While many HIV prevention interventions have traditionally been delivered face-to-face, a study from Columbia University School of Nursing suggests that digital outreach efforts delivered via text messages, interactive games, chat rooms, and social networks may be an effective way to reach at-risk younger men. The research review, published in the Journal of Medical Internet Research, found that eHealth interventions are associated with reductions in risky sexual behaviors and increases in HIV testing among men who have sex with men.
Despite decades of outreach and education efforts that have stabilized human immunodeficiency (HIV) infection rates in the U.S., the pace of new infections amongmen who have sex with men has been steadily increasing, particularly among young adults and racial and ethnic minorities.
"This is a population that is very used to technology, and there is built-in privacy and immediacy with digital communication that may be especially appealing to men who aren’t comfortable disclosing their sexual orientation or their HIV status in a face-to-face encounter," says lead study author Rebecca Schnall, PhD, RN, an assistant professor at Columbia Nursing. "If we want to reduce HIV infection rates, particularly among younger men, we need to explore the use of technology to meet them where they live – online and on their phones."
A team of researchers led by Schnall conducted a systematic literature review to determine the effectiveness of eHealth interventions for HIV prevention among men who have sex with men. Included studies had to be focused exclusively on eHealth, limited to HIV prevention and testing rather than treatment, targeted only to adult men who have sex with men, written in English, designed as experimental or randomized controlled trials, and published between January 2000 and April.
One interactive website, Sexpulse, designed by health professionals and computer scientists to target men who seek sexual partners online, successfully reduced high-risk sexual behaviors. Another site, Keep It Up! (KIU), used video games to help reduce rates of unprotected anal sex. A third initiative, a downloadable video game, helped mitigate shame felt by some young men who have sex with men, though the reduction in risky sexual behavior wasn’t statistically significant.
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