HIV 相关合并症认知与虚拟环境对 HIV 感染男同性恋者心血管疾病预防教育的可及性：一项试点随机对照试验的形成阶段。

Perceptions of HIV-Related Comorbidities and Usability of a Virtual Environment for Cardiovascular Disease Prevention Education in Sexual Minority Men With HIV: Formative Phases of a Pilot Randomized Controlled Trial.

机构信息

School of Nursing, Yale University, Orange, CT, United States.

School of Public Health, Social and Behavioral Sciences, Yale University, New Haven, CT, United States.

出版信息

J Med Internet Res. 2024 Aug 22;26:e57351. doi: 10.2196/57351.

DOI:10.2196/57351

PMID:38924481

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11377913/

Abstract

BACKGROUND

Sexual minority men with HIV are at an increased risk of cardiovascular disease (CVD) and have been underrepresented in behavioral research and clinical trials.

OBJECTIVE

This study aims to explore perceptions of HIV-related comorbidities and assess the interest in and usability of a virtual environment for CVD prevention education in Black and Latinx sexual minority men with HIV.

METHODS

This is a 3-phase pilot behavioral randomized controlled trial. We report on formative phases 1 and 2 that informed virtual environment content and features using qualitative interviews, usability testing, and beta testing with a total of 25 individuals. In phase 1, a total of 15 participants completed interviews exploring HIV-related illnesses of concern that would be used to tailor the virtual environment. In phase 2, usability testing and beta testing were conducted with 10 participants to assess interest, features, and content.

RESULTS

In phase 1, we found that CVD risk factors included high blood pressure, myocardial infarction, stroke, and diabetes. Cancer (prostate, colon, and others) was a common concern, as were mental health conditions. In phase 2, all participants completed the 12-item usability checklist with favorable feedback within 30 to 60 minutes. Beta-testing interviews suggested (1) mixed perceptions of health and HIV, (2) high risk for comorbid conditions, (3) virtual environment features were promising, and (4) the need for diverse avatar representations.

CONCLUSIONS

We identified several comorbid conditions of concern, and findings carry significant implications for mitigating barriers to preventive health screenings, given the shared risk factors between HIV and related comorbidities. Highly rated aspects of the virtual environment were anonymity; meeting others with HIV who identify as gay or bisexual; validating lesbian, gay, bisexual, transgender, queer, and others (LGBTQ+) images and content; and accessibility to CVD prevention education. Critical end-user feedback from beta testing suggested more options for avatar customization in skin, hair, and body representation. Our next phase will test the virtual environment as a new approach to advancing cardiovascular health equity in ethnic and racial sexual minority men with HIV.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04061915; https://clinicaltrials.gov/study/NCT05242952.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/38348.

摘要

背景

HIV 阳性的性少数群体男性患心血管疾病 (CVD) 的风险增加，并且在行为研究和临床试验中代表性不足。

目的

本研究旨在探讨 HIV 相关合并症的认知，并评估对 HIV 阳性的黑人和拉丁裔性少数群体男性进行 CVD 预防教育的虚拟环境的兴趣和可用性。

方法

这是一项 3 期试点行为随机对照试验。我们报告了形成性阶段 1 和 2 的结果，这两个阶段使用定性访谈、可用性测试和对总共 25 个人的测试来确定虚拟环境的内容和功能。在第 1 阶段，共有 15 名参与者完成了访谈，探讨了将用于定制虚拟环境的 HIV 相关关注疾病。在第 2 阶段，对 10 名参与者进行了可用性测试和测试，以评估兴趣、功能和内容。

结果

在第 1 阶段，我们发现 CVD 风险因素包括高血压、心肌梗死、中风和糖尿病。癌症（前列腺、结肠和其他）是一个常见的关注点，心理健康状况也是如此。在第 2 阶段，所有参与者都在 30 到 60 分钟内完成了 12 项可用性检查表，反馈良好。测试访谈表明：(1) 对健康和 HIV 的看法存在差异，(2) 存在多种合并症的高风险，(3) 虚拟环境功能有前景，(4) 需要多样化的头像代表。

结论

我们确定了一些令人关注的合并症，鉴于 HIV 和相关合并症之间存在共同的风险因素，这些发现对减轻预防保健筛查的障碍具有重要意义。虚拟环境的高评价方面包括匿名性；与其他自称男同性恋或双性恋的 HIV 感染者会面；验证女同性恋、男同性恋、双性恋、跨性别、酷儿和其他人（LGBTQ+）的图像和内容；以及获得 CVD 预防教育的机会。来自测试的关键最终用户反馈建议在头像定制方面提供更多选项，包括皮肤、头发和身体特征。我们的下一阶段将测试虚拟环境作为一种新方法，以促进 HIV 阳性的族裔和种族性少数群体男性的心血管健康公平。