McGovern Medical School and University of Texas Health Science Center at Houston, Department of Emergency Medicine, Houston, Texas.
The University of Chicago Pritzker College of Medicine, Department of Emergency Medicine, Chicago, Illinois.
West J Emerg Med. 2022 Feb 28;23(2):211-221. doi: 10.5811/westjem.2021.12.54012.
Cisgender Black women comprise 67% of new human immunodeficiency virus (HIV) diagnoses among women in the South and are 11 times more likely to become HIV positive than White women in Texas. Optimal progress toward ending the HIV epidemic requires strategies that will interrupt transmission pathways in hotspot locations like Harris County, TX. Researchers are calling for public health interventions that can prevent HIV and sexually transmitted infections (STI) transmission; thus, we launched the first video log (vlog)-based, pilot HIV prevention intervention.
In a prospective. randomized controlled trial of two educational intervention strategies delivered as vlogs eligible participants were randomized to either 1) an interactive gaming, education-based strategy, or 2) a storytelling, education-based strategy. Eligible participants were cisgender Black women being seen in the emergency department (ED) for a non-emergent condition who reported recent condomless heterosexual sex, were ages 18-45, and had social media access. Enrolled women completed a screening assessment, informed consent, randomization, and 10-item pre-and-post assessments with true/false statements before and after viewing a brief vlog on a tablet device to identify changes in knowledge before and after being educated on HIV/STI transmission.
Twenty-six women were randomized to the Taboo group, an interactive gaming, education-based strategy, (14 [53.8%]), or to storytelling, an education-based strategy using non-fictional and fictional case scenarios (12 [46.2%]). Taboo participants self-identified as African-American (12 [85.7%]), Black (1 [7.1%]) or "other" (1 [7.1%]), were younger (28.6% were ≥ 30 years), single (57.1%), reported a previous STI (8 [57.1%]), and were likely employed (57.2%). Storytelling participants self-identified as African-American (7 [58.3%]) or Black (5 [41.7%]), were older (49.9% were ≥ 30 years), in a relationship but not married (50%), and half were unemployed. Highest level of education and monthly income varied. The storytelling strategy increased knowledge in two areas and the Taboo strategy increased knowledge in one. No intervention effect was identified in three areas, and a significant decrease in knowledge (P < .0001) was discerned in eight areas for Taboo and six areas for storytelling.
Further research is necessary to confirm whether delivery of HIV prevention interventions with vlogs is a useful approach for HIV-vulnerable populations. Findings suggest that vlogs are a feasible approach to brief behavioral interventions during an ED visit.
在南方，顺性别黑人女性占新诊断出的女性 HIV 病例的 67%，在德克萨斯州，她们感染 HIV 的可能性比白人女性高 11 倍。为了实现终结艾滋病流行的最佳进展，需要采取策略来阻断热点地区（如德克萨斯州哈里斯县）的传播途径。研究人员呼吁采取公共卫生干预措施，预防 HIV 和性传播感染（STI）的传播；因此，我们推出了第一个基于视频博客（vlog）的试点 HIV 预防干预措施。
在一项针对两种教育干预策略的前瞻性、随机对照试验中，符合条件的参与者被随机分配到以下两种策略之一：1）基于互动游戏的教育策略，或 2）基于讲故事的教育策略。符合条件的参与者是在急诊室（ED）因非紧急情况就诊的顺性别黑人女性，她们报告最近有过无保护措施的异性性行为，年龄在 18-45 岁之间，并且可以使用社交媒体。登记的女性在平板电脑上观看一段简短的 vlog 之前和之后完成一项筛选评估、知情同意、随机分组和 10 项预-后评估，这些评估采用真假陈述来确定在接受 HIV/STI 传播教育前后知识的变化。
26 名女性被随机分配到 Taboo 组，这是一种基于互动游戏的教育策略（14 名[53.8%]），或讲故事组，这是一种使用非虚构和虚构案例场景的教育策略（12 名[46.2%]）。Taboo 组参与者自我认同为非裔美国人（12 名[85.7%]）、黑人（1 名[7.1%]）或“其他”（1 名[7.1%]），年龄较小（≥ 30 岁的占 28.6%），单身（57.1%），报告有以前的性传播感染史（8 名[57.1%]），并且可能有工作（57.2%）。讲故事组的参与者自我认同为非裔美国人（7 名[58.3%]）或黑人（5 名[41.7%]），年龄较大（≥ 30 岁的占 49.9%），处于恋爱关系但未婚（50%），并且一半人没有工作。最高教育程度和月收入各不相同。讲故事的策略增加了两个领域的知识，而 Taboo 策略增加了一个领域的知识。在三个领域没有发现干预效果，在 Taboo 组的八个领域和讲故事组的六个领域中，知识有显著下降（P<.0001）。
需要进一步研究来确认使用 vlog 提供 HIV 预防干预措施是否对易感染 HIV 的人群有效。研究结果表明，vlog 是 ED 就诊期间进行简短行为干预的一种可行方法。
