Theory-based Text Messaging to Reduce Methamphetamine Use and HIV Risks Among MSM

基于理论的短信可减少 MSM 中的甲基苯丙胺使用和艾滋病毒风险

• 批准号: 8609013
• 负责人: Cathy J Reback
• 金额: $ 53.41万
• 依托单位: FRIENDS RESEARCH INSTITUTE, INC.
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-02-01 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8609013
• 关键词: AIDS prevention; Adherence; Anal Sex; Anti-Retroviral Agents; Automation; Behavioral; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Communication; Data; Dependence; Drug usage; Effectiveness; Exposure to; Funding; Gays; Goals; HIV; HIV Infections; HIV Seropositivity; HIV risk; Health Educators; Intervention; Methamphetamine; Modeling; Outcome; Participant; Persons; Pilot Projects; Population; Prevalence; Preventive Intervention; Primary Health Care; Randomized; Randomized Controlled Trials; Relative (related person); Research; Risk; Sex Behavior; Site; Social support; Staging; Testing; Text; Time; Work; base; behavior change; cost; cost effective; cost effectiveness; design; digital; follow-up; handheld mobile device; health belief; high risk; high risk behavior; high risk sexual behavior; interest; meetings; men who have sex with men; novel; open label; peer; post intervention; public health relevance; response; sex; sex risk; social cognitive theory; theories; therapy design; transmission process; treatment adherence; web site

DESCRIPTION (provided by applicant): Methamphetamine use among men who have sex with men (MSM) is deeply integrated into socio-sexual networks including physical risk venues such as circuit parties, sex clubs, and bathhouses and digital spaces such as cell phone applications, websites, and digital chat rooms to "hook up" for sex. Thus, methamphetamine use is highly associated with HIV infection due specifically to concomitant high-risk sexual behaviors that occur while using the drug. Text-messaging is a novel, feasible, and sustainable approach for targeting high-risk, out-of-treatment MSM; particularly, MSM who fail to attend face-to-face or site-based interventions. A real-time text-messaging intervention capitalizes on a communication channel to which this population will attend at the exact time they are most likely to make high-risk sexual decisions. This application is in response to PA-10-012 for technologically enhanced Stage II research. Consistent with the specific research interest of the PA, this application builds on findings from an open-label Stage I study that developed and piloted a HIV prevention intervention to reduce methamphetamine use and high-risk sexual behaviors among out-of-treatment, methamphetamine-using MSM. During the pilot study, text messages - based on established behavioral change theories and specifically tailored to urban, out-of-treatment, methamphetamine-using MSM - were developed and tested. The proposed Stage II trial will assess the impact of an 8-week, gay-specific, theory-based text-messaging intervention designed to decrease methamphetamine use and HIV sexual risk behavior and, for the HIV-infected participants, simultaneously increase HIV antiretroviral treatment/adherence in out-of-treatment, methamphetamine-using MSM (N = 285). Participants will receive text messages that are personally tailored to fit their risk profile; the theory-based text messages serve as the mechanisms of behavior change. Participants will be randomized into one of three conditions: Group 1: culturally relevant theory-based text messages interactively transmitted by peer health educators (TXT-PHE); or, Group 2: the same culturally relevant theory-based text messages transmitted by automation (TXT-Auto); or, Group 3: assessment-only (AO) control with no theoretically based text messages. Participants will receive brief weekly text-message assessments on their methamphetamine use and HIV sexual behaviors in the previous seven days. The specific aims of this research are: 1) To determine differential immediate and sustained effects of transmitting theory-based text messages by PHE (TXT-PHE) versus by automation (TXT- Auto), compared to an assessment-only (AO) control condition among out-of-treatment, methamphetamine- using MSM for reductions of methamphetamine use and HIV sexual risk behaviors; and, 2) To determine the cost-effectiveness of TXT-PHE vs. TXT-Auto compared to AO for reducing methamphetamine use and HIV sexual risk behaviors. The randomized three-group design uses repeated assessments at baseline, at the end of the intervention, and at 3-, 6-, and 9-month post-randomization follow-up.

描述（由申请人提供）：男男性行为者（MSM）使用甲基苯丙胺已深深融入社会性网络，包括巡回派对、性俱乐部和浴室等身体风险场所，以及手机应用程序、网站和数字聊天室等数字空间，以“勾搭”性行为。因此，甲基苯丙胺的使用与艾滋病毒感染高度相关，特别是由于使用该药物时伴随发生的高风险性行为。短信是针对高风险、未接受治疗的 MSM 的一种新颖、可行且可持续的方法；特别是未能面对面参加或 基于现场的干预措施。实时短信干预利用了这一人群在最有可能做出高风险性决定的确切时间参与的沟通渠道。此申请是为了响应 PA-10-012 的技术增强型第二阶段研究。与 PA 的具体研究兴趣一致，该申请建立在开放标签第一阶段研究的结果基础上，该研究开发并试点了艾滋病毒预防干预措施，以减少未接受治疗的使用甲基苯丙胺的 MSM 的甲基苯丙胺使用和高风险性行为。在试点研究期间，短信——基于既定的行为改变理论，专门针对城市、未接受治疗、使用甲基苯丙胺的男男性行为者——进行了开发和测试。拟议的第二阶段试验将评估为期 8 周、针对同性恋、基于理论的短信干预的影响，该干预旨在减少甲基苯丙胺的使用和 HIV 性危险行为，并同时提高 HIV 感染者的 HIV 抗逆转录病毒治疗/依从性、使用甲基苯丙胺的 MSM（N = 285）。参与者将收到根据其风险状况量身定制的短信；基于理论的短信充当行为改变的机制。参与者将被随机分配到以下三种条件之一：第 1 组：由同伴健康教育者交互式传输文化相关的基于理论的短信 (TXT-PHE)；或者，第 2 组：通过自动化 (TXT-Auto) 传输相同的文化相关的基于理论的文本消息；或者，第 3 组：仅评估 (AO) 控制，没有基于理论的文本消息。参与者将每周收到简短的短信评估，评估他们在过去 7 天内的甲基苯丙胺使用情况和艾滋病毒性行为。本研究的具体目标是： 1) 确定通过 PHE (TXT-PHE) 与自动化 (TXT-Auto) 传输基于理论的短信的即时和持续差异，与治疗外、使用甲基苯丙胺的 MSM 中仅评估 (AO) 控制条件相比，以减少甲基苯丙胺使用和艾滋病毒性危险行为； 2) 确定 TXT-PHE 与 TXT-Auto 相比 AO 在减少甲基苯丙胺使用和 HIV 性危险行为方面的成本效益。随机三组设计在基线、干预结束时以及随机化后 3、6 和 9 个月的随访时进行重复评估。