Efficacy of Internet-based HIV prevention

描述(申请人提供)：男男性行为者(MSM)是美国最大的艾滋病毒传播群体，在年轻MSM(18-24岁)中感染增加最多，然而，很少有艾滋病毒预防计划被开发并被证明对这一弱势群体有效。为了解决这些艾滋病毒预防问题，我们与社区组织(CBO)在NIH R34拨款的背景下合作开发和试点测试，保持下去！(Kiu！)，这是一个为不同种族的YMSM量身定做的在线艾滋病毒预防计划。乔！是基于艾滋病毒风险行为改变的信息-动机-行为技能(IMB)模型，并由电子学习的校长提供信息。我们的小规模中试随机临床试验(RCT)证明了KiU！干预：我们招募了不同种族的YMSM样本；通过3个月的随访获得了良好的保留率(89%)；保持了强有力的干预参与度；与积极对照相比，无保护肛交显著减少了44%。当前提案的总体目标是促进以技术为基础的行为艾滋病毒预防的科学知识，并通过建立针对YMSM的创新电子健康预防计划的有效性来改善公共健康。我们将以三个具体目标来实现这些目标。首先，我们将整合Kiu！对广泛使用的卫生技术平台进行干预，以增加其可扩展性、适应性和广泛实施的潜力。第二，我们将测试KIAU的疗效！ 多点随机对照试验中的电子健康干预：a)招募在芝加哥和纽约的社区合作伙伴的诊所进行艾滋病毒检测呈阴性的不同种族的YMSM(N=750；&GT；65%)；b)将参与者随机分配到KiU！干预或艾滋病毒知识控制情况；以及c)在基线和3、6和12个月的跟踪评估时衡量干预结果。主要的行为结果将是无保护的肛交行为的计数，主要的生物医学结果将是性传播感染的发生率。第三，我们将探索如果Kiu！根据种族/民族、关系状态(正式关系与非正式关系)和同性恋/双性恋身份，干预措施在YMSM的重要亚群中具有不同的效果。我们的乔！该方法在将电子健康解决方案与艾滋病毒和性传播感染检测联系起来方面具有创新性，并成为将可扩展的行为预防纳入其他生物医学预防战略的典范。 公共卫生相关性：男男性行为者(MSM)是美国最大的艾滋病毒传播群体，在年轻MSM(18-24岁)中感染增加最多，然而，很少有艾滋病毒预防计划被制定并被证明对这一弱势群体有效。这项提案的首要目标是通过建立一项针对YMSM的创新的、基于互联网的艾滋病毒预防计划的有效性来改善公共卫生。

DESCRIPTION (provided by applicant): Men who have sex with men (MSM) are the largest HIV transmission group in the US and infections are increasing most among young MSM (18-24 years), however, few HIV prevention programs have been developed and proven effective with this vulnerable population. To address these HIV prevention concerns, we collaborated with community-based organizations (CBOs) in the context of an NIH R34 grant to develop and pilot test, Keep It Up! (KIU!), an online HIV prevention program tailored to ethnically diverse YMSM. KIU! is based on the Information-Motivation-Behavior Skills (IMB) model of HIV risk behavior change and informed by principals of E-learning. Our small-scale pilot randomized clinical trial (RCT) demonstrated the feasibility and acceptability of the KIU! intervention: we enrolled an ethnically diverse sample of YMSM; achieved excellent retention through 3-month follow-up (89%); maintained robust intervention engagement; and produced a significant 44% decrease in unprotected anal sex relative to an active control. The overarching goal of the current proposal is to advance scientific knowledge of technology-based, behavioral HIV prevention, as well as improve public health by establishing the efficacy of an innovative eHealth prevention program for YMSM. We will accomplish these goals with three specific aims. First, we will integrate the KIU! intervention into a widely-used health technology platform to increase its scalability, adaptability, and potential for broad implementation. Second, we will test the efficacy of the KIU! eHealth intervention in a multisite RCT by: a) enrolling ethnically diverse YMSM (N = 750; > 65% racial/ethnic minorities) who tested HIV negative in the clinics of our community partners in Chicago and New York; b) randomizing participants to either the KIU! intervention or an HIV knowledge control condition; and c) measuring intervention outcomes at baseline and follow-up assessments at 3, 6, and 12 months. The primary behavioral outcome will be the count of unprotected anal sex acts and the primary biomedical outcome will be STI incidence. And third, we will explore if the KIU! intervention has differential efficacy across important sub-groups of YMSM based on race/ethnicity, relationship status (serious versus casual relationships), and gay/bisexual identity. Our KIU! approach is innovative in linking an eHealth solution to HIV and STI testing, as well as serving as model for integrating scalable behavioral prevention into other biomedical prevention strategies. PUBLIC HEALTH RELEVANCE: Men who have sex with men (MSM) are the largest HIV transmission group in the US and infections are increasing most among young MSM (18-24 years), however, few HIV prevention programs have been developed and proven effective with this vulnerable population. The overarching goal of this proposal is to improve public health by establishing the efficacy of an innovative, Internet-based HIV prevention program for YMSM.