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Evaluation of Sex Positive! A Video eHealth Intervention for Men Living with HIV

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Abstract

Sex Positive![+] is a two-arm, video-based web intervention aimed at reducing condomless anal sex (CAS) with partners of known and unknown serostatus that was delivered online to a racially and ethnically diverse sample of 830 gay, bisexual, and other men who have sex with men living with HIV. Men in each arm received 6 weekly videos after completing a baseline assessment and 4 weekly booster videos following a 6-month assessment. Follow-up assessments were conducted every 3 months for 1 year. At 3-month follow-up, men in the intervention arm reported significantly reduced risk of having unknown serodiscordant CAS partners than men in the control arm (RR 0.60, 95% CI 0.39–0.92), partially supporting study hypotheses. Aside from this finding, similar reductions in sexual risk behaviors were observed in both arms over the study period. There is much to be learned about video-based web interventions in terms of methodological development and intervention delivery, including frequency and duration of intervention components.

Resumen

Sex Positive! [+] es una intervención vía web de dos brazos basado en videos diseñados para reducir el sexo anal sin condón (SASC) con parejas de estado serológico conocido y desconocido. Los videos se distribuyeron vía Internet a una muestra racial y étnicamente diversa de 830 hombres homosexuales, bisexuales y otros hombres que tienen sexo con hombres que viven con VIH. Después de completar una evaluación basal, semanalmente se presentó un video a los hombres de cada brazo durante 6 semanas. Comenzando en el sexto mes, un video de refuerzo se presentó semanalmente durante 4 semanas. Las evaluaciones de seguimiento se realizaron cada tres meses durante un año. A los 3 meses de seguimiento, los hombres en el brazo de intervención reportaron una reducción significativa en el riesgo de tener SASC con parejas de estado serológico desconocido comparados con hombres en el brazo de control (RR = 0,60; IC del 95%: 0,39-0,92), lo cual apoya parcialmente la hipótesis del estudio. Además de este hallazgo, se observaron reducciones similares en las conductas de riesgo sexual en ambos brazos durante el período de estudio. Aún hay mucho que aprender acerca de las intervenciones con videos administradas por medio del Internet, específicamente en términos de desarrollo metodológico y modos de implementación, incluyendo la frecuencia y la duración de los componentes de la intervención.

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Funding

This study was supported by a grant from the National Institute of Mental Health (R01 MH100973, PI: Hirshfield). A Certificate of Confidentiality was also obtained from the National Institute of Mental Health to provide additional privacy protections for participants enrolled in this study (ClinicalTrials.gov #NCT02023580).

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Authors and Affiliations

  1. Department of Medicine, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA

    Sabina Hirshfield

  2. Department of Psychology, Lehman College, City University of New York (CUNY), Bronx, NY, USA

    Martin J. Downing Jr.

  3. Department of Epidemiology, Columbia University, New York, NY, USA

    Mary Ann Chiasson & Richard A. Teran

  4. Gartner L2, Research and Advisory, New York, NY, USA

    Irene S. Yoon

  5. Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Steven T. Houang

  6. Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA

    Christian Grov

  7. Department of Epidemiology, Emory University, Atlanta, GA, USA

    Patrick S. Sullivan

  8. Departments of Medicine and Epidemiology, Division of Infectious Diseases, Columbia University, New York, NY, USA

    Rachel J. Gordon

  9. Department of Statistics and Biostatistics and Institute for Health Care Policy and Aging Research, Rutgers University, Piscataway, NJ, USA

    Donald R. Hoover

  10. Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA

    Jeffrey T. Parsons

  11. Graduate Center, City University of New York (CUNY), New York, NY, USA

    Jeffrey T. Parsons

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  1. Sabina Hirshfield
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  2. Martin J. Downing Jr.
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  7. Christian Grov
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  8. Patrick S. Sullivan
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  11. Jeffrey T. Parsons
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Correspondence to Sabina Hirshfield.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Hirshfield, S., Downing, M.J., Chiasson, M.A. et al. Evaluation of Sex Positive! A Video eHealth Intervention for Men Living with HIV. AIDS Behav 23, 3103–3118 (2019). https://doi.org/10.1007/s10461-019-02498-5

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