A novel online HIV prevention program with spicy soap operas and interactive games -- like a rising thermometer of sexual risk -- reduced sexually transmitted infections in gay young men by 40 percent, reports a Northwestern Medicine study.
"That is a huge effect," said lead author Brian Mustanski, director of The Institute for Sexual and Minority Health and Wellbeing at Northwestern University Feinberg School of Medicine. "We were expecting it be 20 percent."
This is the first online HIV prevention program to show effects on a biological outcome. It is targeted to young men ages 18 to 29 who have sex with men, who have the highest rate of HIV infections in the U.S. The results show the effectiveness of an online program to promote safe sex in this highest risk group.
These young men represent 2 percent of young people in the U.S. but account for almost 70 percent of HIV diagnoses, according to the Centers for Disease Control and Prevention (CDC). Their rate of new HIV diagnoses is 44 times higher than that of other men.
"The numbers are alarming," Mustanski said. "The CDC estimates that without an intervention half of young black gay men and a quarter of Latino gay men will get HIV at some point in their lives."
The study will be published June 28 in the American Journal of Preventive Medicine.
Prior studies using eHealth HIV prevention programs used self-reports to determine their effectiveness. "People can sometimes forget or may not always tell the truth. A biological outcome is often considered more trustworthy," Mustanski said. Read more via Science Daily
Online HIV prevention programme reduces STIs by 40% in young men who have sex with men
An interactive online programme, tailored to real-life contexts of ethnically diverse young American men who have sex with men (MSM), resulted in a substantial drop in sexually transmitted infections (STIs) and a fall in condomless anal sex, according to the results of a randomised trial reported in the American Journal of Preventive Medicine.
The Keep It Up! programme “represents a scalable and cost-effective way to deliver behavioural prevention,” the researchers say.
Keep It Up! is an interactive online HIV prevention intervention tailored to ethnically diverse MSM, aged 18 to 29. It uses videos, interactive animations and games to provide information, motivate and teach safer behaviours and instil self-efficacy for prevention strategies.
Each of the nine modules is based on a particular setting or situation that is relevant to men’s lives, such as hooking up online; assumptions about HIV status and monogamy in relationships; the impact of alcohol, drugs and sexual arousal on condom use; power dynamics in a relationship with an older man; and regular HIV testing.
The intervention was informed by principles of e-learning, the information-motivation-behaviour skillsmodel of HIV risk behaviour change and qualitative interviews with young MSM.
Participants can complete the programme in around two hours. Most of the material can be viewed over three days soon after enrolment, with two modules completed after three months and six months respectively. The intervention could be completed on computers and tablets, but not phones, due to technical requirements.
Outcomes were assessed after one year. The study’s primary biomedical outcome was infection with gonorrhoea or chlamydia. In the control group, 11% had infections at baseline, rising to 14% at 12 months. In the intervention group receiving Keep It Up!, 18% had infections at baseline, dropping to 9% one year later (risk ratio 0.60, 95% confidence interval 0.38-0.95).
There were no statistically significant differences in outcomes according to different demographic groups.
A further analysis considered within-person changes in STIs. In members of the control group, there was a 55% increase in infections over the year, compared to a 51% reduction in the intervention group.
The study’s primary behavioural outcome was condomless anal sex with a casual partner in the previous three months. This fell in both arms, but to a greater extent in those receiving the intervention. In the control group, this was reported by 69% at baseline and 44% at 12 months. In the intervention group, it was reported by 68% and 37% respectively.
The study was not powered to detect a difference in new HIV diagnoses, but the numbers reported in each arm were the same at 2%. Read more via AIDSmap