Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, United States.
Michigan Innovations in Addiction Care through Research and Education Program, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.
JMIR Res Protoc. 2024 Aug 29;13:e64433. doi: 10.2196/64433.
BACKGROUND: Gay, bisexual, and other men who have sex with men living with HIV (GBMSM-LWH) in the United States bear a heavy burden of bacterial sexually transmitted infections (STIs). Timely diagnosis and treatment are key to prevention. Only a few studies have combined home specimen self-collection for bacterial STI screening with live audio and video (AV) conferencing. None have focused on GBMSM-LWH or incorporated motivational interviewing (MI), a client-centered, strengths-based counseling approach that seeks to support individuals to create positive behavioral change. OBJECTIVE: Our study seeks to investigate the feasibility and acceptability of an MI-based telehealth intervention that integrates home specimen self-collection from different anatomical sites of possible exposure and MI delivered via live AV conferencing to engage sexually active GBMSM-LWH in bacterial STI screening. METHODS: Participants are being recruited from across the United States via advertising on mobile dating apps and social networking sites and via peer referral. Phase 1 involves piloting the delivery of an innovative telehealth intervention for bacterial STI screening to 75 GBMSM-LWH. Our intervention includes three components: (1) a pretest live AV conferencing session involving an MI-guided discussion to elicit awareness of bacterial STIs; fill any knowledge gaps; bolster the perceived importance of regularly testing for gonorrhea, chlamydia, and syphilis; and build self-efficacy for specimen self-collection; (2) home self-collection and return via mail of a urine sample (for gonorrhea and chlamydia testing), a throat swab (for gonorrhea and chlamydia testing), a rectal swab (for gonorrhea and chlamydia testing), and a finger-stick blood sample (for syphilis testing); and (3) a posttest live AV conferencing session involving an MI-guided discussion to prepare participants for receiving test results and formulate personalized action plans for seeking treatment (if warranted) and repeat testing. Descriptive statistics and progression ratios will be calculated, and potential variations in our intervention's feasibility and acceptability will be numerically summarized and graphically visualized. Phase 2 involves elucidating attitudes, facilitators, and barriers related to engaging in each intervention component via semistructured in-depth interviews with a purposive subsample of 20 participants who complete progressively smaller subsets of the pretest session, specimen return for bacterial STI testing, and the posttest session. Thematic analysis will be used to identify, analyze, and report patterns in the data. Quantitative and qualitative data will be integrated at the design, methods, interpretation, and reporting levels. RESULTS: Study procedures were approved by the Institutional Review Board at the University of Michigan in September 2023. Participant recruitment began in April 2024. CONCLUSIONS: Our study will advance multiple goals of the STI National Strategic Plan for the United States for 2021 to 2025, specifically those pertaining to preventing new STIs; accelerating progress in STI research, technology, and innovation; and reducing STI-related health disparities. TRIAL REGISTRATION: ClinicalTrials.gov NCT06100250; https://www.clinicaltrials.gov/study/NCT06100250. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/64433.
背景:美国的男同性恋者、双性恋者和其他与男性发生性关系的男性(GBMSM-LWH)艾滋病毒感染者面临着细菌性性传播感染(STI)的沉重负担。及时诊断和治疗是预防的关键。只有少数研究将细菌性 STI 筛查的家庭标本自我采集与实时音频和视频(AV)会议相结合。没有一项研究专注于 GBMSM-LWH 或结合动机访谈(MI),MI 是一种以客户为中心、基于优势的咨询方法,旨在支持个人创造积极的行为改变。 目的:我们的研究旨在调查一种基于 MI 的远程医疗干预措施的可行性和可接受性,该措施将不同解剖部位的家庭标本自我采集与通过实时 AV 会议提供的 MI 相结合,以促使活跃的 GBMSM-LWH 进行细菌性 STI 筛查。 方法:参与者正在通过移动约会应用程序和社交网络网站上的广告以及通过同伴推荐从美国各地招募。第 1 阶段涉及向 75 名 GBMSM-LWH 试点提供用于细菌性 STI 筛查的创新远程医疗干预措施。我们的干预措施包括三个部分:(1)预测试实时 AV 会议,涉及 MI 引导的讨论,以引起对细菌性 STIs 的认识;填补任何知识空白;增强定期检测淋病、衣原体和梅毒的重要性;并建立自我效能进行标本自我采集;(2)家庭自我采集和通过邮件返回尿液样本(用于淋病和衣原体检测)、喉咙拭子(用于淋病和衣原体检测)、直肠拭子(用于淋病和衣原体检测)和指尖血样(用于梅毒检测);(3)后测试实时 AV 会议,涉及 MI 引导的讨论,为参与者准备接收测试结果并制定个性化的行动计划,以寻求治疗(如果需要)和重复测试。将计算描述性统计数据和进展比,并数值总结和图形可视化干预措施的可行性和可接受性的潜在变化。第 2 阶段涉及通过对完成预测试会议、细菌 STI 检测标本返回和后测试会议的预测试会议、标本返回进行细菌 STI 检测和后测试会议的逐步较小子集的 20 名参与者的半结构式深入访谈,阐明与参与每个干预组件相关的态度、促进因素和障碍。将使用主题分析来识别、分析和报告数据中的模式。将在设计、方法、解释和报告层面整合定量和定性数据。 结果:该研究程序于 2023 年 9 月获得密歇根大学机构审查委员会的批准。参与者招募于 2024 年 4 月开始。 结论:我们的研究将推进美国 2021-2025 年性传播感染国家战略计划的多个目标,特别是那些与预防新的性传播感染、加速性传播感染研究、技术和创新以及减少性传播感染相关健康差距有关的目标。 试验注册:ClinicalTrials.gov NCT06100250;https://www.clinicaltrials.gov/study/NCT06100250。 国际注册报告标识符(IRRID):DERR1-10.2196/64433。
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