Effect of an online video-based intervention to increase HIV testing in men who have sex with men in Peru

Magaly M Blas, Isaac E Alva, Cesar P Carcamo, Robinson Cabello, Steven M Goodreau, Ann M Kimball, Ann E Kurth, Magaly M Blas, Isaac E Alva, Cesar P Carcamo, Robinson Cabello, Steven M Goodreau, Ann M Kimball, Ann E Kurth

Abstract

Background: Although many men who have sex with men (MSM) in Peru are unaware of their HIV status, they are frequent users of the Internet, and can be approached by that medium for promotion of HIV testing.

Methods: We conducted an online randomized controlled trial to compare the effect of HIV-testing motivational videos versus standard public health text, both offered through a gay website. The videos were customized for two audiences based on self-identification: either gay or non-gay men. The outcomes evaluated were 'intention to get tested' and 'HIV testing at the clinic.'

Findings: In the non-gay identified group, 97 men were randomly assigned to the video-based intervention and 90 to the text-based intervention. Non-gay identified participants randomized to the video-based intervention were more likely to report their intention of getting tested for HIV within the next 30 days (62.5% vs. 15.4%, Relative Risk (RR): 2.77, 95% Confidence Interval (CI): 1.42-5.39). After a mean of 125.5 days of observation (range 42-209 days), 11 participants randomized to the video and none of the participants randomized to text attended our clinic requesting HIV testing (p = 0.001). In the gay-identified group, 142 men were randomized to the video-based intervention and 130 to the text-based intervention. Gay-identified participants randomized to the video were more likely to report intentions of getting an HIV test within 30 days, although not significantly (50% vs. 21.6%, RR: 1.54, 95% CI: 0.74-3.20). At the end of follow up, 8 participants who watched the video and 10 who read the text visited our clinic for HIV testing (Hazard Ratio: 1.07, 95% CI: 0.40-2.85).

Conclusion: This study provides some evidence of the efficacy of a video-based online intervention in improving HIV testing among non-gay-identified MSM in Peru. This intervention may be adopted by institutions with websites oriented to motivate HIV testing among similar MSM populations.

Trial registration: Clinicaltrials.gov NCT00751192.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Randomization process.
Figure 1. Randomization process.
Figure 2. Percentage of non-gay-identified MSM tested…
Figure 2. Percentage of non-gay-identified MSM tested for HIV by time since randomization (in days).
Figure 3. Percentage of gay-identified MSM tested…
Figure 3. Percentage of gay-identified MSM tested for HIV by time since randomization (in days).

References

    1. UNAIDS. AIDS Epidemic Update. Geneva: Joint United Nations Programme on HIV/AIDS; 2007. Available: . Accessed 2010 March 10.
    1. Orellana ER, Picciano JF, Roffman RA, Swanson F, Kalichman SC. Correlates of nonparticipation in an HIV prevention program for MSM. AIDS Educ Prev. 2006;18(4):348–61.
    1. Kusunoki L, Guanira J, Navarro C, Velasquez C. Report of Monitoring the declaration of commitment on HIV/AIDS 2005. 2005. Available: . Accessed 2010 March 10.
    1. Peru Country Progress Report UNGASS. 2008. Available: . Accessed 2010 March 10.
    1. Blas M. Web-based survey to assess risk behaviors for sexually transmitted infections and HIV among men who have sex with men from Peru. 2007. Master of Public Health Thesis. University of Washington.
    1. Blas MM, Alva IE, Cabello R, Garcia PJ, Carcamo C, et al. Internet as a tool to access high-risk men who have sex with men from a resource-constrained setting: a study from Peru. Sex Transm Infect. 2007;83(7):567–570.
    1. Curioso WH, Blas MM, Nodell B, Alva IE, Kurth AE. Opportunities for providing web-based interventions to prevent sexually transmitted infections in Peru. PLoS Med. 2007;4(2):e11.
    1. Bull SS, McFarlane M, King D. Barriers to STD/HIV prevention on the Internet. Health Educ Res. 2001;16(6):661–70.
    1. Levine DK, Scott KC, Klausner JD. Online syphilis testing–confidential and convenient. Sex Transm Dis. 2005;32(2):139–41.
    1. Bowen AM, Horvath K, Williams ML. A randomized control trial of Internet-delivered HIV prevention targeting rural MSM. Health Educ Res. 2007;22(1):120–7.
    1. Centers for Disease Control and Prevention (CDC) Using the Internet for partner notification of sexually transmitted diseases. Los Angeles County, California, 2003. MMWR Morb Mortal Wkly Rep. 2004;53(6):129–31.
    1. Ross MW. The Internet as a medium for HIV prevention and counseling. Focus. 2002;17(5):4–6.
    1. Warner L, Klausner JD, Rietmeijer CA, Malotte CK, O'Donnell L, et al. Effect of a brief video intervention on incident infection among patients attending sexually transmitted disease clinics. PLoS Med. 2008;5(5):e135.
    1. Online film successful in reducing certain HIV risk behaviors. At-risk people watch 9-minute video. AIDS Alert. 2008;23(2):18–9.
    1. Nijland N, van Gemert-Pijnen J, Boer H, Steehouder MF, Seydel ER. Evaluation of internet-based technology for supporting self-care: problems encountered by patients and caregivers when using self-care applications. J Med Internet Res. 2008;10(2):e13.
    1. LimeSurvey, the open source survey application. Available: . Accessed 2008 June 20.
    1. Get tested with Via Libre (for non-gay identified MSM). Available: . Accessed 2010 March 15.
    1. Get tested with Via Libre (for gay-identified MSM). Available: . Accessed 2010 March 15.
    1. Get tested with Via Libre (for trans). Available: . Accessed 2010 March 15.
    1. El Gremio, centro comunitario de Lucha Contra el SIDA. Campana Hazte la Prueba. Available: . Accessed 2007 July 20.
    1. DiClemente CC, Prochaska JO, Fairhurst SK, Velicer WF, Velasquez MM, et al. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol. 1991;59(2):295–304.
    1. Prochaska JO, Velicer WF, Rossi JS, Goldstein MG, Marcus BH, et al. Stages of change and decisional balance for 12 problem behaviors. Health Psychol. 1994;13(1):39–46.
    1. Evers KE, Harlow LL, Redding CA, LaForge RG. Longitudinal changes in stages of change for condom use in women. Am J Health Promot. 1998;13(1):19–25.
    1. Kellerman SE, Lehman JS, Lansky A, Stevens MR, Hecht FM, et al. HIV testing within at-risk populations in the United States and the reasons for seeking or avoiding HIV testing. J Acquir Immune Defic Syndr. 2002;31(2):202–10.
    1. Mikolajczak J, Hospers HJ, Kok G. Reasons for not taking an HIV-test among untested men who have sex with men: an Internet study. AIDS Behav. 2006;10(4):431–5.
    1. Mayer RE. Multimedia Learning. New York: Cambridge University Press; 2001. 222
    1. Myint-U A, Bull S, Greenwood GL, Patterson J, Rietmeijer CA, et al. Safe in the City: Developing an Effective Video-Based Intervention for STD Clinic Waiting Rooms. Health Promot Pract. 2008 doi: .
    1. O'Donnell L, San Doval A, Duran R, O'Donnell CR. The effectiveness of video-based interventions in promoting condom acquisition among STD clinic patients. Sex Transm Dis. 1995;22(2):97–103.
    1. Flatley-Brennan P. Computer network home care demonstration: a randomized trial in persons living with AIDS. Comput Biol Med. 1998;28(5):489–508.
    1. Safren SA, Hendriksen ES, Desousa N, Boswell SL, Mayer KH. Use of an on-line pager system to increase adherence to antiretroviral medications. AIDS Care. 2003;15(6):787–93.
    1. Bull SS, Lloyd L, Rietmeijer C, McFarlane M. Recruitment and retention of an online sample for an HIV prevention intervention targeting men who have sex with men: the Smart Sex Quest Project. AIDS Care. 2004;16(8):931–43.

Source: PubMed

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