A Mobile App to Increase Routine HIV Testing Among High-Risk Diverse MSM

描述（由申请人提供）：尽管目前的测试推广工作，以大幅降低新的艾滋病毒感染率在美国，男性与男性发生性关系（MSM）可能没有意识到需要或动机定期测试艾滋病毒/性传播感染。目前的艾滋病毒检测指南建议至少每年进行一次检测，对于那些有可识别的风险因素的人，包括使用药物和有多个或匿名性伴侣的人，应进行更定期的检测（每3至6个月）。然而，最近的研究表明，三分之一的美国男男性行为者在过去一年中没有进行艾滋病毒检测，尽管在2005年至2011年期间，这一人群的无保护性行为呈增加趋势。为了解决这一差距，我们提出了一项为期3年的研究，以开发和试点测试量身定制的，以理论为基础的（在信息-动机-行为技能模型） 智能手机应用程序（或“app”）干预，以促进在全国范围内有艾滋病毒风险的男男性行为者样本中进行定期艾滋病毒检测。基于我们对男男性接触者的广泛艾滋病预防研究，智能手机应用程序干预的核心组成部分将包括：a）通过个人档案定期评估风险行为; B）根据个人的风险模式和档案，为艾滋病检测频率提供量身定制的建议; c）支持GPS的艾滋病检测位置查找器; d）针对检测关键障碍的激励信息;以及e）一个图形化的吸引人的界面，适合男男性接触者独特的文化和社会偏好。本研究将分3个阶段进行，并有相应的目标。在目标1中，将在美国两个城市进行6个高危MSM焦点小组的研究（明尼苏达州明尼阿波利斯市和密歇根州底特律市），以确定哪些应用程序特性和功能最有可能支持下载、启动使用和持续参与量身定制的HIV/STI测试应用程序。智能手机应用程序将与我们的技术合作伙伴Aim 2合作开发，在密歇根州底特律市和明尼苏达州明尼阿波利斯市的6名目标人群中进行了可用性测试。最后，目标3的目标是评估智能手机应用程序干预的可行性和可接受性，以促进在种族和民族多样化的美国男男性接触者中以定制的规定间隔定期进行艾滋病毒检测。在过去一年中未进行HIV检测的120名HIV阴性/未知MSM高危人群的全国样本将被随机分配到实验组（n=60）或对照组（n=60），并随访6个月，在基线、3个月和6个月进行评估。控制条件将是一个非定制的、仅提供信息的HIV检测应用程序版本。除了可行性和可接受性措施外，还将计算初步的效果估计 为后续的R 01试验提供信息这项拟议中的研究将有助于通过利用智能手机应用程序技术来促进艾滋病毒预防干预措施的科学，以促进有感染艾滋病毒风险的美国男男性行为者的定期检测。研究结果将为一项大型国家RCT研究的开发和实施提供信息，以测试疗效。如果在随后的R 01试验中有效，该干预措施将通过与美国的诊所、社区组织和MSM使用的网站合作，随时可用于扩大全国范围的传播。

DESCRIPTION (provided by applicant): Despite current testing promotion efforts to critically reduce the rate of new HIV infections in the US, men who have sex with men (MSM) may not be aware of the need or motivated to test for HIV/STIs at regular intervals. Current HIV testing guidelines recommend at least annual testing, with more regular testing (every 3 to 6 months) for those with identifiable risk factors, including substance use and having multiple or anonymous sex partners. However, recent studies show that one-third of US MSM have not tested for HIV in the past year, despite the trend of increasing unprotected sex between 2005 and 2011 in this population. To address this gap, we propose a 3-year study to develop and pilot test a tailored, theoretically-based (in the Information- Motivation-Behavioral Skills model) smartphone application (or "app") intervention to facilitate regular HIV testing among a diverse nation-wide sample of MSM who are at-risk for HIV. Derived from our extensive HIV prevention research with MSM, core components of the smartphone app intervention will include: a) regular assessment of risk behaviors via personal profile; b) tailored recommendations for frequency of HIV testing based on individual's risk patterns and profile; c) GPS-enabled HIV testing location finder; d) motivational messages addressing critical barriers to testing; and e) a graphically appealing interface tailored to the unique cultural and social preferences of MSM. The study will be conducted in 3 phases with corresponding aims. In Aim 1, 6 focus groups of high-risk MSM will be conducted in 2 US cities (Minneapolis, MN and Detroit, MI) to determine which app features and functions are most likely to support downloading, initiating use, and sustaining engagement over time of the tailored HIV/STI testing app. The smartphone app will be developed in collaboration with our technology partner in Aim 2, and usability tested among 6 members of the target population in Detroit, MI and Minneapolis, MN. Finally, the goal of Aim 3 is to assess the feasibility and acceptability of the smartphone app intervention to promote regular HIV testing at tailored, prescribed intervals among racially and ethnically diverse US MSM. A national sample of 120 at-risk HIV-negative/unknown MSM who have not been tested for HIV in the past year will be randomly assigned to either the experimental (n=60) or control condition (n=60) and followed for 6 months, with assessments at baseline, 3- and 6-months. The control condition will be a non-tailored, information-only version of the HIV testing app. In addition to feasibility and acceptability measures, preliminary effect estimates will be calculated to inform a subsequent R01 trial. This proposed study would help advance science of HIV prevention interventions by harnessing smartphone app technology to promote regular testing among US MSM who at-risk for acquisition of HIV. Findings will inform the development and implementation of a large, national RCT study to test for efficacy. If effective in the subsequent R01 trial, the intervention will be readily available for scale-up for national dissemination by partnering with clinics, community-based organizations, and websites used by MSM in the US.