CyberSenga: Harnessing the power of the internet to prevent HIV in Ugandan youth

描述(申请人提供)：艾滋病毒/艾滋病是乌干达发病率和死亡率的主要因素。尽管在艾滋病毒预防工作方面取得了积极进展，但最近的数据表明，艾滋病毒流行率总体上正在上升，而艾滋病毒知识--行为的直接贡献者--与十年前相比，特别是在年轻人中正在下降。在资源匮乏的情况下，互联网是一种很有前途的干预交付方式，因为与扩大规模相关的成本很低；如果一个人或100,000人使用该程序，在线传播是相同的。同样重要的是，它在一种没有污名的匿名氛围中提供了获取重要健康信息的途径。我们最近的数据显示，乌干达姆巴拉拉45%的青少年使用过互联网，其中78%的人在前一周至少上网一次。在同一项调查中，81%的受访者表示，如果艾滋病毒预防网站存在，他们会去访问。在这些数据的基础上，我们建议制定一个适合文化的、基于互联网的艾滋病毒预防计划，专门为12至18岁的乌干达青少年设计。我们的具体目标如下：具体目标1：为青少年设计一个6小时的基于互联网的艾滋病毒预防计划。内容将根据乌干达青少年的艾滋病毒预防信息、动机和行为技能需求进行文化定制。具体目标2：在姆巴拉拉日制学校就读中1-4年级(类似于美国高中8-11年级)的青少年中进行随机对照试验(n=500)，测试干预措施。我们的主要结果衡量标准是干预后6个月无保护措施性行为的频率。次要结果将是干预后6个月的性禁欲。我们通过在意向治疗分析中检验干预组和对照组之间结果的显著差异来确定干预效果。该项目有可能开发低成本和可扩展的干预措施，以应对乌干达青少年中艾滋病毒传播的危险行为。

DESCRIPTION (provided by applicant): HIV/AIDS is a major contributor to morbidity and mortality in Uganda. Despite aggressive advances in HIV prevention efforts, recent data suggest that HIV prevalence is increasing generally, and HIV knowledge, a direct contributor to behavior, is on the decline among young people specifically as compared to a decade ago. The Internet is a promising mode of intervention delivery in resource poor-settings because the costs associated with scaling up are minimal; dissemination online is the same if one person or 100,000 people use the program. Just as important, it provides access to important health information in a stigma-free, anonymous atmosphere. Our recent data indicate that 45% of adolescents in Mbarara, Uganda have used the Internet, 78% of whom went online at least once in the previous week. Eighty-one percent of respondents in the same survey indicated they would go to an HIV prevention web site if it existed. Based upon these data, we propose to develop a culturally appropriate, Internet-based HIV prevention program designed specifically for Ugandan adolescents between the ages of 12 and 18 years. Our specific aims are as follows: Specific Aim 1: Design a 6-hour, Internet-based HIV prevention program for adolescents. Content will be culturally tailored to the HIV preventive information, motivation, and behavioral skills needs of Ugandan adolescents. Specific Aim 2: Test the intervention in a randomized controlled trial (n=500) among adolescents attending grades Secondary 1-4 (similar to US high school grades 8th -11th) at day schools in Mbarara. Our main outcome measure is the frequency of unprotected sex 6-months post-intervention. The secondary outcome will be sexual abstinence 6-months post-intervention. We determine intervention efficacy by testing for a significant difference in outcomes between intervention and control group in an intent-to-treat analysis. This project has the potential to develop low-cost and scalable interventions to HIV transmission risk behaviors among adolescents in Uganda.