Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States.
JMIR Public Health Surveill. 2022 Jun 27;8(6):e33867. doi: 10.2196/33867.
BACKGROUND: Digital HIV interventions (DHI) have been efficacious in reducing sexual risk behaviors among sexual minority populations, yet challenges in promoting and sustaining users' engagement in DHI persist. Understanding the correlates of DHI engagement and their impact on HIV-related outcomes remains a priority. This study used data from a DHI (myDEx) designed to promote HIV prevention behaviors among single young men who have sex with men (YMSM; ages 18-24 years) seeking partners online. OBJECTIVE: The goal of this study is to conduct a secondary analysis of the myDex project data to examine whether YMSM's online behaviors (eg, online partner-seeking behaviors and motivations) are linked to participants' engagement (ie, the number of log-ins and the number of sessions viewed). METHODS: We recruited 180 YMSM who were randomized into either myDEx arm or attention-control arm using a stratified 2:1 block randomization. In the myDEx arm, we had 120 YMSM who had access to the 6-session intervention content over a 3-month period. We used Poisson regressions to assess the association between YMSM's baseline characteristics on their DHI engagement. We then examined the association between the participants' engagement and their self-reported changes in HIV-related outcomes at the 3-month follow-up. RESULTS: The mean number of log-ins was 5.44 (range 2-14), and the number of sessions viewed was 6.93 (range 0-22) across the 3-month trial period. In multivariable models, the number of log-ins was positively associated with high education attainment (estimated Poisson regression coefficient [β]=.22; P=.045). The number of sessions viewed was associated with several baseline characteristics, including the greater number of sessions viewed among non-Hispanic YMSM (β=.27; P=.002), higher education attainment (β=.22; P=.003), higher perceived usefulness of online dating for hookups (β=.13; P=.002) and perceived loneliness (β=.06; P=.004), as well as lower experienced online discrimination (β=-.01; P=.007) and limerence (β=-.02; P=.004). The number of sessions viewed was negatively associated with changes in internalized homophobia (β=-.06; P<.001) and with changes in perceived usefulness of online dating for hookups (β=-.20; P<.001). There were no significant associations between the number of log-ins and changes in the participants' behaviors at the 90-day follow-up. CONCLUSIONS: DHI engagement is linked to participants' sociodemographic and online behaviors. Given the importance of intervention engagement in the intervention's effectiveness, DHIs with personalized intervention components that consider the individuals' differences could increase the overall engagement and efficacy of DHIs. TRIAL REGISTRATION: ClinicalTrials.gov NCT02842060; https://clinicaltrials.gov/ct2/show/NCT02842060.
背景:数字 HIV 干预(DHI)在减少性少数群体的性风险行为方面已被证明是有效的,但在促进和维持用户参与 DHI 方面仍存在挑战。了解 DHI 参与的相关因素及其对 HIV 相关结果的影响仍然是当务之急。本研究使用了一项旨在促进单身男男性行为者(YMSM;年龄 18-24 岁)在线寻找伴侣时进行 HIV 预防行为的 DHI(myDEx)的数据进行二次分析。
目的:本研究的目的是对 myDEx 项目数据进行二次分析,以检验 YMSM 的在线行为(例如,在线寻找伴侣的行为和动机)是否与参与者的参与度(即登录次数和观看会话次数)相关。
方法:我们招募了 180 名 YMSM,他们使用分层 2:1 块随机化方法被随机分配到 myDEx 组或对照注意力组。在 myDEx 组中,我们有 120 名 YMSM 在 3 个月的时间内可以访问 6 节干预内容。我们使用泊松回归来评估 YMSM 基线特征与 DHI 参与度之间的关联。然后,我们检查了参与者的参与度与他们在 3 个月随访时自我报告的 HIV 相关结果变化之间的关联。
结果:在 3 个月的试验期间,平均登录次数为 5.44(范围 2-14),观看的会话次数为 6.93(范围 0-22)。在多变量模型中,登录次数与高教育程度呈正相关(估计泊松回归系数[β]=.22;P=.045)。观看的会话次数与一些基线特征相关,包括非西班牙裔 YMSM 观看的会话次数较多(β=.27;P=.002)、较高的教育程度(β=.22;P=.003)、更高的在线约会寻找性伴侣的感知有用性(β=.13;P=.002)和感知孤独感(β=.06;P=.004),以及较低的在线歧视经历(β=-.01;P=.007)和迷恋(β=-.02;P=.004)。观看的会话次数与内化的恐同症变化呈负相关(β=-.06;P<.001),与在线约会寻找性伴侣的感知有用性变化呈负相关(β=-.20;P<.001)。在 90 天随访时,登录次数与参与者行为的变化之间没有显著关联。
结论:DHI 参与度与参与者的社会人口统计学和在线行为相关。鉴于干预参与度对干预效果的重要性,具有个性化干预组件的 DHIs 考虑到个体差异,可能会提高 DHI 的整体参与度和效果。
试验注册:ClinicalTrials.gov NCT02842060;https://clinicaltrials.gov/ct2/show/NCT02842060。
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