AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #285 - Results of a randomized clinical trial of an Internet-based HIV prevention program for young MSM
Authors: Presenting Author: Dr. Brian Mustanski - Northwestern University
Additional Authors: Dr. Colleen Monohan, Dr. Robert Garofalo,
Aim: Rising rates of HIV/AIDS and STIs among U.S. young men who have sex with men (YMSM), combined with the lack of inclusion of MSM-relevant content in school based sex education, underscores the need for innovative prevention targeted at this population. Testing negative for HIV has been linked to increased rates of sexual risk taking among MSM and CDC recommended client-centered counseling is not always being rigorously conducted in testing clinics, highlighting the need new risk reduction tools. The Internet is an ideal tool given high usage for seeking sex partners and health information in this population. In this presentation we describe the Keep It Up! (KIU!) online HIV-prevention program targeted at YMSM upon testing HIV negative at a community-based clinic. KIU! was developed through formative qualitative research and through ongoing participation of the target populations and community-based organizations (CBOs). KIU! is a highly interactive and engaging intervention based on the IMB model of health behavior change. In this presentation we will report results of a study testing the efficacy of KIU! using a randomized control trial (RCT).
Method / Issue: YMSM were recruited from CBOs that conducted HIV testing. Nearly 100% of eligible young men were offered the opportunity to participate in KIU! by clinic staff upon receiving a HIV negative result. 120 YMSM met eligibility criteria and were invited to participate, among whom 98 were enrolled and randomized. 53% of participants were racial/ethnic minorities and the participants were between ages 18-24. Randomization was automated by the program and participants were randomly assigned to either KIU! or a basic HIV knowledge online condition. Participants in both arms were followed to 12 weeks from completion of the intervention.
Results / Comments: Fidelity was very good and retention through the 12-week follow-up was excellent (91%). Participant ratings of intervention acceptability were very high. One participant said in an open-ended response, “this is the future of gay sex-ed.” No adverse events were reported. In terms of outcomes, both arms showed a significant increase in HIV/AIDS knowledge. At the 12-week follow-up the KIU! arm showed a significantly lower rate of unprotected sex relative to the control arm (p <.05). The KIU! arm showed a relatively greater reduction in beliefs about the benefits of unprotected sex and the costs of condom use and an increase in benefits of condom use. Larger intervention effects were found at 12-weeks for the important behavioral outcomes of condom errors and failures, which previously have been reported to be very high among YMSM and associated with STI infection. Both groups showed increases in health protective communication skills at 12-weeks.
Discussion: This is one of the first reports of an RCT of an online HIV-prevention program that had excellent retention and showed significant effects on rates of unprotected sex. Findings suggest that the online KIU! intervention is a promising approach to cost-effectively intervene to reduce HIV risk behaviors among YMSM.
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