An Innovative HIV Prevention Intervention Using Social Networking Technology

描述(由申请人提供)：该项目建议重新配置传统的艾滋病毒预防干预机制，以更好地服务于男男性行为(YMSM)的年轻男性，他们的社会和性模式越来越受到社交网络的影响。利用信息动机行为模型和动机访谈(MI)的原则，该项目将邀请艾滋病毒阴性的YMSM(18-29岁)进行干预，旨在影响他们改变使他们面临艾滋病毒感染风险的行为的意愿，即药物使用和性风险。拟议的项目是对现有干预措施(青年男子健康项目或YMHP)的修改，在现有干预措施中，同意参加纵向评估的人中有24%拒绝参加干预部分。这组人报告的性危险行为明显多于干预参与者，然而，他们并不认为我们目前的干预提供模式-每周四次，由训练有素的顾问进行办公室访问-与他们的生活方式或偏好相适应。根据从这些参与者那里收集的试点数据，拟议的项目对现有干预措施进行调整，以支持(1)干预措施定制过程(纳入关键的信息提供者反馈，而不是提供仅由研究人员设计的会议)和(2)干预措施发生的空间(在线而不是面对面)的变化。这项研究将反复调整和试点现有的面对面干预，通过Facebook等社交网站提供，以增加高危YMSM的参与度，他们很难加入传统的干预努力。这项初步研究分两个阶段进行。在第一阶段，15名前基督教青年会参与者(干预率下降者和只完成一次治疗的人)将参加焦点小组，就通过Facebook的即时通讯(IM)功能收到的艾滋病毒预防干预措施的可行性和实用规格向我们提供建议。将审查这些重点小组的成绩单，以确定修改交付方式、结构和程序的关键建议。一旦干预措施被修改，焦点小组将重新召开会议，以获得更多反馈，我们将根据这些反馈进一步调整干预措施。在第二阶段，30名高危YMSM(年龄18-29岁)将被登记参加修改后的干预试点，他们是Facebook用户。干预将持续4周，包括8次每周30分钟的MI聊天窗口会议，包括根据每个参与者是否准备好改变他们的药物使用和高危性行为而量身定做的干预方法的连续序列。第二阶段的数据将包括干预前的行为风险评估，以及对所有30名干预参与者的个别访谈，以对干预过程、结构和内容的可行性和可接受性进行定性评估。拟议的设计提供了一个理想的论坛来开发、实施和迭代微调通过社交网络提供的开创性互动干预，这将反过来为更大规模的疗效试验奠定基础。 公共卫生相关性：拟议研究的结果将为高危吸毒的男男性行为青年(YMSM)提供现有的艾滋病毒预防干预措施，以使他们更容易被这一人群接受、文化上合适和可获得。这种通过社交网络提供的面对面干预的迭代修改将有助于更成功地招募难以参与的艾滋病毒阴性行为危险的青年男同性恋者。这一模式为全国性的减少性风险和药物使用努力带来了实实在在的好处，因为它(1)为传统的面对面干预模式提供了一个务实的替代方案，(2)促进了与更广泛、更多样化的高危YMSM群体的接触，包括服务不足的农村人口，以及(3)为公共卫生/服务机构的高危YMSM之间的在线干预试验提供了一种可行的、在文化上可以接受的方案，使它们能够规避预算、时间和人员配备的限制。

DESCRIPTION (provided by applicant): This project proposes to reconfigure traditional HIV prevention intervention mechanisms to better serve young men who have sex with men (YMSM), whose social and sexual patterns are increasingly shaped by social networking. Drawing on the Information Motivation Behavior model and the principles of Motivational Interviewing (MI), this project will engage HIV-negative YMSM (ages 18-29) in an intervention intended to impact their readiness to change behaviors that put them at risk for HIV infection, namely drug use and sexual risk. The proposed project is a modification of an existing intervention (the Young Men's Health Project or YMHP), in which 24% of those who consented to participate in longitudinal assessments declined participation in the intervention component. This group reported significantly more sexual risk behaviors than intervention participants, however, did not find our current mode of intervention delivery - four weekly office visits with a trained counselor - to fit their lifestyle or preferences. In response to pilot data collected from these participants, the proposed project adapts the existing intervention to support changes in (1) the intervention tailoring process (incorporating key informant feedback instead of delivering solely researcher-designed sessions) and (2) the space in which the intervention takes place (online rather than face-to-face). The study will iteratively adapt and pilot-test the existing face-to-face intervention for delivery through social networking sites, such as Facebook, to increase engagement of high-risk YMSM, who have been difficult to enroll in traditional intervention efforts. This pilot study entails a two-phase process. During Phase I, 15 former YMHP participants (intervention decliners and those who only completed one session) will participate in focus groups to advise us on the feasibility and pragmatic specifications of an HIV prevention intervention received via the instant messaging (IM) function of Facebook. Transcripts of these focus groups will be examined to isolate key recommendations for modifying the delivery modality, structure, and procedures. Once the intervention is modified, the focus groups will be reconvened for additional feedback, from which we will further adjust the intervention. During Phase II, 30 high-risk YMSM (ages 18-29) who are Facebook users will be enrolled in a pilot of the modified intervention. The intervention will span 4 weeks and contain 8 bi-weekly 30 minute MI chat-window sessions consisting of a sequential progression of intervention approaches tailored to each participant's readiness to change their drug use and high risk sexual behavior. Data from Phase II will include pre-post intervention behavioral risk assessments, as well as individual interviews with all 30 intervention participants for a qualitative evaluation regarding the feasibility and acceptability of the intervention's process, structure, and content. The proposed design provides an ideal forum to develop, implement, and iteratively fine-tune a pioneering, interactive intervention delivered via social networking, which will in turn set the stage for a larger efficacy trial. PUBLIC HEALTH RELEVANCE: Findings from the proposed study will inform existing HIV prevention interventions for high-risk drug-using young men who have sex with men (YMSM), in order to make them more acceptable, culturally appropriate, and accessible to this population. This iterative modification of a face-to-face intervention to be delivered via social networking will facilitate more successful recruitment of hard-to-engage HIV-negative behaviorally risky YMSM. This model has tangible benefits to sexual risk and drug use reduction efforts nationally as it (1) provides a pragmatic alternative to the traditional face-to-face intervention model, (2) facilitates engagement with a wider, more diverse pool of high-risk YMSM, including underserved rural populations, and (3) provides a feasible and culturally acceptable protocol for online intervention trials among high-risk YMSM to public health/service agencies, allowing them to circumvent budget, time and staffing constraints.