CyberSenga: Harnessing the power of the internet to prevent HIV in Ugandan youth

描述（由申请人提供）：艾滋病毒/艾滋病是乌干达发病率和死亡率的主要原因。尽管艾滋病毒预防工作取得了积极进展，但最近的数据表明，艾滋病毒流行率普遍上升，与十年前相比，特别是在年轻人中，艾滋病毒知识（直接影响行为的因素）正在下降。在资源匮乏的环境中，互联网是一种很有前途的干预方式，因为与扩大规模相关的成本很小；无论是一个人使用还是10万人使用，在线传播都是一样的。同样重要的是，它提供了在没有耻辱、匿名的氛围中获取重要健康信息的途径。我们最近的数据显示，乌干达姆巴拉拉45%的青少年使用过互联网，其中78%的人在前一周至少上网一次。在同一项调查中，81%的受访者表示，如果存在艾滋病毒预防网站，他们会去。基于这些数据，我们建议制定一个文化上合适的、基于互联网的艾滋病毒预防计划，专门为乌干达12至18岁的青少年设计。我们的具体目标如下：具体目标1：为青少年设计一个6小时、基于互联网的艾滋病毒预防方案。内容将根据乌干达青少年的艾滋病毒预防信息、动机和行为技能需求进行文化调整。具体目标2：在一项随机对照试验（n=500）中，在Mbarara日制学校就读中学1-4年级（类似于美国高中8 -11年级）的青少年中测试干预措施。我们的主要结果测量是干预后6个月无保护性行为的频率。次要结果是干预后6个月的性节制。在意向治疗分析中，我们通过检测干预组和对照组之间结果的显著差异来确定干预效果。该项目有潜力为乌干达青少年的艾滋病毒传播风险行为制定低成本和可扩展的干预措施。

DESCRIPTION (provided by applicant): HIV/AIDS is a major contributor to morbidity and mortality in Uganda. Despite aggressive advances in HIV prevention efforts, recent data suggest that HIV prevalence is increasing generally, and HIV knowledge, a direct contributor to behavior, is on the decline among young people specifically as compared to a decade ago. The Internet is a promising mode of intervention delivery in resource poor-settings because the costs associated with scaling up are minimal; dissemination online is the same if one person or 100,000 people use the program. Just as important, it provides access to important health information in a stigma-free, anonymous atmosphere. Our recent data indicate that 45% of adolescents in Mbarara, Uganda have used the Internet, 78% of whom went online at least once in the previous week. Eighty-one percent of respondents in the same survey indicated they would go to an HIV prevention web site if it existed. Based upon these data, we propose to develop a culturally appropriate, Internet-based HIV prevention program designed specifically for Ugandan adolescents between the ages of 12 and 18 years. Our specific aims are as follows: Specific Aim 1: Design a 6-hour, Internet-based HIV prevention program for adolescents. Content will be culturally tailored to the HIV preventive information, motivation, and behavioral skills needs of Ugandan adolescents. Specific Aim 2: Test the intervention in a randomized controlled trial (n=500) among adolescents attending grades Secondary 1-4 (similar to US high school grades 8th -11th) at day schools in Mbarara. Our main outcome measure is the frequency of unprotected sex 6-months post-intervention. The secondary outcome will be sexual abstinence 6-months post-intervention. We determine intervention efficacy by testing for a significant difference in outcomes between intervention and control group in an intent-to-treat analysis. This project has the potential to develop low-cost and scalable interventions to HIV transmission risk behaviors among adolescents in Uganda.