Evaluation of 3T, a Sex-Positive HIV/STI Mobile App Intervention for Young Black Men Ages 14-19 Attracted to Men

Mobile App Promoting Sexual Health for Young Black Men Who Have Sex With Men

This study features a 2-arm cluster randomized controlled trial with approximately 300 young black men who have sex with men (YBMSM) to assess the effectiveness of the 3T mobile app. To be eligible participants will be required to identify as male; Black, African-American, or biracial Black/African American; age 14-17 at baseline; self-identify as gay, bisexual, fluid, or sexually attracted to men; own a smartphone, and reside in any state in the United States. Those in the treatment arm will be provided with the 3T app, to be downloaded to their own device, and asked to use it during a three month period. Those in the control arm will be asked to download a general health app and use it during the same three month period. Participants will complete brief online surveys at baseline and at 3- and 6-months following the conclusion of the app-use period to assess effectiveness in changing sexual risk behaviors and communication and condom use behaviors and attitudes.

Study Overview

• Status: Recruiting
• Conditions: Sexual Behavior; Health Knowledge, Attitudes, Practice; HIV/AIDS and Infections
• Intervention / Treatment: Behavioral: 3T Tune in! Turn on! Turn up!; Behavioral: General Health App

Detailed Description

The overarching aim of this proposed Phase II research project is to fill a gap in prevention by completing the development and establishing the effectiveness of 3T: Tune in, Turn on, Turn up, a multimedia interactive sex-positive smartphone app-delivered HIV and other sexually transmitted infection (STI) intervention designed for use by YBMSM ages 14-17. The larger and longer term aims of developing an intervention specifically tailored to this population, utilizing a technology platform to reach youth where they are, is to contribute to a reduction in HIV/STI risk, increase HIV testing, and an increase in the quality of overall sexual health and relationships among YBMSM. To do this 3T emphasizes partner reduction, avoidance of concurrent partners, use of condoms if having anal or vaginal sex, and getting HIV/STI tests. 3T also focuses on improving quality of sexual experience and relationships, helping participants become clearer about what they do/don't want to do sexually, communicating their choices, and learning ways to enhance sexual experience without increasing HIV/STI risk. dfusion and its research partner, ETR, will meet the following specific Phase II aims:

• In conjunction with advisory panel members, develop content and corresponding storyboards for all activities. The curriculum will include content on risk reduction, sexual health and the quality of sexual experiences, and developing healthy relationships;
• Successful development of the first mobile app-delivered STI/HIV prevention program specifically designed for YBMSM aged 14-17. Reaching this aim requires continued development of the app technology, including the multimedia interactive activities, games, data collection, activity randomization, and a messaging/forum system. Research shows that YBMSM use the Internet to find information related to sex and sexuality, find friends and sexual partners, and YBMSM are increasingly using mobile apps, such as Grindr, to meet sex partners.20 The reliance on mobile devices for education and entertainment make it the ideal technology platform for reaching the YBMSM audience;
• Conduct a rigorous evaluation to determine the effectiveness of the intervention to reduce HIV/STI risk.

The evaluation features a 2-arm cluster randomized controlled trial with approximately 300 young black men who have sex with men (YBMSM) to assess the effectiveness of the 3T mobile app. To be eligible participants will be required to identify as male; Black, African-American, or biracial Black/African American; age 14-17 at baseline; self-identify as gay, bisexual, fluid, or sexually attracted to men; own a smartphone, and reside in any state in the United States. Those in the treatment arm will be provided with the 3T app, to be downloaded to their own device, and asked to use it during a three month period. Those in the control arm will be asked to download a general health app and use it during the same three month period. Participants will complete brief online surveys at baseline and at 3- and 6-months following the conclusion of the app-use period to assess effectiveness in changing sexual risk behaviors and relationship and communication behaviors and attitudes.

Recruitment. We will use a chain-referral technique for recruiting, starting with a group of 100 "seeds" recruited using a multi-pronged strategy including: 1) Engaging Organizations. Approximately 15-20 organizations from across the U.S. that serve YBMSM will be approached to help recruit participants through social media and in-person (see letters of support.) 2) Using Google Adwords. Placing study advertisements on Google based on keyword for participant recruitment; 3) Using Social Media Advertising including targeted advertising on social media sites and sponsoring study posts with social media influencers in the YBMSM community. To minimize contamination, we will randomize initial seeds and all persons in their recruitment chain to either the treatment arm or the attention control arm.

• Study Type: Interventional
• Enrollment (Anticipated): 250
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Tamara Kuhn, MS; Phone Number: 8314402104; Email: tamara.kuhn@dfusioninc.com
• Study Contact Backup: Name: Karin Coyle, PhD; Phone Number: 8314402140; Email: karin.coyle@etr.org

Study Locations

• United States
  • California
    • Scotts Valley, California, United States, 95066
      • Recruiting
      • ETR
      • Contact: Karin Coyle, PhD; Phone Number: 831-440-2140; Email: karin.coyle@etr.org
      • Principal Investigator: Karin Coyle, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 19 years (ADULT, CHILD)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

1. self-identification of being aged 14-19;
2. ownership of an iphone or Android smartphone
3. self-identification of racial identity as black, African American, or biracial; and
4. self-identifying as gay, bisexual, same gender loving, or sexually attracted to the same gender.
5. capacity to assent, based on formal assessment
6. a willingness to participate after complete understanding of the topics of study, as indicated by a completed assent form
7. resides in the US

Exclusion Criteria:

• Anyone not meeting inclusion criteria

Study Plan

How is the study designed?

Design Details

• Primary Purpose: PREVENTION
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: 3T Tune in! Turn on! Turn up!; The intervention is a mobile app delivered sexual health promotion program designed specifically for young black men who have sex with men or who are attracted to men. The mobile app will include more than 30 interactive activities including resource maps, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) content, and communication forums. The app helps participants to become clearer about what they do/don't want to do sexually, to communicate their choices. It also focuses on ways to increase healthy relationships, enhance sexual experience if having sex while reducing HIV/STI risk. The intervention/app is intended to be used regularly (e.g., two times per week) during the 90 day active participation period.	Behavioral: 3T Tune in! Turn on! Turn up!; A sex positive multimedia interactive mobile app delivered HIV/STI intervention developed for use by YBMSM ages 14-17. The program employs a theory based approach to address essential knowledge, perceptions of risk, peer norms, attitudes and skill with two primary goals: (1) To reduce HIV/STI the program emphasizes partner reduction, avoidance of concurrent partners, condoms and HIV/STI tests; and (2) To improve sexual health and relationships.
ACTIVE_COMPARATOR: General Health App; Participants will download a general health mobile app (focused on promoting drinking water). The control mobile app is intended to be used regularly during the 90 day active participation period.	Behavioral: General Health App; The control group will download a mobile app that addresses general health behaviors, specifically drinking more water.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Condomless anal intercourse or condomless vaginal intercourse	Number of times engaged in condomless receptive or insertive anal intercourse or condomless vaginal intercourse in the last 3 months	Baseline, before intervention period
Condomless anal intercourse or condomless vaginal intercourse	Number of times engaged in condomless receptive or insertive anal intercourse or condomless vaginal intercourse in the last 3 months	3 months post intervention period
Condomless anal intercourse or condomless vaginal intercourse	Number of times engaged in condomless receptive or insertive anal intercourse or condomless vaginal intercourse in the last 3 months	6 months post intervention period

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sexual partners, no condom, in the last 3 months	# partners with whom had anal or vaginal sex without using condoms in the last 3 months	Baseline, before intervention period
Sexual partners, no condom, in the last 3 months	# partners with whom had anal or vaginal sex without using condoms in the last 3 months	3 months post intervention period
Sexual partners, no condom, in the last 3 months	# partners with whom had anal or vaginal sex without using condoms in the last 3 months	6 months post intervention period
Self-reported STI/HIV testing in last three months	Number of times reported having been tested for STI, including HIV in the last 3 months	Baseline, before intervention period
Self-reported STI/HIV testing in last three months	Number of times reported having been tested for STI, including HIV in the last 3 months	3 months post intervention period
Self-reported STI/HIV testing in last three months	Number of times reported having been tested for STI, including HIV in the last 3 months	6 months post intervention period
Dyadic Communication Scale	Scale measures beliefs regarding communication with partner about sexual desires/behavior. Average of 6 items on a 5-point scale (1 to 5), with a range of 6 - 30, with a higher score indicating better outcomes	Baseline, before intervention period
Dyadic Communication Scale	Scale measures beliefs regarding communication with partner about sexual desires/behavior. Average of 6 items on a 5-point scale (1 to 5), with a range of 6 - 30, with a higher score indicating better outcomes	3 months post intervention period
Dyadic Communication Scale	Scale measures beliefs regarding communication with partner about sexual desires/behavior. Average of 6 items on a 5-point scale (1 to 5), with a range of 6 - 30, with a higher score indicating better outcomes	6 months post intervention period
Condom Pleasure Scale	Scale measures beliefs regarding condoms regarding condoms and pleasure. Average of 5 items on a 5-point scale (1 to 5), with a range of 5 - 25, with a higher score indicating better outcomes	Baseline, before intervention period
Condom Pleasure Scale	Scale measures beliefs regarding condoms regarding condoms and pleasure. Average of 5 items on a 5-point scale (1 to 5), with a range of 5 - 25, with a higher score indicating better outcomes	3 months post intervention period
Condom Pleasure Scale	Scale measures beliefs regarding condoms regarding condoms and pleasure. Average of 5 items on a 5-point scale (1 to 5), with a range of 5 - 25, with a higher score indicating better outcomes	6 months post intervention period
Condom Turn Off Scale	Scale measures beliefs regarding condoms regarding condoms and challenges using them. Average of 5 items on a 5-point scale (1 to 5), with a range of 5 - 25, with a higher score indicating better outcomes	Baseline, before intervention period
Condom Turn Off Scale	Scale measures beliefs regarding condoms regarding condoms and challenges using them. Average of 5 items on a 5-point scale (1 to 5), with a range of 5 - 25, with a higher score indicating better outcomes	3 months post intervention period
Condom Turn Off Scale	Scale measures beliefs regarding condoms regarding condoms and challenges using them. Average of 5 items on a 5-point scale (1 to 5), with a range of 5 - 25, with a higher score indicating better outcomes	6 months post intervention period

Collaborators and Investigators

• Sponsor: ETR Associates
• Collaborators: Dfusion Inc.
• Investigators: Principal Investigator: Tamara Kuhn, MS, Dfusion Inc.

Study record dates

Study Major Dates

• Study Start (ACTUAL): March 1, 2021
• Primary Completion (ANTICIPATED): October 1, 2022
• Study Completion (ANTICIPATED): November 1, 2022

Study Registration Dates

• First Submitted: October 20, 2019
• First Submitted That Met QC Criteria: October 20, 2019
• First Posted (ACTUAL): October 22, 2019

Study Record Updates

• Last Update Posted (ACTUAL): July 28, 2022
• Last Update Submitted That Met QC Criteria: July 26, 2022
• Last Verified: July 1, 2022

More Information

Terms related to this study

• Keywords: Healthy relationships
• Additional Relevant MeSH Terms: RNA Virus Infections; Virus Diseases; Infections; Blood-Borne Infections; Communicable Diseases; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; Immunologic Deficiency Syndromes; Immune System Diseases; Slow Virus Diseases; HIV Infections; Acquired Immunodeficiency Syndrome
• Other Study ID Numbers: 3T

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No