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Online interactive program leads to lower STD rates among young MSM

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July 10, 2018

Photo of Brian Mustanski
Brian Mustanski

An online intervention program for young HIV-negative men who have sex with men resulted in significantly lower STD incidences and a decrease in high-risk behavior, according to study results published in the American Journal of Preventive Medicine.

“The CDC estimates that without an intervention, half of young black gay men and a quarter of Latino gay men will get HIV at some point in their lives,” Brian Mustanski, PhD, director of the Institute of Sexual and Minority Health and Wellbeing at Northwestern University Feinberg School of Medicine, said in a news release.

Men who have sex with men (MSM) aged 18 to 29 years have the highest rate of HIV infection in the United States, according to the release.

For their study, Mustanski and colleagues enrolled 901 HIV-negative MSM aged 18 to 29 years who reported condomless anal sex. The men were recruited from Atlanta, Chicago and New York through advertising and HIV testing sites between May 2013 and March 2017. The participants completed surveys and were tested for STDs.

They were randomly assigned to the online Keep it Up! Program (KIU!) intervention (n = 445) or to a control cohort (n = 456), which was based on existing online HIV information. The majority of participants (63%) were ethnic/racial minorities.

Eleven percent of the control cohort and 19% of the KIU! Cohort reported any STD at baseline, with rectal STDs significantly higher in the KIU group.

Gonorrhea or chlamydia at 12-month follow-up and reports of condomless anal sex at 3-, 6- and 12-month follow-ups were primary outcomes.

The KIU! intervention involved various types of content, including videos, interactive animation and games. According to the news release, instead of a typical HIV prevention approach, which provides facts about how HIV is transmitted and how to use a condom, KIU! focuses on the lives of young gay men and weaves HIV prevention information into their typical experiences.

Online program modules targeted a particular setting relevant to the men, including dating. One was about going to a bar and using drugs and alcohol, which taught participants about the benefits of avoiding substance use and reducing the risk for acquiring STDs when using substances, including carrying condoms so they do not need to acquire them while intoxicated, according to the news release.

The intervention also included interactive games and a soap opera-style video that followed a group of young MSM and highlighted risks for infection and the importance of testing and prevention methods.

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STI incidence at 12 months was 40% lower among MSM who participated in the intervention program (RR = 0.60; 95% CI, 0.38-0.95). Approximately 44% of control participants and 37% of participants in the intervention program reporting condomless anal sex at 12 months (prevalence ratio = 0.83; 95% CI, 0.70-0.99).

“Only two of 59 current HIV-related evidence-based interventions target young MSM, and there is an urgent need to bring prevention services for this high-risk population to scale,” the researchers concluded. “The fact that KIU! significantly reduced self-reported and biological outcomes among young MSM with a brief, efficient eHealth intervention suggests that KIU! is ideally suited for scale-up implementation research on how the KIU! intervention might be more effectively implemented, kept current, and integrated with new prevention options, such as PrEP.” – by Bruce Thiel

Disclosures: Mustanski reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.