mHealth and HIV self-testing for high-risk men in China

 在这项R34申请（PAR-14-179：改善艾滋病毒/艾滋病治疗和预防的干预措施和服务的临床试验规划补助金）中，我们建议开发和试点测试一种干预措施，以改善艾滋病毒自我检测（HST）的科学性，作为一项公共卫生战略，以增加低检测率人群中的艾滋病毒检测。HST为实现更高水平的艾滋病毒检测提供了一个令人信服的战略，因为寻求传统形式的诊所艾滋病毒检测的障碍减少了。然而，作为一项公共卫生战略，单纯的HST规模扩大是不够的：接受HST阴性结果的个人需要有动机进行重复检测，并鼓励减少其风险行为。因此，我们提出了一种组合策略，将HST与基于移动的应用程序（“app”）的HIV风险降低和行为改变动机信息相结合。该提案研究将在中国进行，我们之前的研究表明，男男性行为者（MSM）的检测率低，行为风险高，临床艾滋病预防服务存在障碍。该研究将利用中国人群对移动的电话和基于应用程序的电子消息传递技术的广泛普遍访问，为MSM开发一种结合HST和基于mHealth应用程序的消息传递策略的测试。我们将采用三阶段研究方法来实现我们的具体目标。首先，我们将进行形成性定性研究，以了解中国男男性行为者艾滋病自我检测（HST）的促进因素和障碍。第二，基于定性研究结果，我们将开发一个简短信息库，以激励风险降低和行为改变，我们将使用认知访谈技术和开放试点来完善和最终确定基于应用程序的消息传递内容和实施策略。第三，我们将在一个高危MSM样本中对HST+基于移动的应用程序的风险降低信息的组合与单独HST进行试点测试，以在未来6个月内重复HST和性风险行为的变化。拟议的研究是创新的，因为它是第一个已知的尝试，以开发一个组合的方法，以HST，利用先进的移动的技术作为一个平台，重复测试和激励行为改变。我们将使用研究结果来支持后续应用程序，以测试HST与基于应用程序的消息传递相结合的干预措施对性风险行为和HIV复检的有效性。

 DESCRIPTION (provided by applicant): In this R34 application (PAR-14-179: Clinical Trial Planning Grant for Interventions and Services to Improve Treatment and Prevention of HIV/AIDS), we propose to develop and pilot test an intervention to improve the science of HIV self-testing (HST) as a public health strategy to increase HIV testing among populations with low testing rates. HST offers a compelling strategy for achieving higher levels of HIV testing, due to the reduced barriers associated with seeking traditional forms of clinic-based HIV testing. However, HST scale-up alone is insufficient as a public health strategy: individuals who receive an HST negative result require motivation to engage in repeat testing and encouragement to reduce their risk behaviors. Thus, we propose a combination strategy that incorporates HST with mobile application- ("app"-) based HIV risk reduction and behavior change motivation messages. The proposal research will take place in China, where our prior research has demonstrated low rates of testing, high behavioral risk, and barriers to clinical HIV prevention services among men who have sex with men (MSM). The research will leverage the broad general access to mobile phone and app-based electronic messaging technology in the Chinese population to develop a test a combined HST plus mHealth app-based messaging strategy for MSM. We will use a three-phase research approach to address our specific aims. First, we will conduct formative qualitative research to understand the facilitators and barriers to HIV self-testing (HST) among MSM in China. Second, based on qualitative findings, we will develop a library of brief messages to motivate risk reduction and behavior change, and we will use cognitive interviewing techniques and an open pilot to refine and finalize the app-based messaging content and implementation strategy. Third, we will pilot test the combination of HST plus mobile app-based risk reduction messaging compared to HST alone in a sample of high-risk MSM, with respect to repeat HST and changes in sexual risk behaviors in the next 6 months. The proposed study is innovative because it is the first known attempt to develop a combination approach to HST that leverages advances in mobile technology as a platform for repeat testing and motivating behavior change. We will use findings to support a subsequent application to test the effectiveness of the combined HST plus app-based messaging intervention on sexual risk behavior and HIV retesting.