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Acceptability and Preliminary Efficacy of an Online HIV Prevention Intervention for Single Young Men Who Have Sex with Men Seeking Partners Online: The myDEx Project

  • José A. BauermeisterEmail author
  • Ryan C. Tingler
  • Michele Demers
  • Daniel Connochie
  • Gage Gillard
  • John Shaver
  • Tanaka Chavanduka
  • Gary W. Harper
Original Paper

Abstract

Prevention of new cases of HIV among young gay, bisexual and other men who have sex with men (YGBMSM; ages 18–24) remains a priority. We developed and pilot tested an online intervention (myDEx) using a pilot randomized trial design with 180 online-recruited single YGBMSM who reported recent unprotected anal intercourse, self-reporting as HIV negative or status-unaware, and who met sexual partners through online dating applications. myDEx participants reported higher overall satisfaction (d = 0.46) and willingness to recommend the intervention to friends (d = 0.48) than controls. myDEx participants were less likely to report foregoing condoms to achieve an emotional connection with a partner (d =0 .43), and more likely to report greater emotional regulation during their partner-seeking behaviors (d = 0.44). myDEx participants reported fewer partners with whom they had condomless receptive anal sex (d = 0.48). Our pilot results demonstrate the potential of the myDEx intervention, suggesting that a larger efficacy trial may be warranted in the future.

Keywords

mHealth Decisional balance Limerence LGBT Sexual behavior 

Resumen

La prevención de nuevos casos de VIH entre jóvenes gays, bisexuales y otros hombres que tienen sexo con hombres (YGBMSM; edades 18-24) sigue siendo una prioridad. Desarrollamos una intervención en línea (myDEx) y utilizamos un estudio piloto en un diseño aleatorio controlado con una muestra de 180 YGBMSM. Los participantes, reclutados en línea, fueron elegibles si tuvieron relaciones sexuales anales sin protección, informaron ser VIH negativo o serodesconocido, y buscaron parejas sexuales a través de aplicaciones sociales. En contraste con el grupo control, los participantes de myDEx informaron mayor satisfacción (d = .46) y disposición a recomendar la intervención a sus amigos (d = .48). Los participantes de myDEx disminuyeron la propensidad a evitar el uso de condones para lograr una conexión emocional con un compañero (d = .43), y una mejora en la regulación emocional durante la búsqueda de parejas (d = .44). Los participantes de myDEx redujeron el número de parejas con las que tuvieron relaciones sexuales anales receptivas sin condón (d = .48). Nuestros resultados piloto demuestran el potencial de la intervención myDEx y justifican un estudio de eficacia en el futuro.

Notes

Acknowledgements

We greatly appreciate the hard work of the study staff, and are indebted to the study participants for volunteering their time. This research was sponsored by the US National Institutes of Health (NIH), under R34 MH101997. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH.

Funding

This research was sponsored by the US National Institutes of Health (NIH), under R34 MH101997. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH.

Compliance with Ethical Standards

Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical Approval

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.

Informed Consent

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

References

  1. 1.
    CDC. HIV and young men who have sex with men. 2018; 1: 4. http://www.cdc.gov/healthyyouth/sexualbehaviors/pdf/hiv_factsheet_ymsm.pdf.
  2. 2.
    Kann L. Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9–12—United States and selected sites, 2015. MMWR. Surveillance Summaries. 2016;65.Google Scholar
  3. 3.
    Moller AC, Merchant G, Conroy DE, et al. Applying and advancing behavior change theories and techniques in the context of a digital health revolution: proposals for more effectively realizing untapped potential. J Behav Med. 2017;40(1):85–98.Google Scholar
  4. 4.
    Muessig KE, Nekkanti M, Bauermeister J, Bull S, Hightow-Weidman LB. A systematic review of recent smartphone, Internet and Web 2.0 interventions to address the HIV continuum of care. Curr HIV/AIDS Rep. 2015;12(1):173–90.Google Scholar
  5. 5.
    Kubicek K, Carpineto J, McDavitt B, Weiss G, Kipke MD. Use and perceptions of the internet for sexual information and partners: a study of young men who have sex with men. Arch Sex Behav. 2011;40(4):803–16.Google Scholar
  6. 6.
    Pingel ES, Bauermeister JA, Johns MM, Eisenberg A, Leslie-Santana M. “A safe way to explore”: reframing risk on the Internet amidst young gay men’s search for identity. J Adolesc Res. 2013;28(4):453–78.Google Scholar
  7. 7.
    Pingel ES, Thomas L, Harmell C, Bauermeister J. Creating comprehensive, youth centered, culturally appropriate sex education: What do young gay, bisexual and questioning men want? Sex Res Soc Policy. 2013;10(4):293–301.Google Scholar
  8. 8.
    Harper GW, Serrano PA, Bruce D, Bauermeister JA. The internet’s multiple roles in facilitating the sexual orientation identity development of gay and bisexual male adolescents. Am J Men’s Health. 2016;10(5):359–76.Google Scholar
  9. 9.
    Hightow-Weidman LB, Muessig KE, Bauermeister J, Zhang C, LeGrand S. Youth, Technology, and HIV: recent advances and future directions. Curr HIV/AIDS Rep. 2015;12(4):500–15.Google Scholar
  10. 10.
    Bauermeister JA, Pingel ES, Jadwin-Cakmak L, et al. Acceptability and preliminary efficacy of a tailored online HIV/STI testing intervention for young men who have sex with men: the Get Connected! program. AIDS Behav. 2015;19(10):1860–74.Google Scholar
  11. 11.
    Mustanski B, Greene GJ, Ryan D, Whitton SW. Feasibility, acceptability, and initial efficacy of an online sexual health promotion program for LGBT youth: the Queer Sex Ed intervention. J Sex Res. 2015;52(2):220–30.Google Scholar
  12. 12.
    Mustanski B, Parsons JT, Sullivan PS, Madkins K, Rosenberg E, Swann G. Biomedical and behavioral outcomes of keep it up!: an eHealth HIV prevention program RCT. Am J Prev Med. 2018;55(2):151–8.Google Scholar
  13. 13.
    Lelutiu-Weinberger C, Pachankis JE, Gamarel KE, Surace A, Golub SA, Parsons JT. Feasibility, acceptability, and preliminary efficacy of a live-chat social media intervention to reduce HIV risk among young men who have sex with men. AIDS Behav. 2015;19(7):1214–27.Google Scholar
  14. 14.
    Kubicek K, Carpineto J, McDavitt B, et al. Integrating professional and folk models of HIV risk: YMSM’s perceptions of high-risk sex. AIDS Educ Prevent. 2008;20(3):220–38.Google Scholar
  15. 15.
    Siegler AJ, Wirtz S, Weber S, Sullivan PS. Developing a web-based geolocated directory of HIV pre-exposure prophylaxis-providing clinics: the PrEP locator protocol and operating procedures. JMIR Public Health Surveill. 2017;3(3):e58.Google Scholar
  16. 16.
    Marks SJ, Merchant RC, Clark MA, et al. Potential healthcare Insurance and provider barriers to pre-exposure prophylaxis utilization among young men who have sex with men. AIDS Patient Care STDS. 2017;31(11):470–8.Google Scholar
  17. 17.
    Mitchell JW, Lee JY, Woodyatt C, Bauermeister J, Sullivan P, Stephenson R. HIV-negative male couples’ attitudes about pre-exposure prophylaxis (PrEP) and using PrEP with a sexual agreement. AIDS Care. 2016;28(8):994–9.Google Scholar
  18. 18.
    Eaton LA, Driffin DD, Bauermeister J, Smith H, Conway-Washington C. Minimal awareness and stalled uptake of pre-exposure prophylaxis (PrEP) among at risk, HIV-negative, black men who have sex with men. AIDS Patient Care STDS. 2015;29(8):423–9.Google Scholar
  19. 19.
    Bauermeister JA, Muessig KE, LeGrand S, et al. HIV and sexuality stigma reduction through engagement in online forums: results from the HealthMPowerment intervention. AIDS Behav. 2018.  https://doi.org/10.1007/s10461-018-2256-5.Google Scholar
  20. 20.
    Hermanstyne KA, Green HD Jr, Cook R, et al. Social network support and decreased risk of seroconversion in black MSM: results of the BROTHERS (HPTN 061) study. J Acquir Immune Defic Syndr. 2018;78(2):163–8.Google Scholar
  21. 21.
    Carpineto J, Kubicek K, Weiss G, Iverson E, Kipke MD. Young men’s perspectives on family support and disclosure of same-sex attraction. J LGBT Issues Couns. 2008;2(1):53–80.Google Scholar
  22. 22.
    Soler JH, Caldwell CH, Córdova D, Harper G, Bauermeister JA. Who counts as family? Family typologies, family support, and family undermining among young adult gay and bisexual men. Sex Res Soc Policy. 2017;15(2):123–38.Google Scholar
  23. 23.
    Grov C, Breslow AS, Newcomb ME, Rosenberger JG, Bauermeister JA. Gay and bisexual men’s use of the Internet: research from the 1990s through 2013. J Sex Res. 2014;51(4):390–409.Google Scholar
  24. 24.
    Mustanski BS, Newcomb ME, Du Bois SN, Garcia SC, Grov C. HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions. J Sex Res. 2011;48(2–3):218–53.Google Scholar
  25. 25.
    Bauermeister JA. Sexual partner typologies among single young men who have sex with men. AIDS Behav. 2015;19(6):1116–28.Google Scholar
  26. 26.
    Janulis P, Feinstein BA, Phillips G 2nd, Newcomb ME, Birkett M, Mustanski B. Sexual partner typologies and the association between drug use and sexual risk behavior among young men who have sex with men. Arch Sex Behav. 2018;47(1):259–71.Google Scholar
  27. 27.
    Sullivan SP, Pingel ES, Stephenson R, Bauermeister JA. “It was supposed to be a onetime thing”: experiences of romantic and sexual relationship typologies among young gay, bisexual, and other men who have sex with men. Arch Sex Behav. 2018;47(4):1221–30.Google Scholar
  28. 28.
    Hergenrather KC, Emmanuel D, Durant S, Rhodes SD. Enhancing HIV prevention among young men who have sex with men: a systematic review of HIV behavioral interventions for young gay and bisexual men. AIDS Educ Prevent. 2016;28(3):252–71.Google Scholar
  29. 29.
    Shaver J, Freeland R, Goldenberg T, Stephenson R. Gay and bisexual men’s perceptions of HIV risk in various relationships. Am J Men’s Health. 2018;12(4):655–65.Google Scholar
  30. 30.
    Bauermeister JA, Carballo-Dieguez A, Ventuneac A, Dolezal C. Assessing motivations to engage in intentional condomless anal intercourse in HIV risk contexts (“Bareback Sex”) among men who have sex with men. AIDS Educ Prev. 2009;21(2):156–68.Google Scholar
  31. 31.
    Wade R, Harper GW, Bauermeister JA. Psychosocial functioning and decisional balance to use condoms in a racially/ethnically diverse sample of young gay/bisexual men who have sex with men. Arch Sex Behav. 2018;47(1):195–204.Google Scholar
  32. 32.
    Albarracin D, Johnson BT, Fishbein M, Muellerleile PA. Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. Psychol Bull. 2001;127(1):142–61.Google Scholar
  33. 33.
    Gerrard M, Gibbons FX, Houlihan AE, Stock ML, Pomery EA. A dual-process approach to health risk decision making: the prototype willingness model. Dev Rev. 2008;28(1):29–61.Google Scholar
  34. 34.
    Gamarel KE, Golub SA. Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships. Ann Behav Med. 2015;49(2):177–86.Google Scholar
  35. 35.
    Golub S, Starks TJ, Payton G, Parsons J. The critical role of intimacy in the sexual risk behaviors of gay and bisexual men. AIDS Behav. 2011;16:626–32.Google Scholar
  36. 36.
    Peplau LA, Fingerhut AW. The close relationships of Lesbians and gay men. Annu Rev Psychol. 2007;58:405–24.Google Scholar
  37. 37.
    Eisenberg A, Bauermeister J, Johns MM, Pingel E, Santana ML. Achieving safety: Safer sex, communication, and desire among young gay men. J Adolesc Res. 2011;26(5):645–69.Google Scholar
  38. 38.
    Mitchell JW, Lee JY, Woodyatt C, Bauermeister J, Sullivan P, Stephenson R. Perceived challenges and rewards of forming a sexual agreement among HIV-negative male couples. Arch Sex Behav. 2016;45(6):1525–34.Google Scholar
  39. 39.
    Goldenberg T, Finneran C, Andes KL, Stephenson R. ‘Sometimes people let love conquer them’: how love, intimacy, and trust in relationships between men who have sex with men influence perceptions of sexual risk and sexual decision-making. Cult Health Sex. 2015;17(5):607–22.Google Scholar
  40. 40.
    Bauermeister JA. Romantic ideation, partner-seeking, and HIV risk among young gay and bisexual men. Arch Sex Behav. 2012;41(2):431–40.Google Scholar
  41. 41.
    Goldenberg T, Stephenson R, Bauermeister JA. Cognitive and emotional factors associated with sexual risk-taking behaviors among young men who have sex with men. Arch Sex Behav. (in press).Google Scholar
  42. 42.
    CDC. HIV risk reduction tool: beta version. https://wwwn.cdc.gov/hivrisk/(2018). Accessed 17 Sept 2018.
  43. 43.
    Bauermeister JA, Tingler RC, Demers M, Harper GW. Development of a tailored HIV prevention intervention for single young men who have sex with men who meet partners online: protocol for the myDEx Project. JMIR Res Protoc. 2017;6(7):e141.Google Scholar
  44. 44.
    DeLone WH, McLean ER. The DeLone and McLean model of information systems success: a ten-year update. J Manage Inf Syst. 2003;19(4):9–30.Google Scholar
  45. 45.
    DeLone WH, McLean ER. Information systems success: the quest for the dependent variable. Inf Syst Res. 1992;3(1):60–95.Google Scholar
  46. 46.
    Carballo-Diéguez a, Dolezal C, Ventuneac a. Sexual Practices Assessment Schedule. New York: HIV Center for Clinical and Behavioral Studies, Columbia University & New York State Psychiatric Institute; 2002.Google Scholar
  47. 47.
    DiNenno EA, Prejean J, Irwin K, et al. Recommendations for HIV screening of gay, bisexual, and other men who have sex with men - United States, 2017. MMWR Morb Mortal Wkly Rep. 2017;66(31):830–2.Google Scholar
  48. 48.
    Fisher JD, Fisher WA, Misovich SJ, Kimble DL, Malloy TE. Changing AIDS risk behavior: effects of an intervention emphasizing AIDS risk reduction information, motivation, and behavioral skills in a college student population. Health Psychol. 1996;15(2):114–23.Google Scholar
  49. 49.
    Bauermeister JA, Carballo-Diéguez A, Ventuneac A, Dolezal C. Assessing motivations to engage in intentional condomless anal intercourse in HIV-risk contexts (“Bareback Sex”) among men who have sex with men. AIDS Educ Prevent. 2009;21(2):156.Google Scholar
  50. 50.
    Bauermeister JA, Ventuneac A, Pingel E, Parsons JT. Spectrums of love: examining the relationship between romantic motivations and sexual risk among young gay and bisexual men. AIDS Behav. 2012;16(6):1549–59.Google Scholar
  51. 51.
    Missildine W, Feldstein G, Punzalan JC, Parsons JT. S/he Loves Me, S/he Loves Me Not: questioning heterosexist assumptions of gender differences for romantic and sexually motivated behaviors. Sex Addict Compuls. 2005;12(1):65–74.Google Scholar
  52. 52.
    Kraemer HC, Mintz J, Noda A, Tinklenberg J, Yesavage JA. Caution regarding the use of pilot studies to guide power calculations for study proposals. Arch Gen Psychiatry. 2006;63(5):484–9.Google Scholar
  53. 53.
    Noar SM. Computer technology-based interventions in HIV prevention: state of the evidence and future directions for research. AIDS Care. 2011;23(5):525–33.Google Scholar
  54. 54.
    Noar SM, Mehrotra P. Toward a new methodological paradigm for testing theories of health behavior and health behavior change. Patient Educ Couns. 2011;82(3):468–74.Google Scholar
  55. 55.
    Ybarra ML, Prescott TL, Phillips GL, Bull SS, Parsons JT. Pilot RCT results of an mHealth HIV prevention program for sexual minority male adolescents. Pediatrics. 2017.  https://doi.org/10.1542/peds.2016-2999.Google Scholar
  56. 56.
    Rendina HJ, Jimenez RH, Grov C, Ventuneac A, Parsons JT. Patterns of lifetime and recent HIV testing among men who have sex with men in New York City who use Grindr. AIDS Behav. 2014;18(1):41–9.Google Scholar
  57. 57.
    Hammack PL, Meyer IH, Krueger EA, Lightfoot M, Frost DM. HIV testing and pre-exposure prophylaxis (PrEP) use, familiarity, and attitudes among gay and bisexual men in the United States: a national probability sample of three birth cohorts. PLoS ONE. 2018;13(9):e0202806.Google Scholar
  58. 58.
    Fritz MS, Mackinnon DP. Required sample size to detect the mediated effect. Psychol Sci. 2007;18(3):233–9.Google Scholar
  59. 59.
    Glasman LR, Skinner D, Bogart LM, et al. Do assessments of HIV risk behaviors change behaviors and prevention intervention efficacy? An experimental examination of the influence of type of assessment and risk perceptions. Ann Behav Med. 2015;49(3):358–70.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.University of PennsylvaniaPhiladelphiaUSA
  2. 2.University of MichiganAnn ArborUSA
  3. 3.University of PennsylvaniaPhiladelphiaUSA

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