Men's INTernet Study III (MINTS-III) for HIV Prevention

描述（由申请人提供）：MINTS-III是响应PA-07-295的竞争性延续申请重新提交。它建立在MINTS-I的基础上，MINTS-I是关于互联网和男同性恋者中艾滋病毒风险的首批调查研究之一；MINTS-II开发并测试了Sexpulse，这是一项针对使用互联网寻求与男性发生性关系的男性的在线艾滋病毒预防干预措施。MINTS-II是第一个在线RCT的MISM报告可接受的保留超过12个月和短期疗效。在3个月的随访中，干预组报告的危险行为减少明显大于空白对照组（20%）。我们还观察到控制组报告的危险行为显著减少，我们假设这是面板调节的产物。MINTS-III是在这个有前途的研究领域合乎逻辑的下一步。我们的第一个目标是通过加强Sexpulse的剂量来提高干预措施的长期艾滋病毒预防效果。以用户为中心的干预设计迭代将包含针对个人风险行为的个性化、量身定制的反馈；将研究调查纳入干预；并添加后续助推器，所有这些都旨在提高长期行为效果。在目标2中，我们提出了两个子研究来检验性风险行为在线测量的可靠性和有效性。目的3在一项1000例高风险MISM的随机对照试验中检验强化干预、Sexpulse 1.1和增强干预的长期风险降低效果。该随机对照试验设计通过三个级别的招募进行了增强，以便在Aim 4中，我们可以研究风险测量的威胁，特别是面板调节。我们的最终目标是在500例无/低风险MISM的随机对照试验中测试Sexpulse 1.1（包括在线助推器）的长期保护功效。在成功完成这些目标后，Sexpulse 1.1应该是一个强大的、被证明有效的干预措施，可以战略性地进行传播。

DESCRIPTION (provided by applicant): MINTS-III is a competing continuation application resubmission in response to PA-07-295. It builds upon MINTS-I, one of the first survey studies of the Internet and HIV risk among MSM; and MINTS-II, which developed and tested Sexpulse, an online, HIV prevention intervention for Men who use the Internet to seek Sex with Men (MISM). MINTS-II is the first online RCT of MISM to report acceptable retention over 12 months and short-term efficacy. At the 3-month follow-up, the intervention group reported a significantly greater (20%) reduction in risk behavior than the null control. We also observed a significant reduction in reported risk behavior in the control group, which we hypothesize is the product of panel conditioning. MINTS-III is the logical next step in this promising area of research. Our first aim is to increase the long-term HIV prevention effectiveness of the intervention by strengthening the dosage of Sexpulse. A substantial user-centered design iteration of the intervention will incorporate personalized, tailored feedback on individual risk behavior; integrate research surveys into the intervention; and add follow-up boosters all aimed at increasing the long-term behavioral effectiveness. In Aim 2, we propose two sub-studies to examine the reliability and validity of online measures of sexual risk behavior. Aim 3 tests the long-term risk reduction efficacy of the strengthened intervention, Sexpulse 1.1, and boosters, in an RCT of 1000 high-risk MISM. This RCT design has been enhanced by three levels of recruitment so that in Aim 4, we can study threats to risk measurement, especially panel conditioning. Our final aim tests the long-term protective efficacy of Sexpulse 1.1 (including online boosters) in an RCT on 500 no/lower risk MISM. Upon successful completion of these aims, Sexpulse 1.1 should be a strong and demonstrated-effective intervention that can be strategically positioned for dissemination. PUBLIC HEALTH RELEVANCE: PA-07-295 calls for "targeted research to test the effectiveness of adapted 'Internet-based' interventions, the effectiveness of the Internet and other technologies as a mechanism to deliver health information to consumers, and the impact of technology use on consumer health." The significance to science includes testing measures and methods to study response bias in online HIV risk assessments. The significance to public health includes rigorous testing of a promising intervention as both a risk reduction and protection intervention for MSM, the population most affected by HIV in the US. The significance to advancing innovative methods of HIV prevention includes testing a new approach to HIV prevention based on computer gaming theory that appears promising in a population currently well-informed but disengaged from HIV prevention.