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

描述(由申请人提供)：尽管目前的检测宣传努力极大地降低了美国新的艾滋病毒感染率，但男男性行为者(MSM)可能没有意识到定期检测艾滋病毒/性传播疾病的必要性或动机。目前的艾滋病毒检测指南建议至少每年进行一次检测，对那些有可识别的风险因素的人进行更定期的检测(每3至6个月)，包括使用药物和有多个或匿名性伴侣。然而，最近的研究表明，尽管2005年至2011年间，这一人群中无保护措施的性行为有增加的趋势，但三分之一的美国男男性接触者在过去一年里没有进行艾滋病毒检测。为了解决这一差距，我们建议进行一项为期3年的研究，以开发和试点一种量身定做的、基于理论的(在信息-动机-行为技能模型中) 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MSM样本中进行定期艾滋病毒检测。智能手机应用程序干预源自我们对MSM进行的广泛的艾滋病毒预防研究，其核心组件将包括：a)通过个人档案对危险行为进行定期评估；b)根据个人的风险模式和档案对艾滋病毒检测的频率提出量身定做的建议；c)启用GPS的艾滋病毒检测定位系统；d)解决检测的关键障碍的激励性信息；以及e)针对MSM独特的文化和社会偏好量身定做的图形吸引人的界面。这项研究将分三个阶段进行，有相应的目标。在目标1中，将在两个美国城市(明尼苏达州明尼阿波利斯和密歇根州底特律)进行6个高危MSM焦点小组，以确定哪些应用程序特性和功能最有可能支持定制的HIV/STI检测应用程序的下载、启动使用和持续参与。这款智能手机应用程序将与我们在AIM 2的技术合作伙伴合作开发，并在密歇根州底特律和明尼苏达州明尼阿波利斯的6名目标人群中进行可用性测试。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，以促进在不同种族和民族的美国MSM中以定制的、规定的间隔进行定期艾滋病毒检测。对全国120名在过去一年中没有接受艾滋病毒检测的高危艾滋病毒阴性/未知男男性行为者进行抽样，随机分配到试验组(n=60)或对照组(n=60)，跟踪6个月，并在基线、3个月和6个月进行评估。控制条件将是艾滋病毒检测应用程序的非定制、仅限信息的版本。除了可行性和可接受性措施外，还将计算初步效果估计 以通知随后的R01试验。这项拟议的研究将通过利用智能手机应用程序技术来促进在有感染艾滋病毒风险的美国MSM中进行定期检测，从而帮助推进艾滋病毒预防干预的科学。这些发现将为开发和实施一项大型的全国性随机对照试验研究提供依据，以测试疗效。如果在随后的R01试验中有效，这种干预措施将通过与美国MSM使用的诊所、社区组织和网站合作，随时可以扩大到全国传播。

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.