Abstract
Introduction: HIV diagnoses among young men who have sex with men are increasing, but few effective HIV prevention interventions exist for this population. An RCT was conducted of the online Keep It Up! intervention to determine if it significantly reduced condomless anal sex and sexually transmitted infections compared with an HIV knowledge condition. Study design: From May 2013 to March 2017, a total of 901 participants were enrolled in a double-blinded RCT of Keep It Up! with 1-year follow-up. After completing baseline surveys and sexually transmitted infection testing, participants were randomized by an eHealth platform to the intervention or control condition. Setting/participants: HIV-negative men who have sex with men reporting condomless anal sex, aged 18–29 years, were recruited through advertising and from HIV testing sites and outreach in Atlanta, Georgia; Chicago, Illinois; and New York, New York. Intervention: Multimedia was used to address HIV knowledge and motivate safer behaviors. The control condition reflected existing online HIV information. Main outcome measures: Primary outcomes were incident gonorrhea or chlamydia at 12-month follow-up and self-reported condomless anal sex with casual partners at 3-, 6-, and 12-month follow-up. Results: In 2017, data were analyzed from 445 (49%) participants randomized to the intervention and 456 (51%) to the control. Participants were primarily racial/ethnic minorities (63%). Sexually transmitted infections at Month 12 was 40% lower for intervention participants (risk ratio=0.60, 95% CI=0.38, 0.95, p=0.01). For the primary behavioral outcome, both arms showed reductions over time with 44% of control and 37% of intervention participants reporting condomless anal sex at Month 12 (prevalence ratio=0.83, 95% CI=0.70, 0.99, p=0.04). Conclusions: The Keep It Up! intervention resulted in significantly lower sexually transmitted infection incidence and a small but significant decrease in condomless anal sex 12 months post-intervention relative to an online HIV knowledge condition. In addition, this study demonstrated the feasibility and acceptability of at-home sexually transmitted infection testing as part of an eHealth intervention. Trial registration: This study is registered at www.clinicaltrials.gov NCT01836445.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 151-158 |
| Number of pages | 8 |
| Journal | American Journal of Preventive Medicine |
| Volume | 55 |
| Issue number | 2 |
| DOIs | |
| State | Published - Aug 2018 |
Funding
Thanks to the Centers for Disease Control and Prevention (CDC) Division of Sexually Transmitted Diseases Prevention laboratory for testing of the urine and rectal samples collected for this research. The NIH supported Third Coast Center for AIDS Research (CFAR; P30AI117943) and Emory CFAR (P30AI050409) are acknowledged for creating supportive environments for HIV/AIDS research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, the National Institute of Mental Health, NIH, or the CDC. This study was supported by a grant from the National Institute on Drug Abuse and National Institute of Mental Health (R01DA035145). All authors made substantial contributions to the manuscript. Drs. Mustanski, Parsons, and Sullivan were responsible for the study design, led the writing of the manuscript, and contributed to data interpretation. Dr. Rosenberg and Mr. Swann led data analysis and interpretation and contributed to writing the manuscript. Ms. Madkins oversaw data collection, assisted with creating figures, and was responsible for formatting and editing the manuscript. This trial is registered at clinicaltrials.gov under the identifier NCT01836445. Dr. Sullivan received grants from NIH, CDC, MAC AIDS Fund, and Gilead Sciences, as well as personal fees from the CDC outside the submitted work. Dr. Rosenberg received grants from NIH and the CDC, personal fees from Medidata Inc., and textbook royalties from Cengage Learning. Dr. Mustanski, Dr. Parsons, Ms. Madkins, and Mr. Swann have no financial disclosures. Thanks to the Centers for Disease Control and Prevention (CDC) Division of Sexually Transmitted Diseases Prevention laboratory for testing of the urine and rectal samples collected for this research. The NIH supported Third Coast Center for AIDS Research (CFAR; P30AI117943) and Emory CFAR (P30AI050409) are acknowledged for creating supportive environments for HIV/AIDS research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, the National Institute of Mental Health, NIH, or the CDC. This study was supported by a grant from the National Institute on Drug Abuse and National Institute of Mental Health (R01DA035145). All authors made substantial contributions to the manuscript. Drs. Mustanski, Parsons, and Sullivan were responsible for the study design, led the writing of the manuscript, and contributed to data interpretation. Dr. Rosenberg and Mr. Swann led data analysis and interpretation and contributed to writing the manuscript. Ms. Madkins oversaw data collection, assisted with creating figures, and was responsible for formatting and editing the manuscript. This trial is registered at clinicaltrials.gov under the identifier NCT01836445. Dr. Sullivan received grants from NIH, CDC, MAC AIDS Fund, and Gilead Sciences, as well as personal fees from the CDC outside the submitted work. Dr. Rosenberg received grants from NIH and the CDC, personal fees from Medidata Inc., and textbook royalties from Cengage Learning. Dr. Mustanski, Dr. Parsons, Ms. Madkins, and Mr. Swann have no financial disclosures.
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Epidemiology
