Theory-based Text Messaging to Reduce Methamphetamine Use and HIV Risks Among MSM

描述（由申请人提供）：男男性行为者（MSM）使用甲基苯丙胺深深地融入了社会性网络，包括身体风险场所，如巡回派对，性俱乐部和澡堂以及数字空间，如手机应用程序，网站和数字聊天室，以“勾搭”性。因此，甲基苯丙胺的使用与艾滋病毒感染高度相关，特别是因为使用该药物时发生的伴随高风险性行为。短信是一种新的，可行的，可持续的方法，针对高风险，治疗外的男男性行为者，特别是男男性行为者谁不参加面对面或 现场干预。实时短信干预利用了一个沟通渠道，这一人群将在他们最有可能做出高风险性决定的确切时间参加。本申请是对PA-10-012的响应，用于技术增强的第二阶段研究。与PA的特定研究兴趣一致，该应用程序建立在开放标签I期研究的结果基础上，该研究开发并试点了艾滋病毒预防干预措施，以减少治疗外使用甲基苯丙胺的MSM中的甲基苯丙胺使用和高风险性行为。在试点研究中，短信-基于既定的行为改变理论，并专门为城市，治疗，甲基苯丙胺使用MSM量身定制-被开发和测试。拟议的第二阶段试验将评估为期8周的、针对同性恋的、基于理论的短信干预的影响，该干预旨在减少甲基苯丙胺的使用和HIV性风险行为，并针对HIV感染的参与者，同时增加HIV抗逆转录病毒治疗/治疗外使用甲基苯丙胺的MSM的依从性（N = 285）。参与者将收到个人定制的短信，以适应他们的风险状况;基于理论的短信作为行为改变的机制。参与者将被随机分为三个条件之一：第1组：由同伴健康教育者（TXT-PHE）交互传输的文化相关的基于理论的文本消息;或者，第2组：由自动化（TXT-Auto）传输的相同的文化相关的基于理论的文本消息;或者，第3组：仅评估（AO）对照，没有基于理论的文本消息。参与者将在过去七天内每周收到关于其甲基苯丙胺使用和艾滋病毒性行为的简短短信评估。本研究的具体目的是：1）确定通过PHE（TXT-PHE）和自动化传输基于理论的文本消息的即时和持续效果的差异（TXT-自动），与仅评估（AO）对照条件相比，在治疗结束后，使用甲基苯丙胺的MSM中减少甲基苯丙胺的使用和HIV性风险行为;和2）确定TXT-PHE与TXT-Auto相比AO减少甲基苯丙胺使用和HIV性风险行为的成本效益。随机三组设计在基线、干预结束时以及随机化后3个月、6个月和9个月随访时进行重复评估。

DESCRIPTION (provided by applicant): Methamphetamine use among men who have sex with men (MSM) is deeply integrated into socio-sexual networks including physical risk venues such as circuit parties, sex clubs, and bathhouses and digital spaces such as cell phone applications, websites, and digital chat rooms to "hook up" for sex. Thus, methamphetamine use is highly associated with HIV infection due specifically to concomitant high-risk sexual behaviors that occur while using the drug. Text-messaging is a novel, feasible, and sustainable approach for targeting high-risk, out-of-treatment MSM; particularly, MSM who fail to attend face-to-face or site-based interventions. A real-time text-messaging intervention capitalizes on a communication channel to which this population will attend at the exact time they are most likely to make high-risk sexual decisions. This application is in response to PA-10-012 for technologically enhanced Stage II research. Consistent with the specific research interest of the PA, this application builds on findings from an open-label Stage I study that developed and piloted a HIV prevention intervention to reduce methamphetamine use and high-risk sexual behaviors among out-of-treatment, methamphetamine-using MSM. During the pilot study, text messages - based on established behavioral change theories and specifically tailored to urban, out-of-treatment, methamphetamine-using MSM - were developed and tested. The proposed Stage II trial will assess the impact of an 8-week, gay-specific, theory-based text-messaging intervention designed to decrease methamphetamine use and HIV sexual risk behavior and, for the HIV-infected participants, simultaneously increase HIV antiretroviral treatment/adherence in out-of-treatment, methamphetamine-using MSM (N = 285). Participants will receive text messages that are personally tailored to fit their risk profile; the theory-based text messages serve as the mechanisms of behavior change. Participants will be randomized into one of three conditions: Group 1: culturally relevant theory-based text messages interactively transmitted by peer health educators (TXT-PHE); or, Group 2: the same culturally relevant theory-based text messages transmitted by automation (TXT-Auto); or, Group 3: assessment-only (AO) control with no theoretically based text messages. Participants will receive brief weekly text-message assessments on their methamphetamine use and HIV sexual behaviors in the previous seven days. The specific aims of this research are: 1) To determine differential immediate and sustained effects of transmitting theory-based text messages by PHE (TXT-PHE) versus by automation (TXT- Auto), compared to an assessment-only (AO) control condition among out-of-treatment, methamphetamine- using MSM for reductions of methamphetamine use and HIV sexual risk behaviors; and, 2) To determine the cost-effectiveness of TXT-PHE vs. TXT-Auto compared to AO for reducing methamphetamine use and HIV sexual risk behaviors. The randomized three-group design uses repeated assessments at baseline, at the end of the intervention, and at 3-, 6-, and 9-month post-randomization follow-up.