Lancet HIV. 2015 Jan;2(1):e27-32. doi: 10.1016/S2352-3018(14)00006-X.
BACKGROUND: Social media technologies offer new approaches to HIV prevention and promotion of testing. We examined the efficacy of the Harnessing Online Peer Education (HOPE) social media intervention to increase HIV testing among men who have sex with men (MSM) in Peru. METHODS: In this cluster randomised controlled trial, Peruvian MSM from Greater Lima (including Callao) who had sex with a man in the past 12 months, were 18 years of age or older, were HIV negative or serostatus unknown, and had a Facebook account or were willing to create one (N=556) were randomly assigned (1:1) by concealed allocation to join intervention or control groups on Facebook for 12 weeks. For the intervention, Peruvian MSM were trained and assigned to be HIV prevention mentors (peer-leaders) to participants in Facebook groups. The interventions period lasted 12 weeks. Participants in control groups received an enhanced standard of care, including standard offline HIV prevention available in Peru and participation in Facebook groups (without peer leaders) that provided study updates and HIV testing information. After accepting a request to join the groups, continued participation was voluntary. Participants also completed questionnaires on HIV risk behaviours and social media use at baseline and 12 week follow-up. The primary outcome was the number of participants who received a free HIV test at a local community clinic. The facebook groups were analysed as clusters to account for intracluster correlations. This trial is registered with ClinicalTrials.gov, number NCT01701206. FINDINGS: Of 49 peer-leaders recruited, 34 completed training and were assigned at random to the intervention Facebook groups. Between March 19, 2012, and June 11, 2012, and Sept 26, 2012, and Dec 19, 2012, 556 participants were randomly assigned to intervention groups (N=278) or control groups (N=278); we analyse data for 252 and 246. 43 participants (17%) in the intervention group and 16 (7%) in the control groups got tested for HIV (adjusted odds ratio 2·61, 95% CI 1·55–4·38). No adverse events were reported. INTERPRETATION: Development of peer-mentored social media communities seemed to be an efficacious method to increase HIV testing among high-risk populations in Peru. Results suggest that the HOPE social media intervention could improve HIV testing rates among MSM in Peru. FUNDING: National Institute of Mental Health.
背景:社交媒体技术为 HIV 预防和检测推广提供了新途径。我们研究了利用在线同伴教育(HOPE)社交媒体干预措施,以增加秘鲁男男性行为者(MSM)的 HIV 检测率。
方法:在这项整群随机对照试验中,来自秘鲁利马大都市区(包括卡亚俄)的过去 12 个月内与男性发生过性行为、年龄在 18 岁或以上、HIV 阴性或血清学状态未知、拥有 Facebook 账户或愿意创建一个账户(N=556)的 MSM 被随机(1:1)分配到干预组或对照组的 Facebook 上,参加为期 12 周的试验。对于干预组,秘鲁 MSM 接受培训并被分配为 Facebook 群组中的 HIV 预防导师(同伴领袖)。干预期持续 12 周。对照组参与者接受强化标准护理,包括秘鲁现有的标准线下 HIV 预防措施,并参加提供研究更新和 HIV 检测信息的 Facebook 群组(没有同伴领袖)。接受加入群组的请求后,继续参与是自愿的。参与者还在基线和 12 周随访时完成了关于 HIV 风险行为和社交媒体使用的问卷。主要结局是在当地社区诊所接受免费 HIV 检测的参与者人数。对 Facebook 群组进行了分析,以考虑到组内相关性。该试验在 ClinicalTrials.gov 注册,编号为 NCT01701206。
结果:招募的 49 名同伴领袖中,有 34 人完成了培训,并被随机分配到干预 Facebook 群组。2012 年 3 月 19 日至 6 月 11 日和 9 月 26 日至 12 月 19 日期间,556 名参与者被随机分配到干预组(N=278)或对照组(N=278);我们分析了 252 名和 246 名参与者的数据。干预组中有 43 名参与者(17%)和对照组中有 16 名参与者(7%)接受了 HIV 检测(调整后的优势比 2.61,95%CI 1.55-4.38)。没有报告不良事件。
解释:开发同伴指导的社交媒体社区似乎是一种有效的方法,可以增加秘鲁高危人群的 HIV 检测率。结果表明,HOPE 社交媒体干预措施可以提高秘鲁 MSM 的 HIV 检测率。
资助:美国国立精神卫生研究所。
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