Pilot RCT Results of an mHealth HIV Prevention Program for Sexual Minority Male Adolescents
Pilot RCT Results of an mHealth HIV Prevention Program for Sexual Minority Male Adolescents
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DOI：
10.1542/peds.2016-2999
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发表时间：
2017-07-01
期刊：
影响因子：
8
通讯作者：
Mustanski, Brian
中科院分区：
文献类型：
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作者：
Ybarra, Michele L.;Prescott, Tonya L.;Mustanski, Brian
背景：Guy2Guy(G2G)是第一个针对年仅14岁的性少数男性开发的全面艾滋病毒预防计划，并通过短信在全国范围内传播。在这里，我们报告了先导随机对照试验的结果。方法：G2G与注意力匹配的“健康生活方式”对照组(例如，自尊)进行测试。这两个程序都持续了5周，每天发送5到10条短信。6周后提供1周的增强剂。参与者是年龄在14岁到18岁之间的男同性恋者、双性恋者和/或同性恋者，他们有无限制的短信计划。2014年10月至2015年4月，美国各地通过Facebook招募青年，并通过电话招募。干预后90天的结果是无套性行为(CSA)和禁欲，其次是艾滋病毒检测。我们还在干预结束时检查了这些结果，并根据性经历对其进行分层。结果：在干预后90天，CSA或禁欲方面没有显著差异。在基线时性行为活跃的参与者中，干预参与者报告接受艾滋病毒检测的可能性显著增加(调整后的优势比=3.42，P=.001)。与对照组相比，他们禁欲的可能性也更低(调整后的优势比=0.48，P=0.05)。在干预结束时，干预组的CSA显著低于对照组(发生率比=0.39，P=0.04)，但在分析中加入年龄后就失去了显著性(发生率比=0.58，P=.26)。结论：G2G在提高青少年HIV检测率方面是有希望的。性积极干预信息似乎增加了参与者对性行为的舒适度(即，减少禁欲)，而不会增加他们传播艾滋病毒的可能性(即，更多的CSA)。可能需要额外的内容或功能来刺激避孕套的使用。
BACKGROUND: Guy2Guy (G2G) is the first comprehensive HIV prevention program developed for sexual minority males as young as 14 years old and is delivered nationally via text messaging. Here, we report the results of the pilot randomized control trial.METHODS: G2G was tested against an attention-matched "healthy lifestyle" control (eg, self-esteem). Both programs lasted 5 weeks and delivered 5 to 10 text messages daily. A 1-week booster was delivered 6 weeks subsequently. Participants were cisgender males ages 14 to 18 years old who were gay, bisexual, and/or queer and had an unlimited text messaging plan. Youth were recruited across the United States via Facebook and enrolled by telephone from October 2014 to April 2015. Ninety-day postintervention outcomes were condomless sex acts (CSA) and abstinence and, secondarily, HIV testing. We also examined these outcomes at intervention end and stratified them by sexual experience.RESULTS: At 90 days postintervention, there were no significant differences in CSAs or abstinence noted. Among participants who were sexually active at baseline, intervention participants were significantly more likely to report getting an HIV test (adjusted odds ratio = 3.42, P = .001). They were also less likely than control youth to be abstinent (adjusted odds ratio = 0.48, P = .05). CSAs were significantly lower for those in the intervention versus control at intervention end (incident rate ratio = 0.39, P = .04), although significance was lost once age was added to the analysis (incident rate ratio = 0.58, P = .26).CONCLUSIONS: G2G appears promising in increasing adolescent HIV testing rates. Sex-positive intervention messages appear to have increased the participants' comfort with having sex (ie, less abstinence) while not increasing their potential for HIV transmission (ie, more CSAs). Additional content or features may be needed to invigorate condom use.