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)中使用甲基苯丙胺已深度融入社会性网络，包括巡回派对、性俱乐部和浴室等身体危险场所，以及手机应用程序、网站和数字聊天室等数字空间，以“勾搭”性行为。因此，甲基安非他明的使用与艾滋病毒感染高度相关，特别是由于在使用毒品时伴随的高风险性行为。短信是一种新的、可行的和可持续的方法，针对高危的、正在接受治疗的MSM；特别是那些没有参加面对面或 以现场为基础的干预。实时短信干预利用了一种交流渠道，这些人将在他们最有可能做出高风险性行为决定的确切时间参与其中。这项申请是为了响应PA-10-012进行技术增强的第二阶段研究。与PA的具体研究兴趣一致，这项申请建立在一项开放标签第一阶段研究的结果基础上，该研究开发并试点了艾滋病毒预防干预措施，以减少甲基苯丙胺的使用和使用甲基苯丙胺的MSM中的高危性行为。在试点研究期间，开发和测试了短信--基于既定的行为改变理论，并专门针对城市、非治疗期间、使用MSM的甲基苯丙胺定制的短信。拟议的第二阶段试验将评估为期8周、针对同性恋、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艾滋病毒的性行为风险行为，并对艾滋病毒感染的参与者同时增加艾滋病毒抗逆转录病毒治疗/在不治疗的情况下坚持使用甲基苯丙胺的男男性接触者(N=285)。参与者将收到个人定制的短信，以适应他们的风险概况；基于理论的短信充当行为改变的机制。参与者将被随机分成三种情况之一：第一组：由同伴健康教育者互动发送的基于文化相关理论的短信(TXT-Phe)；或第二组：通过自动化传输的相同文化相关基于理论的短信(TXT-Auto)；或第三组：仅评估(AO)对照，没有基于理论的短信。参与者将接受每周一次的简短短信评估，评估他们在过去七天内使用冰毒和艾滋病毒的性行为。这项研究的具体目的是：1)确定通过PHE(TXT-Phe)与自动化(TXT-Auto)发送基于理论的文本消息的即时和持续效果的差异，比较非治疗、使用甲基苯丙胺的MSM在减少甲基苯丙胺使用和HIV性行为风险方面的仅评估(AO)控制条件；以及2)确定TXT-Phe与TXT-Auto在减少甲基苯丙胺使用和HIV性行为方面的成本效益。随机三组设计在基线、干预结束时以及随机化后3、6和9个月的随访中使用重复评估。

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.