户提供。