In the Journals

myDEx online tool improves HIV prevention

Photo of José A. Bauermeister
José A. Bauermeister

Young gay, bisexual and other men who have sex with men, or YGBMSM, who used an online, interactive educational intervention were more likely to use condoms, get tested for HIV and begin pre-exposure prophylaxis compared with YGBMSM who viewed an information-only website, according to the results of a pilot trial published in AIDS and Behavior.

“Young MSM, in particular, account for more than a third of all HIV infections among MSM and more than 70% of new infections among people aged 13 to 24 years,” José A. Bauermeister, PhD, MPH, presidential professor of nursing and director of the program on sexuality, technology and action research at the University of Pennsylvania School of Nursing, told Infectious Diseases in Children. “Young gay, bisexual and other men who have sex with men do not receive comprehensive sex education in schools regarding their same-sex attractions. Compared to face-to-face workshops, the mHealth approach allows us to provide interactive, personalized and appealing content to young men regardless of their geographic location and their ability or comfort to attend in-person events.”

Bauermeister and colleagues designed the My Desires & Expectations (myDEx) tool to address cognitive and emotional factors that influence YGBMSM sexual decision-making when seeking partners online. myDEx was tested in a randomized trial with 180 YGBMSM participants, who were randomly assigned in a 2:1 ratio to receive the intervention or an information-only site that mirrored the CDC’s HIV Risk Reduction Tool (control). A follow-up assessment was completed by participants at 30, 60 and 90 days after randomization.

Online intervention for HIV prevention 
The My Desires & Expectations (myDEx) tool addresses cognitive and emotional factors that influence YGBMSM sexual decision-making when seeking partners online.
Source: José Bauermeister, PhD, MPH/Penn Nursing

Most participants (86.5%) had been previously tested for HIV, but only 45.8% were tested within the past 3 months as recommended by the CDC. STDs were common among the participants, with 17.4% reporting ever having one diagnosed. Although most YGBMSM (94.8%) had heard of pre-exposure prophylaxis (PrEP), only 27 participants (17.4%) had ever taken it.

Participants reported higher satisfaction with myDEx and were more likely to recommend it to a friend compared with those in the control arm. More participants using myDEx also suggested that the intervention led them to having a healthier lifestyle.

myDEx users were less likely to have condomless receptive anal sex (26.7% vs. 45.7%; P = .04) and condomless insertive anal sex (33.3% vs. 42.9%; P =.27) compared with controls. The researchers observed a trend that those using the intervention were more likely to report condom use with a serounknown or serodiscordant partner who was not known to be on PrEP or virally suppressed.

In addition, more participants were more likely to start PrEP in the myDEx group than in the control group (8.9% vs. 3.7%), although this finding was not statistically significant.

“The pilot trial suggests that we were successful in creating an appealing and persuasive intervention for MSM,” Bauermeister said. “We are currently exploring funding opportunities to transform our study intervention into a large-scale program that may be delivered as a stand-alone app, rather than a clinical trial, and downloaded for use through the Apple and Android stores.” – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.

Photo of José A. Bauermeister
José A. Bauermeister

Young gay, bisexual and other men who have sex with men, or YGBMSM, who used an online, interactive educational intervention were more likely to use condoms, get tested for HIV and begin pre-exposure prophylaxis compared with YGBMSM who viewed an information-only website, according to the results of a pilot trial published in AIDS and Behavior.

“Young MSM, in particular, account for more than a third of all HIV infections among MSM and more than 70% of new infections among people aged 13 to 24 years,” José A. Bauermeister, PhD, MPH, presidential professor of nursing and director of the program on sexuality, technology and action research at the University of Pennsylvania School of Nursing, told Infectious Diseases in Children. “Young gay, bisexual and other men who have sex with men do not receive comprehensive sex education in schools regarding their same-sex attractions. Compared to face-to-face workshops, the mHealth approach allows us to provide interactive, personalized and appealing content to young men regardless of their geographic location and their ability or comfort to attend in-person events.”

Bauermeister and colleagues designed the My Desires & Expectations (myDEx) tool to address cognitive and emotional factors that influence YGBMSM sexual decision-making when seeking partners online. myDEx was tested in a randomized trial with 180 YGBMSM participants, who were randomly assigned in a 2:1 ratio to receive the intervention or an information-only site that mirrored the CDC’s HIV Risk Reduction Tool (control). A follow-up assessment was completed by participants at 30, 60 and 90 days after randomization.

Online intervention for HIV prevention 
The My Desires & Expectations (myDEx) tool addresses cognitive and emotional factors that influence YGBMSM sexual decision-making when seeking partners online.
Source: José Bauermeister, PhD, MPH/Penn Nursing

Most participants (86.5%) had been previously tested for HIV, but only 45.8% were tested within the past 3 months as recommended by the CDC. STDs were common among the participants, with 17.4% reporting ever having one diagnosed. Although most YGBMSM (94.8%) had heard of pre-exposure prophylaxis (PrEP), only 27 participants (17.4%) had ever taken it.

Participants reported higher satisfaction with myDEx and were more likely to recommend it to a friend compared with those in the control arm. More participants using myDEx also suggested that the intervention led them to having a healthier lifestyle.

myDEx users were less likely to have condomless receptive anal sex (26.7% vs. 45.7%; P = .04) and condomless insertive anal sex (33.3% vs. 42.9%; P =.27) compared with controls. The researchers observed a trend that those using the intervention were more likely to report condom use with a serounknown or serodiscordant partner who was not known to be on PrEP or virally suppressed.

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In addition, more participants were more likely to start PrEP in the myDEx group than in the control group (8.9% vs. 3.7%), although this finding was not statistically significant.

“The pilot trial suggests that we were successful in creating an appealing and persuasive intervention for MSM,” Bauermeister said. “We are currently exploring funding opportunities to transform our study intervention into a large-scale program that may be delivered as a stand-alone app, rather than a clinical trial, and downloaded for use through the Apple and Android stores.” – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.