mHealth and HIV self-testing for high-risk men in China

 描述(由申请人提供)：在这份R34申请(PAR-14-179：改善艾滋病毒/艾滋病治疗和预防的干预和服务的临床试验规划补助金)中，我们建议开发和试行一种干预措施，以提高艾滋病毒自我检测(HST)的科学水平，作为一种公共卫生战略，在低检测率人群中增加艾滋病毒检测。HST为实现更高水平的艾滋病毒检测提供了一个令人信服的战略，因为与寻求以临床为基础的传统形式的艾滋病毒检测相关的障碍减少了。然而，仅仅扩大HST作为一项公共卫生战略是不够的：HST阴性结果的个人需要动机进行重复检测并鼓励他们减少危险行为。因此，我们提出了一种将HST与基于移动应用(APP)的HIV风险降低和行为改变动机消息相结合的组合策略。这项提案研究将在中国进行，我们之前的研究表明，在那里，男男性行为者(MSM)的检测率低、行为风险高，以及临床艾滋病毒预防服务的障碍。这项研究将利用中国人普遍获得手机和基于APP的电子消息技术的优势，为MSM开发一种基于HST和mHealth APP的组合消息传递策略的测试。我们将使用三个阶段的研究方法来解决我们的具体目标。首先，我们将进行形成性的定性研究，以了解中国地区男男性接触者中艾滋病病毒自我检测的促进者和障碍。第二，根据定性结果，我们将开发一个简短消息库，以激励降低风险和改变行为，我们将使用认知访谈技术和开放试点来细化和最终确定基于APP的消息内容和实施策略。第三，我们将在一个高危MSM样本中试点测试HST和基于移动应用程序的降低风险消息的组合与单独使用HST相比，在未来6个月内重复HST和性危险行为的变化。这项拟议的研究具有创新性，因为这是已知的第一次尝试开发一种结合HST的方法，利用移动技术的进步作为重复测试和激励行为改变的平台。我们将使用研究结果来支持后续的应用程序，以测试HST和基于APP的消息干预组合对性风险行为和艾滋病毒重新检测的有效性。

 DESCRIPTION (provided by applicant): In this R34 application (PAR-14-179: Clinical Trial Planning Grant for Interventions and Services to Improve Treatment and Prevention of HIV/AIDS), we propose to develop and pilot test an intervention to improve the science of HIV self-testing (HST) as a public health strategy to increase HIV testing among populations with low testing rates. HST offers a compelling strategy for achieving higher levels of HIV testing, due to the reduced barriers associated with seeking traditional forms of clinic-based HIV testing. However, HST scale-up alone is insufficient as a public health strategy: individuals who receive an HST negative result require motivation to engage in repeat testing and encouragement to reduce their risk behaviors. Thus, we propose a combination strategy that incorporates HST with mobile application- ("app"-) based HIV risk reduction and behavior change motivation messages. The proposal research will take place in China, where our prior research has demonstrated low rates of testing, high behavioral risk, and barriers to clinical HIV prevention services among men who have sex with men (MSM). The research will leverage the broad general access to mobile phone and app-based electronic messaging technology in the Chinese population to develop a test a combined HST plus mHealth app-based messaging strategy for MSM. We will use a three-phase research approach to address our specific aims. First, we will conduct formative qualitative research to understand the facilitators and barriers to HIV self-testing (HST) among MSM in China. Second, based on qualitative findings, we will develop a library of brief messages to motivate risk reduction and behavior change, and we will use cognitive interviewing techniques and an open pilot to refine and finalize the app-based messaging content and implementation strategy. Third, we will pilot test the combination of HST plus mobile app-based risk reduction messaging compared to HST alone in a sample of high-risk MSM, with respect to repeat HST and changes in sexual risk behaviors in the next 6 months. The proposed study is innovative because it is the first known attempt to develop a combination approach to HST that leverages advances in mobile technology as a platform for repeat testing and motivating behavior change. We will use findings to support a subsequent application to test the effectiveness of the combined HST plus app-based messaging intervention on sexual risk behavior and HIV retesting.