Web-based Programs Encourage Safer Sex Behaviors among Men at Risk for HIV/AIDS
A single-session, online, multimedia intervention effectively reduced risky sexual behaviors among young men who have sex with men, a group at high risk for HIV/AIDS and other sexually transmitted infections. Such low-cost programs may help reverse the steady rise in HIV diagnoses among this population. The study was published online ahead of print on June 5, 2009, in the journal, AIDS and Behavior.
Based on the Information-Motivational-Behavioral Skills (IMB) model for reducing HIV risk,
Kelly M. Carpenter, Ph.D., of Talaria, Inc., and colleagues developed a multimedia, online intervention that aimed to:
- Increase knowledge of risk factors
- Provide skills training for safer sex behaviors
- Increase motivation for behavior change.
The researchers recruited 112 men who have sex with men, ages 18–39. Participants were HIV negative or did not know their status and had engaged in unprotected sex within the preceding three months. All participants completed a 25-minute baseline assessment and then were randomly assigned to the experimental intervention or a control group program. Both the intervention and control program required 1.5–2 hours to complete, though participants had up to a week to finish. Participants were asked to return to the study Web site three months later to complete a 20-minute follow-up questionnaire.
The intervention presented a variety of interactive exercises, multimedia clips, quizzes, and other materials that provided information about safer sex practices and tested participants’ knowledge of HIV risk factors. Those in the control group completed an online stress reduction program that described the effects of stress on the body and health reasons for reducing stress, in addition to leading participants in relaxation exercises, such as deep breathing and guided imagery. The control program did not include any sexual risk reduction information.
Results of the Study
Participants in both groups reported fewer risky behaviors compared with their baseline assessments. Those who received the intervention reported fewer instances of unprotected sex with partners who were HIV+ or of unknown status.
However, the researchers noted that few minorities participated in the study, a group that may be at highest risk for HIV infection and most in need of preventive interventions. Also, since the entire study was conducted online, the effects of only partially completing the intervention or completing only the baseline assessment are unknown.
The findings show that Internet-based interventions can affect HIV risk behavior. According to the researchers, delivering such programs online may eventually make it possible to provide effective interventions to underserved populations, such as rural or minority communities, at a lower cost than in-person interventions. Internet-based delivery also allows high-risk individuals to access the intervention privately, at their convenience, and possibly at important “teaching opportunities,” such as when they are actively seeking new partners online. Another possible advantage over face-to-face intervention programs is the individual’s ability to leave an online intervention and return when he feels more motivated, suggested the researchers.
Regarding the sexual risk reduction seen in the control group, the researchers suggested that just completing the baseline assessment may have drawn participants’ attention to their own unsafe behaviors and provided enough motivation for them to change.
More research is needed to determine the best length for online interventions. Longer, more detailed interventions may have greater effects on behavior, but more people may are likely to start and finish shorter ones. Future studies should also focus on enrolling more minority participants, include measures of safer sex skills other than condom use, (for example, talking to one’s partner(s) about HIV status), and gather more information on the effectiveness of individual intervention components.
Carpenter KM, Stoner SA, Mikko AN, Dhanak LP, Parsons JT. Efficacy of a Web-Based Intervention to Reduce Sexual Risk in Men Who Have Sex with Men. AIDS Behav. 2009 Jun 5. [Epub ahead of print]
PubMed PMID: 19499321