An online intervention (HealthMpowerment.org) designed to mitigate sexual risk behaviors among young black men who have sex (MSM) with men has demonstrated efficacy in reducing such behaviors in the short term, according to a study recently published in AIDS and Behavior. However, those who stayed with the intervention for less than 1 year did not sustain behavioral changes.
This randomized controlled trial included 474 individuals, 66.7% of whom identified as gay and 42.0% of whom had HIV at study initiation. Of these, 194 were assigned to HealthMpowerment.org, and 210 were assigned to an information-only site as controls. Compared to the control group, self-reported anal sex without a condom was 32% lower among the intervention group at 3 months (95% CI, 0.43-0.93). This effect was not sustained at the 1-year mark. The intervention group also spent significantly more total time than controls on their respective website (102.6 [standard deviation (SD) =224.97] min vs 23.90 [SD=61.87] min, respectively).
The 3-month rate of condomless anal sex among those with detectable viral loads of HIV in the intervention group was 82% less than controls (95% CI, 0.04-0.32). A further analysis, which excluded those who had used the intervention website for less than an hour during the 3-month period, revealed approximately 4.85 (95% CI, 2.15-7.53) fewer instances of condomless anal sex than among controls.
Following enrollment, individuals were given a computer-assisted self-interviewing survey using Qualtrics software and were randomly assigned to either intervention or control. Further information was gathered using follow-up surveys. Participants were asked to disclose the number of condomless anal sex acts in the previous 3 months as well as the HIV status of any male partners with whom they had intercourse. Information on substance use, social support/isolation, and symptoms of depression was also gathered. The impact of intervention on change in condomless anal sex was estimated using a linear mixed modelling framework.
The study researchers concluded that “[their] study provides evidence for the efficacy of [HealthMpowerment.org] to reduce sexual risk behaviors among young black MSM, particularly among the subset of participants who utilized the intervention for a greater amount of time. Behavioral changes were not sustained over 12 months. These findings suggest that while [HealthMpowerment.org] can be effective for some young black MSM, a non-directed online intervention may not be enough to sustain behavior changes.”
Hightow-Weidman LB, LeGrand S, Muessig KE, et al. A randomized trial of an online risk reduction intervention for young black MSM [published online September 29, 2018]. AIDS Behav. doi: 10.1007/s10461-018-2289-9