Mobile Technology and Incentives (MOTIVES) for Racial and Ethnic Minorities in Los Angeles, CA

项目摘要 艾滋病毒不成比例地影响性少数群体和性别少数群体，如男男性行为者（MSM）和 跨性别女性（TGW）这些人并不总是能迅速收到最新的信息， 在新的预防技术，如暴露前预防的时代，不断发展的准则， 面对最近的艾滋病毒预防发展，人们感到困惑。缺乏对传统健康的参与 护理系统也导致艾滋病毒检测不频繁。MSM和TGW急需新的供应方式 提供最新和准确的艾滋病毒预防信息，以促进艾滋病毒健康知识普及，并强调 潜在传染性的间接评估的陷阱，而不是trimestral测试的建议， CDC.短信等移动的技术为改善关键信息的获取提供了一种动态的新方式， 预防信息和照顾男男性行为者和女同性恋者，但更好的方法，使他们适应的独特需要， MSM和TGW是需要的，保持他们参与的创造性方法至关重要。鉴于越来越 认识到，即使人们拥有所有必要的信息和动机，他们通常也无法表现出 健康的行为，这一建议采用了行为经济学的新见解，以提供频繁的反馈 鼓励参与者保持参与并支持他们保持艾滋病毒阴性的意愿。这 该提案需要一个3阶段的基于移动的技术和BE支持的艾滋病毒预防干预-称为 移动的技术和激励措施（MOTIVES）-增加对艾滋病毒预防信息的参与， 提高测试频率。形成性阶段1包括与MSM和TGW进行的30次半结构化访谈， 根据初步研究的见解，最终确定计划的干预措施。第二阶段将招募200名艾滋病毒- 阴性MSM和TGW在一项为期18个月的两组随机对照试验（RCT）。那些参与干预的人 小组将每周收到有关艾滋病预防信息的短信，并可以赢得奖励积分， 正确回答每周测验，以保持他们参与并提高他们对艾滋病毒预防的保留率 信息.那些至少每三个月一次艾滋病毒检测呈阴性的人可以参加奖品 抽奖赢得奖品，与那些正确回答每周测验更大的机会。对照组 将获得同样的艾滋病毒预防信息，但没有奖励。主要结果包括 艾滋病检测频率和艾滋病预防知识。第三阶段包括7个退出焦点小组（5-8个 每组参与者），以评估研究改进的领域并估计未来规模扩大的参数。 具体目标是：1）制定动机并最终确定每周短信信息内容， 激励措施的类型; 2）实施和评估动机的影响; 3）评估 通过焦点小组改进MOTIVES并使用点估计关键任务设计参数 以及后续全功率R 01应用程序的置信区间估计。

PROJECT ABSTRACT HIV disproportionately affects sexual and gender minorities such as men who have sex with men (MSM) and transgender women (TGW). These individuals do not always receive the most up-to-date information on rapidly evolving guidelines in a time of new prevention technologies such as pre-exposure prophylaxis, leading to confusion in the face of recent HIV prevention developments. A lack of engagement in the traditional health care system also leads to infrequent testing for HIV. Novel ways are urgently needed to supply MSM and TGW with the most recent and accurate HIV prevention information to promote HIV health literacy and highlight the pitfalls of indirect assessments of potential infectivity rather than trimestral testing as recommended by the CDC. Mobile technologies such as text messaging present a dynamic new way to improve access to critical prevention information and care for MSM and TGW, but better ways of adapting them to the unique needs of MSM and TGW are needed, and creative ways of keeping them engaged are critical. Given the growing recognition that even if people have all necessary information and are motivated, they commonly fail to show healthy behavior, this proposal employs novel insights from behavioral economics to provide frequent feedback and incentives to keep participants engaged and support them in their intention to remain HIV negative. This proposal entails a 3-phase mobile technology based and BE supported HIV prevention intervention – called Mobile Technology and Incentives (MOTIVES) - to increase engagement with HIV prevention information and improve testing frequency. Formative Phase 1 includes 30 semi-structured interviews with MSM and TGW to finalize the planned intervention based on the insights from a preliminary study. Phase 2 will enroll 200 HIV- negative MSM and TGW in an 18-month, two-arm randomized controlled trial (RCT). Those in the intervention group will receive weekly text messages with HIV prevention information, and can win reward points for correctly answering weekly quizzes to keep them engaged and improve their retention of the HIV prevention information. Those who continue to test negative for HIV at least once every three months can enter a prize drawing to win prizes, with larger chances for those correctly answering the weekly quizzes. The control group will receive the same HIV prevention information but without the incentives. The primary outcomes include frequency of HIV testing and HIV prevention knowledge. Phase 3 includes 7 exit focus groups (with 5-8 participants per group) to evaluate areas for study improvement and estimate parameters for future scale up. The Specific Aims are to 1) develop MOTIVES and finalize the weekly text message information content and the types of incentives; 2) implement and evaluate the impact of MOTIVES; and 3) evaluate areas of improvement for MOTIVES through focus groups and estimate mission-critical design parameters with point and confidence interval estimates for a subsequent, fully-powered R01 application.