Formative Research for Mobile App Promoting Sexual Health for Young Black Men who Have Sex with Men (psh4ybmsm)

 描述(由申请人提供)：为与男性发生性关系的年轻黑人男性推广性健康的移动应用程序自疫情开始以来，与男性发生性行为的男性，特别是与男性发生性行为的黑人男性(BMSM)受到艾滋病毒/艾滋病的影响不成比例，但近年来，艾滋病毒对与男性发生性行为的年轻黑人男性(YBMSM)的影响迅速上升。基督教青壮年男男性接触者(13-29岁)中新感染艾滋病毒的人数比男男性接触者中的任何其他年龄段和种族都要多，2006-2009年增加了48%。在非裔美国人MSM84中，年轻的MSM占所有新感染艾滋病毒的45%。为数不多的干预措施仅集中在18-29岁的青春期男男性行为者，留下了对青少年BMSM的干预措施的匮乏；此外，研究发现，对YMSM的性教育不容易从朋友、家人或学校获得，许多YMSM依赖年长的伴侣、互联网和色情内容进行教育。该项目将通过测试创建性行为阳性智能手机应用程序的可行性来填补这些空白，并填补为青壮年男童服务的社区组织、卫生部门、诊所和学校的一个重要产品细分市场，该应用基于HIV/STI干预开发，供14-18岁的青年会使用。干预的概念是以形成性工作为指导的，其中制定了活动的面对面版本，促进性健康，并进行了试点测试，证实了该方法的实用性。Psh4plomsm采用了一种基于理论的方法来解决基本知识、风险认知、同伴规范、态度和技能，主要目标有两个：(1)为了减少艾滋病毒/性传播感染，psh4plomsm强调不发生性行为、减少伴侣、避免同时发生性行为、避孕套和艾滋病毒/性传播感染检测；(2)为了改善性健康和关系，它帮助参与者更清楚地了解他们在性方面做什么/不想做什么，交流他们的选择，并学习如何在减少艾滋病毒/性传播感染风险的同时增强性体验。该项目提供了许多创新，包括创建性接触积极的多媒体智能手机应用程序提供的艾滋病毒/性传播感染预防计划，该计划是专门为14-18岁的青年男性接触者设计的，旨在减少风险和性反应，这是一个很难通过亲自干预接触到的群体；纳入了旨在增强性体验的内容，这是目标受众呼吁的一种方法；审查PREP和PEP的利弊；根据用户活动和投入定制内容--例如，根据性别认同、报告的伴侣数量和性行为频率，引导用户提供专门为其需求量身定做的内容；以及上下文敏感的助推器内容交付，如监控短信文本、Instagram和推特订阅源中的关键字(即连接、艾滋病毒测试)--如果检测到应用程序在当前以上下文合适的内容进行响应。第一阶段将通过最终确定干预内容、使用形成性研究设计应用程序、开发和可用性测试两项干预活动和一项上下文敏感功能来测试可行性。第二阶段将完成开发并进行多地点随机对照试验，以评估疗效。

 DESCRIPTION (provided by applicant): Mobile App Promoting Sexual Health for Young Black Men who Have Sex with Men (psh4ybmsm) Men who have sex with men, and particularly Black men who have sex with men (BMSM) have been disproportionately affected by HIV/AIDS since the beginning of the epidemic, but in recent years the impact of HIV among young Black men who have sex with men (YBMSM) has escalated rapidly. More new HIV infections occur among YBMSM (aged 13-29) than any other age and racial group of MSM, with an increase of 48% from 2006-2009. Young MSM account for 45% of all new HIV infections among African American MSM84. The few interventions focused solely on YBMSM, target ages 18-29, leaving a dearth of interventions for teen BMSM; further, research has found that sex education for YMSM is not readily available from friends, family, or schools, with many YMSM relying on older partners, the Internet, and pornography for education. This project will address these gaps and fill an important product niche for community-based organizations, health departments, clinics, and schools serving YBMSM by testing the feasibility of creating a sex positive smartphone app based HIV/STI intervention developed for use by YBMSM ages 14-18. The concept for the intervention was guided by formative work in which an in-person version of the activities, Promoting Sexual Health, was developed and pilot tested, confirming the utility of the approach. psh4ybmsm employs a theory based approach to address essential knowledge, perceptions of risk, peer norms, attitudes and skill with two primary goals: (1) To reduce HIV/STI, psh4ybmsm emphasizes not having sex, partner reduction, avoidance of concurrent partners, condoms and HIV/STI tests; and (2) To improve sexual health and relationships, it helps participants to become clearer about what they do/don't want to do sexually, to communicate their choices, and to learn ways to enhance sexual experience while reducing HIV/STI risk. The project offers a number of innovations, including the creation of the first sex-positive multimedia interactive smartphone app-delivered HIV/STI prevention program specifically designed for YBMSM aged 14-18 that addresses risk reduction and sexual response, a group difficult to reach via in-person intervention; the inclusion of content designed to enhance sexual experience, an approach called for by the target audience; a review of the pros/cons of PREP and PEP; content tailoring based on user activity and inputs--for example, based on gender identity, reported number of partners and frequency of sexual activity, the user is guided toward content specifically tailored for their needs; and context sensitive delivery of booster content, such as monitoring SMS texts, Instagram, and Twitter feeds for keywords (i.e. hookup, HIV test)--if detected the app responds with context-appropriate content in the moment. Phase I will test feasibility by finalizing intervention content, designing the app using formative research, and developing and usability testing two intervention activities and one context sensitive function. Phase II will complete development and conduct a multi-site randomized controlled trial to assess effectiveness.