An Innovative HIV Prevention Intervention Using Social Networking Technology

项目描述（由申请人提供）：本项目提出重新配置传统的艾滋病预防干预机制，以更好地服务于社交和性模式日益受到社交网络影响的男男性行为者（YMSM）。利用信息激励行为模型和动机访谈（MI）的原则，该项目将让艾滋病毒阴性的YMSM（18-29岁）参与干预，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准备情况，即吸毒和性风险。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。这一组报告的性危险行为明显多于干预组，然而，我们目前的干预模式——由训练有素的咨询师每周一次的办公室访问——并不适合他们的生活方式或偏好。根据从这些参与者那里收集的试点数据，拟议的项目调整了现有的干预措施，以支持以下方面的变化：(1)干预措施定制过程（纳入关键信息反馈，而不是仅仅提供研究人员设计的会议）和(2)干预发生的空间（在线而不是面对面）。这项研究将反复调整和试点测试现有的面对面干预，通过社交网站，如Facebook，来增加高风险的YMSM的参与，他们很难参加传统的干预工作。这项初步研究需要两个阶段的过程。在第一阶段，15名前青年艾滋病计划参与者（干预下降者和只完成一次干预的人）将参加焦点小组，通过Facebook的即时通讯（IM）功能向我们提供关于艾滋病预防干预的可行性和实用规范的建议。将审查这些焦点小组的记录，以分离出修改交付方式、结构和程序的关键建议。一旦干预措施被修改，焦点小组将重新召集，以获得额外的反馈，我们将进一步调整干预措施。在第二阶段，30名Facebook用户的高风险YMSM（18-29岁）将被纳入改良干预的试点。干预将持续4周，包括8次每两周30分钟的MI聊天窗口会议，包括针对每个参与者改变其药物使用和高危性行为的准备程度量身定制的连续进展干预方法。第二阶段的数据将包括干预前后的行为风险评估，以及对所有30名干预参与者的个人访谈，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。提出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拓性互动干预，这将反过来为更大规模的疗效试验奠定基础。

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.