Piloting a Mobile App for HIV Risk Reduction among Young Latinas & Black Females

描述（由申请人提供）：在美国估计有超过170万人感染过艾滋病毒，新感染人数在年轻的拉丁裔和年轻的黑人妇女中最高。美国年轻人的艾滋病发病率要么保持不变，要么在增加，主要是由于性传播。鉴于13-29岁的年轻人艾滋病毒感染率最高，对性健康和生殖健康（SRH）服务的需求很大，而且与其他年龄组相比，这一人群的智能手机拥有率很高，移动平台可能提供减少艾滋病毒/性传播感染风险行为的有效机会。由青年同伴教育者（18至21岁）提供信息的智能手机应用程序的开发尚未在市场上发布，这为开展实验性设计研究提供了一个独特的机会，以了解年轻拉丁裔和黑人妇女（YLBW）如何使用该应用程序以及它如何影响性健康和生殖健康服务的知识。具体而言，拟议的试点项目将考察18-25岁的未成年女性使用智能手机应用程序获取性健康和生殖健康信息是否能够提高对性健康和生殖健康服务（如PEP、Plan B、HIV、STI和妊娠检测）以及其他社会服务（如药物滥用治疗）的了解和利用。该试点项目将借鉴社会认知理论、社会网络理论和互动技术教学框架，以实现以下两个目标：(1)识别和探索参与者将使用具有位置功能的SRH智能手机应用程序的设置和情况，并进一步定制应用程序内容以满足目标受众的需求。(2)试点一项干预措施，评估使用性健康和生殖健康智能手机应用程序（包括推送消息）与自我指导的性健康和生殖健康教育是否能提高知识水平，并增加性健康和生殖健康服务（如B计划、PEP、HIV、其他性传播感染和妊娠检测）的使用。我们建议那些使用性健康和生殖健康应用程序的人更好地了解和更多地使用性健康和生殖健康服务。第一个目标的分析将应用扎根理论，第二个目标将比较干预和比较武器之间的差异，还将包括社会网络分析。拟议的研究和培训计划还旨在通过进一步加强我的定量、技术、出版和资助技能，促进我作为一名公共卫生研究人员的发展，从而成为一名成功的学术研究人员。我的职业目标是准备成为一名独立的HIV/STI/SRH研究员，从事开发、研究和实施具有文化竞争力和有效的行为干预措施，以便为有色人种的年轻人提供基于证据的HIV预防建议。

DESCRIPTION (provided by applicant): Of the more than 1.7 million estimated people ever infected with HIV in the U.S., new infections are highest among young Latinas and young Black women. HIV incidence rates among youth in the U.S. have either remained constant or are increasing, primarily due to sexual transmission. Given that young people between ages 13-29 have the highest HIV incidence and a substantial need of sexual and reproductive health (SRH) services, and this population has a high smartphone ownership in comparison to other age groups, mobile platforms may offer an effective opportunity to decrease HIV/STI risk behaviors. The development of a smartphone app informed by youth peer educators (18 to 21y.o.) not yet released in the market offers a unique opportunity to conduct an experimental design study to understand how young Latinas and Black women (YLBW) use the app and how it influences knowledge of SRH services. Specifically, the proposed pilot project examines if YLBW ages 18-25 who use a smartphone app for SRH information can achieve increased knowledge and utilization of SRH services such as PEP, Plan B, HIV, STI, and pregnancy testing, and to other social services, such as substance abuse treatment. This pilot project will draw from social cognitive theory, social network theory, and interactive technology pedagogy frameworks to address the following two aims: (1) Identify and explore the settings and situations where participants will use a location enabled SRH smartphone app, and further tailor the app content to meet the needs of the target audience. (2) Pilot an intervention to assess whether access to an SRH smartphone application, including push messages, versus self-directed SRH education improves knowledge and increases the use of SRH services such as Plan B, PEP, HIV, other STI, and pregnancy testing. We propose those with access to an SRH app will have better knowledge and greater use of SRH services. Analysis for the first aim will apply grounded theory and for the second aim, will compare differences between the intervention and comparison arms, and will also include social network analysis. The proposed research and training plans are additionally designed to foster my development as a public health researcher by further strengthening my quantitative, technological, publication, and grantsmanship skill sets in order to launch a successful career as an academic researcher. My career goal is to prepare for a career as an independent HIV/STI/SRH researcher in developing, researching and implementing culturally competent and effective behavioral interventions, in order to make evidenced-based HIV prevention recommendations for young people of color. PUBLIC HEALTH RELEVANCE: Smartphone applications and mobile technologies more generally offer the potential to provide information (e.g., proper condom use, directions to a testing site, PEP or Plan B) to a highly vulnerable population and their networks, allowing users to access it when it is needed most. The findings of this research will be important contributions to the field as no other studies are available which currently explore how smartphone apps impact Sexual and Reproductive Health (SRH) knowledge, use of services and connect young women of color to HIV, STI, and pregnancy testing and/or social services. The proposed project will expand researchers' limited knowledge about how best to educate and intervene among Latina and Black women ages 18-25 to prevent HIV/STIs and address its sequalae (such as late diagnosis, access to care, and the risk of poor health outcomes among those who contract HIV/STI), which has been shown to be worse among youth of color.