Developing and Pilot Testing a Mobile Phone-Based HIV/STI Prevention Intervention

描述(由申请人提供)：本提案是针对男男性行为者(MSM)年轻的非裔美国人的艾滋病毒感染率惊人而提出的。美国疾病控制与预防中心最近报告称，2006至2009年间，除年轻的MSM外，美国所有人群的艾滋病毒发病率都保持稳定。年轻男男性接触者的总体发病率增加是由年轻的非裔美国男男性接触者中艾滋病毒感染增加48%所推动的。这项研究的广泛和长期目标是确定降低艾滋病毒感染率的策略。 年轻的非裔美国男男性接触者。这项研究将利用男性热衷于使用手机技术的优势，提供一种创新的干预措施，以改变他们的性危险行为。其具体目标是：1)开发一种基于手机的交互式艾滋病毒/性传播感染风险降低干预措施，该干预措施可接受且可行，可在18至24岁的非裔美国MSM中实施；2)开发一种可接受且可行的短信辅助策略，旨在提高其有效性；3)初步测试艾滋病毒/性传播感染风险降低干预措施与注意力控制干预措施在提高男性报告在肛交和阴道性交中持续使用避孕套的比例方面的有效性；4)初步测试在随机接受定制短信辅助干预的男性中，与其他男性相比，艾滋病毒/性传播感染风险降低的有效性是否比对照干预有所提高。年龄在18岁到24岁之间的非洲裔美国男性，如果在筛查前两个月内报告与男性发生过肛交，将有资格参加。干预和辅助战略将使用迭代过程来制定，包括焦点小组、社区咨询委员会的投入、可用性测试和小规模试点测试。潜在疗效的证据将基于一项试点随机对照试验，该试验涉及180名男性，并进行了6个月的随访。男性将被随机分配到艾滋病毒/性传播感染风险降低组或注意力控制干预组。此外，他们将被随机分配来接收或不接收特定于干预的、单独定制的短信。该方法借鉴了社会认知理论和申请者对目标人群的初步研究。自我报告的始终如一的避孕套使用、其他性行为、艾滋病毒检测和假设为中介干预效果的变量将通过音频计算机辅助的自我访谈收集。使用移动电话技术进行干预将缓解参与者对通过参加小组或研讨会干预而暴露他们与男性的性关系的担忧。如果目前智能手机使用的趋势继续下去，这项研究有可能产生一种成本效益高的干预措施，供地方、州或全国性组织为其年轻的非裔美国MSM客户提供。这项拟议的研究具有重大的公共卫生意义，因为尽管年轻的非裔美国MSM的艾滋病毒感染率在美国是最高的，但为他们量身定做的有效的艾滋病毒/性传播感染干预措施很少。

DESCRIPTION (provided by applicant): This proposal is submitted in response to the alarming rates of HIV among young African American men who have sex with men (MSM). The CDC recently reported that between 2006 and 2009, HIV incidence was stable among all populations in the US except young MSM. The overall increase in incidence among young MSM was driven by a 48% increase in HIV infections among young African American MSM. The broad, long-term objective of this research is to identify strategies to reduce the rates of HIV in young African American MSM. This research will take advantage of the men's avid use of mobile phone technology to deliver an innovative intervention to change their sexual risk behavior. The Specific Aims are to: 1) develop an interactive mobile phone-based HIV/STI risk-reduction intervention that is acceptable and feasible to be implemented with African American MSM ages 18 to 24 years; 2) develop an acceptable and feasible text-messaging adjunctive strategy designed to increase its efficacy; 3) pilot test the efficacy of the HIV/STI risk-reductio intervention compared with an attention-control intervention in increasing the proportion of men who report consistent condom use during anal and vaginal intercourse; and 4) pilot test whether the efficacy of the HIV/STI risk-reduction compared with the control intervention is enhanced among men randomized to the tailored text-messaging adjunctive intervention as compared with other men. African American men ages 18 to 24 years who report having anal intercourse with a man in the 2 months prior to screening will be eligible to participate. The intervention and adjunctive strategy will be developed using an iterative process involving focus groups, input from a community advisory board, usability testing, and small-scale pilot testing. Evidence of potential efficacy will be based on a pilot randomized controlled trial involving 180 men with 6-month follow-up. Men will be randomly assigned to the HIV/STI risk-reduction or an attention-control intervention. In addition, they will be randomly assigned to receive or not receive intervention-specific, individually tailored text messages. The approach draws on social cognitive theory and the applicant's Preliminary Studies with the target population. Self-reported consistent condom use, other sexual behaviors, HIV testing, and variables hypothesized to mediate intervention efficacy will be collected via audio-computer-assisted self-interviewing. The use of a mobile phone technology for intervention would allay participants' concerns about revealing their sexual involvement with men by virtue of participating in a group or workshop intervention. If current trends in smartphone use continue, this research has the potential to produce a cost-effective intervention that local, state, or national organizations might offer to their young African American MSM clients. The proposed research has great public health significance because although young African American MSM have some of the highest rates of HIV in the US, there is a paucity of efficacious HIV/STI interventions tailored to them.