Fifty-two non-treatment-seeking methamphetamine-using men who have sex with men were enrolled in Project Tech Support, an open-label pilot study to evaluate whether exposure to theory-based [social support theory (SST), social cognitive theory (SCT), and health belief model (HBM)] text messages could promote reductions in HIV sexual risk behaviors and/or methamphetamine use. Multivariable analyses revealed that increased relative exposure to HBM or SCT (vs. SST) text messages was associated with significant reductions in the number of HIV serodiscordant unprotected (i.e., without a condom) anal sex partners, engagement in sex for money and/or drugs, and frequency of recent methamphetamine use; additionally, increased relative exposure to HBM (vs. SCT or SST) messages was uniquely associated with reductions in the overall number of non-primary anal sex partners (all p ≤ 0.05, two-tailed). Pilot data demonstrated that text messages based on the principles of HBM and SCT reduced sentinel HIV risk and drug use behaviors in active methamphetamine users.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Centers for Disease Control and Prevention. HIV in the United States: at a glance. Atlanta, GA: US Department of Health and Human Services; 2013.
Centers for Disease Control and Prevention. Estimated HIV incidence in the United States, 2007–2010. Atlanta, GA: US Department of Health and Human Services; 2012.
Friedman MR, Wei C, Klem ML, Silvestre AJ, Markovic N, Stall R. HIV infection and sexual risk among men who have sex with men and women (MSMW): a systematic review and meta-analysis. PLoS ONE. 2014;9(1):e87139.
Centers for Disease Control and Prevention. Methamphetamine use and risk for HIV/AIDS. Atlanta, GA: US Department of Health and Human Services; 2007.
Shoptaw S, Reback CJ. Associations between methamphetamine use and HIV among men who have sex with men: a model for guiding public policy. J Urban Health. 2006;83(6):1151–7.
Hirshfield S, Remien RH, Humberstone M, Walavalkar I, Chiasson MA. Substance use and high-risk sex among men who have sex with men: a national online study in the USA. AIDS Care. 2004;16(8):1036–47.
Brewer DD, Golden MR, Handsfield HH. Unsafe sexual behavior and correlates of risk in a probability sample of men who have sex with men in the era of highly active antiretroviral therapy. Sex Transm Dis. 2006;33(4):250–5.
Schwarcz S, Scheer S, McFarland W, et al. Prevalence of HIV infection and predictors of high-transmission sexual risk behaviors among men who have sex with men. Am J Public Health. 2007;97(6):1067–75.
Halkitis P, Moeller R, Siconolfi D, Jerome R, Rogers M, Schillinger J. Methamphetamine and poly-substance use among gym-attending men who have sex with men in New York City. Ann Behav Med. 2008;35(1):41–8.
Forrest D, Metsch L, LaLota M, Cardenas G, Beck D, Jeanty Y. Crystal methamphetamine use and sexual risk behaviors among HIV-positive and HIV-negative men who have sex with men in South Florida. J Urban Health. 2010;87(3):480–5.
Freeman P, Walker BC, Harris DR, et al. Methamphetamine use and risk for HIV among young men who have sex with men in 8 US cities. Arch Pediatr Adolesc Med. 2011;165(8):736–40.
Kreuter MW, Wray RJ. Tailored and targeted health communication: strategies for enhancing information relevance. Am J Health Behav. 2003;27(Suppl 3):S227–32.
Fjeldsoe BS, Marshall AL, Miller YD. Behavior change interventions delivered by mobile telephone short-message service. Am J Prev Med. 2009;36(2):165–73.
Cole-Lewis H, Kershaw T. Text messaging as a tool for behavior change in disease prevention and management. Epidemiol Rev. 2010;32(1):56–69.
Lim MSC, Hocking JS, Hellard ME, Aitken CK. SMS STI: a review of the uses of mobile phone text messaging in sexual health. Int J STD AIDS. 2008;19(5):287–90.
Wei J, Hollin I, Kachnowski S. A review of the use of mobile phone text messaging in clinical and healthy behaviour interventions. J Telemed Telecare. 2011;17(1):41–8.
Head KJ, Noar SM, Iannarino NT, Grant Harrington N. Efficacy of text messaging-based interventions for health promotion: a meta-analysis. Soc Sci Med. 2013;97:41–8.
Rainie L. Internet, broadband, and cell phone statistics. Washington, DC: Pew Research Center; 2010.
Muench F, Weiss RA, Kuerbis A, Moregenstern J. Developing a theory driven text messaging intervention for addiction care with user driven content. Psychol Addict Behav. 2013;27(1):315–21.
Fox S. Mobile health 2010. Washington, DC: Pew Research Center; 2010.
Smith A. Technology trends among people of color. Washington, DC: Pew Research Center; 2010.
Lenhart A. Cell phones and American adults. Washington, DC: Pew Research Center; 2010.
McClure EA, Acquavita SP, Harding E, Stitzer ML. Utilization of communication technology by patients enrolled in substance abuse treatment. Drug Alcohol Depend. 2013;129(1–2):145–50.
National Coalition for the Homeless. HIV/AIDS and homelessness. Washington, DC: National Coalition for the Homeless; 2009.
Centers for Disease Control and Prevention. HIV in the United States. Atlanta, GA: US Department of Health and Human Services; 2013.
Centers for Disease Control and Prevention. HIV and substance use in the United States. Atlanta, GA: US Department of Health and Human Services; 2013.
Centers for Disease Control and Prevention. HIV among youth. Atlanta, GA: US Department of Health and Human Services; 2014.
Lester RT, Ritvo P, Mills EJ, et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet. 2010;376(9755):1838–45.
Pop-Eleches C, Thirumurthy H, Habyarimana J, et al. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS. 2011;25(6):825–34.
Finitsis DJ, Pellowski JA, Johnson BT. Text message intervention designs to promote adherence to antiretroviral therapy (ART): a meta-analysis of randomized controlled trials. PLoS ONE. 2014;9(2):e88166.
Khosropour CM, Lake JG, Sullivan PS. Are MSM willing to SMS for HIV prevention? J Health Commun. 2014;19(1):57–66.
Menacho LA, Blas MM, Alva IE, Orellana ER. Short text messages to motivate HIV testing among men who have sex with men: a qualitative study in Lima. Peru Open AIDS J. 2013;7:1–6.
Ingersoll K, Dillingham R, Reynolds G, et al. Development of a personalized bidirectional text messaging tool for HIV adherence assessment and intervention among substance abusers. J Subst Abuse Treat. 2014;46:66–73.
Zou H, Fairley CK, Guy R, et al. Automated, computer generated reminders and increased detection of gonorrhoea, chlamydia and syphilis in men who have sex with men. PLoS ONE. 2013;8(4):e61972.
Moore DJ, Montoya JL, Blackstone K, et al. Preliminary evidence for feasibility, use, and acceptability of individualized texting for adherence building for antiretroviral adherence and substance use assessment among HIV-infected methamphetamine users. AIDS Res Treat. 2013;2013:585143.
Reback C, Grant D, Fletcher J, et al. Text messaging reduces HIV risk behaviors among methamphetamine-using men who have sex with men. AIDS Behav. 2012;16(7):1993–2002.
Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31(2):143–64.
Fishbein M. The role of theory in HIV prevention. AIDS Care. 2000;12(3):273–8.
Boone TL, Lefkowitz ES. Safer sex and the health belief model. J Psychol Human Sex. 2004;16(1):51–68.
Eastin MS, LaRose R. Alt. support: modeling social support online. Comput Human Behav. 2005;21(6):977–92.
Lin P, Simoni JM, Zemon V. The health belief model, sexual behaviors, and HIV risk among Taiwanese immigrants. AIDS Educ Prev. 2005;17(5):469–83.
Downing-Matibag TM, Geisinger B. Hooking up and sexual risk taking among college students: a health belief model perspective. Qual Health Res. 2009;19(9):1196–209.
Lakey B, Cohen S. Social support theory and measurement. In: Cohen S, Underwood LG, Gottlieb BH, editors. Social support measurement and intervention: a guide for health and social scientists. Oxford: Oxford University Press; 2000. p. 29–52.
Uchino BN. Social support and health: a review of physiological processes potentially underlying links to disease outcomes. J Behav Med. 2006;29(4):377–87.
Wills TA, Ainette MG. Social networks and social support. In: Baum A, Revenson TA, Singer J, editors. Handbook of health psychology. 2nd ed. New York, NY: Psychology Press; 2012. p. 465–92.
Uchino BN. Social support and physical health: understanding the health consequences of relationships. New Haven, CT: Yale University Press; 2004.
Reilly T, Woo G. Social support and maintenance of safer sex practices among people living with HIV/AIDS. Health Soc Work. 2004;29(2):97–105.
Wohl AR, Galvan FH, Myers HF, et al. Do social support, stress, disclosure and stigma influence retention in HIV care for Latino and African American men who have sex with men and women? AIDS Behav. 2011;15(6):1098–110.
Woodward EN, Pantalone DW. The role of social support and negative affect in medication adherence for HIV-infected men who have sex with men. J Assoc Nurses AIDS Care. 2012;23(5):388–96.
Glick SN, Golden MR. Early male partnership patterns, social support, and sexual risk behavior among young men who have sex with men. AIDS Behav. 2013. doi:10.1007/s10461-013-0678-7.
Scott H, Pollack L, Rebchook G, Huebner D, Peterson J, Kegeles S. Peer social support is associated with recent HIV testing among young black men who have sex with men. AIDS Behav. 2013;18(5):913–20.
O’Leary A, Wolitski RJ, Remien RH, et al. Psychosocial correlates of transmission risk behavior among HIV-seropositive gay and bisexual men. AIDS. 2005;19(Suppl 1):S67–75.
Mausbach BT, Semple SJ, Strathdee SA, Zians J, Patterson TL. Efficacy of a behavioral intervention for increasing safer sex behaviors in HIV-positive MSM methamphetamine users: results from the EDGE study. Drug Alcohol Depend. 2007;87(2–3):249–57.
Armitage CJ, Conner M. Social cognition models and health behaviour: a structured review. Psychol Health. 2000;15(2):173–89.
Champion VL, Skinner CS. The health belief model. In: Glanz K, Rimer BK, Viswanath K, editors. Health behavior and health education: theory, research, and practice. San Francisco, CA: Jossey-Bass; 2008. p. 45–66.
Carpenter CJ. A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Commun. 2010;25(8):661–9.
van der Snoek EM, de Wit JBF, Götz HM, Mulder PGH, Neumann MHA, van der Meijden WI. Incidence of sexually transmitted diseases and HIV infection in men who have sex with men related to knowledge, perceived susceptibility, and perceived severity of sexually transmitted diseases and HIV infection: Dutch MSM–cohort study. Sex Transm Dis. 2006;33(3):193–8.
Reback CJ, Ling D, Shoptaw S, Rohde J. Developing a text messaging risk reduction intervention for methamphetamine-using MSM: research note. Open AIDS J. 2010;4:116–22.
Hilbe JM. Negative binomial regression. 2nd ed. New York, NY: Cambridge University Press; 2011.
Kleinbaum DC, Klein M. Ordinal logistic regression., Statistics for biology and healthNew York, NY: Springer; 2010. p. 463–88.
Taylor D, Bury M, Campling N, et al. A review of the use of the health belief model (HBM), the theory of reasoned action (TRA), the theory of planned behaviour (TPB) and the trans-theoretical model (TTM) to study and predict health related behaviour change. London: National Institute for Health and Clinical Excellence; 2006.
Prochaska JO. The transtheoretical model of behavior change. In: Gellman MD, Turner JR, editors. Encyclopedia of behavioral medicine. New York, NY: Springer; 2013. p. 1997–2000.
Hall KL, Rossi JS. Meta-analytic examination of the strong and weak principles across 48 health behaviors. Prev Med. 2008;46(3):266–74.
Rosenstock IM. Historical origins of the health belief model. Health Educ Behav. 1974;2(4):328–35.
Gallant MP. The influence of social support on chronic illness self-management: a review and directions for research. Health Educ Behav. 2003;30(2):170–95.
Simoni JM, Frick PA, Huang B. A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy. Health Psychol. 2006;25(1):74–81.
Atkinson NL, Gold RS. The promise and challenge of eHealth interventions. Am J Health Behav. 2002;26(6):494–503.
Noar SM, Benac CN, Harris MS. Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychol Bull. 2007;133(4):673–93.
ClinicalTrials.gov. [Internet], Bethesda, MD: National Library of Medicine, US. 2014 Jan-. Identifier NCT02008526. Theory-based text messaging to reduce methamphetamine use and HIV risks among MSM. http://clinicaltrials.gov/ct2/show/NCT02008526?term=NCT02008526&rank=1. Accessed 27 May 2014.
This study was supported by the Centers for Disease Control and Prevention, cooperative agreement #UR6PS000312. Drs. Reback and Shoptaw acknowledge additional support from the National Institute of Mental Health (P30 MH58107). The authors would also like to thank Catherine M. Branson, Joshua Rusow, and Kimberly Kisler, MPH, Ph.D. for their contributions to the development of this manuscript, and Deborah Ling Grant Ph.D., MPH, MBA for her work as Project director during the implementation of the study.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
About this article
Cite this article
Reback, C.J., Fletcher, J.B., Shoptaw, S. et al. Exposure to Theory-Driven Text Messages is Associated with HIV Risk Reduction Among Methamphetamine-Using Men Who have Sex with Men. AIDS Behav 19, 130–141 (2015). https://doi.org/10.1007/s10461-014-0985-7
- Men who have sex with men (MSM)
- Text messaging (SMS)
- Mobile technology