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Targeted E-Health HIV Intervention Reduces STIs and Sexual Risk Behaviors

New study shows promising results for the Keep It Up! intervention

Science Update

The U.S. National HIV/AIDS Strategy calls for reductions in new HIV infections by the year 2020, particularly among young men who have sex with men (YMSM). Although electronically delivered health services have been found to be an effective way to deliver HIV prevention information, very few interventions target YMSM. But findings from a new study suggest an electronically delivered HIV prevention intervention may be effective in reducing sexually transmitted infections (STIs) and sexual risk behaviors in this group.

Developing programs that target YMSM is especially important, as HIV incidence is high in this group and diagnoses have been increasing. “We will not reach the goals of the National AIDS Strategy to significantly reduce new infections in the United States without new innovative approaches to help YMSM reduce their risk for HIV,” said study lead author Brian Mustanski, Ph.D., of the Northwestern University Feinberg School of Medicine.

The Keep It Up! 2.0 (KIU!) eHealth intervention program consists of seven modules that use videos, interactive animation, and games to increase participant’s knowledge related to HIV prevention and to motivate them to engage in HIV preventative behaviors. It is tailored to racially and ethnically diverse English speaking YMSM.  

In this study, funded by the National Institute of Mental Health and the National Institute on Drug Abuse, the researchers tested the effectiveness of KIU! at three sites in the U.S.: Atlanta, Ga.; Chicago, Ill.; and, New York, N.Y. The yearlong double-blind, randomized control trial compared KIU! to a control intervention, which was geared toward a general audience and provided HIV/STI transmission and prevention information using static images and text. Participants completed the interventions (either the KIU! or the control intervention) at the beginning of the study. Participants who were receiving the KIU! intervention then received “booster” information on topics, such as the importance of HIV testing and HIV prevention in romantic relationships, 3 and 6 months later.

Participants were tested for STIs at the beginning of the study and again 12 months after completing their assigned intervention. Participants also reported any engagement in sexual risk behaviors and other health-related behaviors at the beginning of the study and at 3, 6, and 12 months following completion of the intervention.

STI incidence was found to be 40 percent lower in the KIU! group compared with the control group at the 12-month timepoint. The KIU! intervention also led to a small but significant reduction in reported sexual risk behaviors compared with the control intervention at the 12-month timepoint. The researchers found similar results when the data were broken down by age, enrollment location, race and ethnicity, and sexual orientation.  

The KIU! intervention represents a potentially cost-effective way to deliver behavioral prevention to an at-risk group. The consistency of the results across demographic factors suggests that the intervention is effective and generalizable within the target group.

“Through dialogue with community organizations and health departments, we sought to create a program that could be integrated with HIV testing in a way that builds on existing public health practice,” said Dr. Mustanski. “As a next step, we are hoping to study dissemination and implementation strategies that help this highly effective program reach as many YMSM as possible.”

To learn more about this study and see a video, view the Northwestern University website.

References

Mustanski, B., Parsons, J. T., Sullivan, P., Madkins, K., Rosenberg, E., & Swann, G. (in press). Biomedical and behavioral outcomes of Keep It Up!: An eHealth HIV prevention program RCT. American Journal of Preventive Medicine.

Grants

NIDA and NIMH: R01DA035145, NIMH: R34MH079714, Clinical Trial ID: NCT01836445