School of Public Health, Oregon Health & Science University - Portland State University, Portland, OR, United States.
Division of Prevention Science, University of California, San Francisco, San Francisco, CA, United States.
J Med Internet Res. 2024 Feb 28;26:e44861. doi: 10.2196/44861.
While rates of HIV and sexually transmitted infections (STIs) are extremely high among adolescents and young adults in the United States, rates of HIV and STI testing remain low. Given the ubiquity of mobile phones and the saliency of peers for youths, text messaging strategies may successfully promote HIV or STI testing among youths.
This study aimed to understand the types of messages youths believe were motivating and persuasive when asked to text friends to encourage them to seek HIV or STI testing services at a neighborhood clinic.
We implemented an adolescent peer-based text messaging intervention to encourage clinic attendance and increase STI and HIV testing among youths (n=100) at an adolescent clinic in San Francisco, California. Participants were asked to send a text message to 5 friends they believed were sexually active to encourage their friends to visit the clinic and receive STI or HIV screening. Thematic analysis was used to analyze the content of the text messages sent and received during the clinic visit. Member checking and consensus coding were used to ensure interrater reliability and significance of themes.
We identified four themes in the messages sent by participants: (1) calls to action to encourage peers to get tested, (2) personalized messages with sender-specific information, (3) clinic information such as location and hours, and (4) self-disclosure of personal clinic experience. We found that nearly all text messages included some combination of 2 or more of these broad themes. We also found that youths were inclined to send messages they created themselves, as opposed to sending the same message to each peer, which they tailored to each individual to whom they were sent. Many (40/100, 40%) received an immediate response to their message, and most participants reported receiving at least 1 positive response, while a few reported that they had received at least 1 negative response. There were some differences in responses depending on the type of message sent.
Given the high rates of STI and HIV and low rates of testing among adolescents, peer-driven text messaging interventions to encourage accessing care may be successful at reaching this population. This study suggests that youths are willing to text message their friends, and there are clear types of messages they develop and use. Future research should use these methods with a large, more diverse sample of youths and young adults for long-term evaluation of care seeking and care retention outcomes to make progress in reducing HIV and STI among adolescents and young adults.
尽管美国青少年和年轻人中的艾滋病毒和性传播感染（STI）发病率极高，但艾滋病毒和 STI 检测率仍然很低。鉴于手机的普及和年轻人对年轻人的重要性，短信策略可能会成功地促进年轻人进行艾滋病毒或 STI 检测。
本研究旨在了解青少年认为哪些类型的信息具有激励性和说服力，当被要求向朋友发送短信以鼓励他们到邻里诊所寻求艾滋病毒或 STI 检测服务时。
我们在加利福尼亚州旧金山的一家青少年诊所实施了一项基于青少年同伴的短信干预措施，以鼓励就诊并增加青少年的性传播感染和艾滋病毒检测（n=100）。参与者被要求向他们认为有性行为的 5 个朋友发送一条短信，以鼓励他们的朋友去诊所接受性传播感染或艾滋病毒筛查。使用主题分析来分析在诊所就诊期间发送和接收的短信的内容。成员检查和共识编码用于确保评分者之间的可靠性和主题的显著性。
我们在参与者发送的信息中确定了四个主题：（1）鼓励同伴接受检测的行动呼吁，（2）带有发送者特定信息的个性化信息，（3）诊所信息，如位置和时间，以及（4）自我披露个人诊所经验。我们发现，几乎所有的短信都包含了这四个主题中的两个或更多。我们还发现，青少年倾向于发送自己创建的信息，而不是向每个同伴发送相同的信息，而是根据他们发送的对象进行个性化。许多（40/100，40%）收到了对他们的信息的即时回复，大多数参与者报告收到了至少 1 条积极回复，而少数参与者报告收到了至少 1 条消极回复。回复的方式因发送的信息类型而异。
鉴于青少年的性传播感染和艾滋病毒发病率高，而检测率低，鼓励获得护理的基于同伴的短信干预措施可能会成功地接触到这一人群。本研究表明，青少年愿意向朋友发送短信，并且他们有明确的信息类型可供开发和使用。未来的研究应该在更大、更多样化的青少年和年轻人样本中使用这些方法进行长期评估，以了解护理寻求和护理保留的结果，从而在减少青少年和年轻人中的艾滋病毒和性传播感染方面取得进展。
