A Randomized Controlled Trial of a Mobile Application to Improve HIV Preventive Behaviors among Youth Men Who Have Sex with Men in Thailand
DOI:
https://doi.org/10.55489/njcm.170520266222Keywords:
AIDS, Knowledge, Youth Men Who Have Sex with Men, Mobile Application, HIV prevention, Preventive BehaviorsAbstract
Background: Human Immunodeficiency Virus (HIV) remains highly prevalent among young men who have sex with men (YMSM), necessitating innovative, theory-driven prevention strategies. The objectives of this study were to evaluate the effectiveness of a Cognitive Behavioral Group Counseling (CBGC)-based mobile application in improving HIV prevention knowledge, attitudes, and behaviors among YMSM.
Methods: A randomized controlled trial was conducted among 60 YMSM aged 18-24 years, allocated equally into experimental and control groups. The intervention group received a CBGC-based mobile application over 10 weeks, followed by 14 weeks of follow-up. Outcomes were assessed using validated questionnaires measuring knowledge, attitudes, and preventive behaviors. Data were analyzed using paired and independent t-tests with a significance level of 0.05.
Results: The experimental group demonstrated significant improvements in HIV prevention knowledge, attitudes, and behaviors compared to the control group. Post-intervention scores were significantly higher in the intervention group, with notable increases in high-level knowledge, positive attitudes, and consistent preventive practices. No significant changes were observed in the control group.
Conclusion: The CBGC-based mobile intervention was effective in enhancing HIV preventive outcomes among YMSM. Digital, theory-based interventions offer a promising approach for targeted HIV prevention in high-risk youth populations.
References
World Health Organization. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021: accountability for the global health sector strategies 2016–2021: actions for impact. Geneva: World Health Organization; 2021. [Cited 2022 Mar 15] Available from: https://www.who.int/publications/i/item/9789240027077
Department of Disease Control, Ministry of Public Health. National strategy on ending the AIDS problem, 2017-2030. [Internet]. [Cited 2022 Mar 15]. Available from: https://www.prepwatch.org/wp-content/uploads/2022/07/Thailand-National-Strategy-to-End-AIDS-2017-30.pdf
Stenger MR, Baral S, Stahlman S, Wohlfeiler D, Barton JE, Peterman T. As through a glass, darkly: the future of sexually transmissible infections among gay, bisexual and other men who have sex with men. Sex Health. 2017 Feb;14(1):18-27. DOI: https://doi.org/10.1071/SH16104 PMid:27585033 PMCid:PMC5334461
Seekaew P, Pengnonyang S, Jantarapakde J, Meksena R, Sungsing T, Lujintanon S, et al. Discordance between self-perceived and actual risk of HIV infection among men who have sex with men and transgender women in Thailand: a cross-sectional assessment. J Int AIDS Soc. 2019 Dec;22(12):e25430. DOI: https://doi.org/10.1002/jia2.25430 PMid:31855324 PMCid:PMC6922021
Vibulsanti S, et al. Thailand National Guidelines on HIV/AIDS Diagnosis, Treatment and Prevention 2020/2021. Bangkok: Aksorn Graphic and Design Publishing; 2020.
DiNenno EA, Prejean J, Irwin K, Delaney KP, Bowles K, Martin T, et al. Recommendations for HIV Screening of Gay, Bisexual, and Other Men Who Have Sex with Men - United States, 2017. MMWR Morb Mortal Wkly Rep. 2017;66(31):830-832. DOI: https://doi.org/10.15585/mmwr.mm6631a3 PMid:28796758 PMCid:PMC5687782
Muessig KE, Nekkanti M, Bauermeister J, Bull S, Hightow-Weidman LB. A systematic review of recent smartphone, Internet and Web 2.0 interventions to address the HIV continuum of care. Curr HIV/AIDS Rep. 2015 Mar;12(1):173-190. DOI: https://doi.org/10.1007/s11904-014-0239-3 PMid:25626718 PMCid:PMC4370788
Anand T, Nitpolprasert C, Ananworanich J, Pakam C, Nonenoy S, Jantarapakde J, et al. Innovative strategies using communications technologies to engage gay men and other men who have sex with men into early HIV testing and treatment in Thailand. J Virus Erad. 2015 Apr 1;1(2):111-115. DOI: https://doi.org/10.1016/S2055-6640(20)30483-0 PMid:27482400 PMCid:PMC4946676
Sullivan PS, Jones J, Kishore N, Stephenson R. The roles of technology in primary HIV prevention for men who have sex with men. Curr HIV/AIDS Rep. 2015;12(4):481-488. DOI: https://doi.org/10.1007/s11904-015-0293-5 PMid:26519083
Phanuphak N, Anand T, Jantarapakde J, Nitpolprasert C, Himmad K, Sungsing T, et al. What would you choose: Online or Offline or Mixed services? Feasibility of online HIV counselling and testing among Thai men who have sex with men and transgender women and factors associated with service uptake. J Int AIDS Soc. 2018 Jul;21 Suppl 5(Suppl Suppl 5):e25118. DOI: https://doi.org/10.1002/jia2.25118 PMid:30033644 PMCid:PMC6055119
Mimiaga MJ, Pantalone DW, Biello KB, Hughto JMW, Frank J, O'Cleirigh C, et al. An initial randomized controlled trial of behavioral activation for treatment of concurrent crystal methamphetamine dependence and sexual risk for HIV acquisition among men who have sex with men. AIDS Care. 2019 Sep;31(9):1083-1095. DOI: https://doi.org/10.1080/09540121.2019.1595518 PMid:30887824 PMCid:PMC6625920
Nelson KM, Perry NS, Horvath KJ, Smith LR. A systematic review of mHealth interventions for HIV prevention and treatment among gay, bisexual, and other men who have sex with men. Transl Behav Med. 2020 Oct 12;10(5):1211-1220. DOI: https://doi.org/10.1093/tbm/ibaa007 PMid:33044531 PMCid:PMC7549406
Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Routledge; Lawrence Erlbaum Associates Publishers; 1988.
Friedman LM, Furberg CD, DeMets DL, Reboussin DM, Granger CB. Fundamentals of Clinical Trials. 5th ed. Springer; 2015. DOI: https://doi.org/10.1007/978-3-319-18539-2
Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332. DOI: https://doi.org/10.1136/bmj.c332 PMid:20332509 PMCid:PMC2844940
Giovenco D, Muessig KE, Horvitz C, Biello KB, Liu AY, Horvath KJ, Golinkoff JM, et al. Adapting technology-based HIV prevention and care interventions for youth: lessons learned across five U.S. Adolescent Trials Network studies. Mhealth. 2021 Apr 20;7:21. DOI: https://doi.org/10.21037/mhealth-20-43 PMid:33898590 PMCid:PMC8063021
Department of Disease Control, Ministry of Public Health, Thailand. Thai National AIDS Program Review 2022. Bangkok: Ministry of Public Health; 2022. Available from: https://ddc.moph.go.th/uploads/publish/1387420230220043246.pdf
Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31(2):143-164. DOI: https://doi.org/10.1177/1090198104263660 PMid:15090118
Zhao J, Freeman B, Li M. Can mobile phone apps influence people's health behavior change? An evidence review. J Med Internet Res. 2016;18(11): e287. DOI: https://doi.org/10.2196/jmir.5692 PMid:27806926 PMCid:PMC5295827
Schnall R, Travers J, Rojas M, Carballo-Diéguez A. eHealth interventions for HIV prevention in high-risk men who have sex with men: a systematic review. J Med Internet Res. 2014;16(5): e134. DOI: https://doi.org/10.2196/jmir.3393 PMid:24862459 PMCid:PMC4051738
Nguyen LH, Tran BX, Rocha LEC, Nguyen HLT, Yang C, Latkin CA, et al. A Systematic Review of eHealth Interventions Addressing HIV/STI Prevention Among Men Who Have Sex With Men. AIDS Behav. 2019 Sep;23(9):2253-2272. DOI: https://doi.org/10.1007/s10461-019-02626-1 PMid:31401741 PMCid:PMC6766471
Schnall R, Rojas M, Bakken S, Brown W, Carballo-Dieguez A, Carry M, et al. A user-centered model for designing consumer mobile health (mHealth) applications (apps). J Biomed Inform. 2016 Apr;60:243-51. DOI: https://doi.org/10.1016/j.jbi.2016.02.002 PMID: 26903153 PMCID: PMC4837063
Mustanski B, Parsons JT, Sullivan PS, Madkins K, Rosenberg E, Swann G. Biomedical and behavioral outcomes of keep it up!: an eHealth HIV prevention program RCT. Am J Prev Med. 2018;55(2):151-158. DOI: https://doi.org/10.1016/j.amepre.2018.04.026 PMid:29937115 PMCid:PMC6314292
Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, del Rio C, et al. The Comparability of Men Who Have Sex with Men Recruited from Venue-Time-Space Sampling and Facebook: A Cohort Study. JMIR Res Protoc. 2014;3(3):e37. DOI: https://doi.org/10.2196/resprot.3342 PMid:25048694 PMCid:PMC4129125
Young SD, Cumberland WG, Lee SJ, Jaganath D, Szekeres G, Coates T. Social networking technologies as an emerging tool for HIV prevention: a cluster randomized trial. Ann Intern Med. 2013 Sep 3;159(5):318-324. DOI: https://doi.org/10.7326/0003-4819-159-5-201309030-00005 PMid:24026317 PMCid:PMC3879120
LeGrand S, Muessig KE, Pike EC, Baltierra N, Hightow-Weidman LB. If you build it will they come? Addressing social isolation within a technology-based HIV intervention for young black men who have sex with men. AIDS Care. 2014; 26:1194-1200. DOI: https://doi.org/10.1080/09540121.2014.894608 PMid:24617609 PMCid:PMC406520
Ventola CL. Social media and health care professionals: benefits, risks, and best practices. Pharm Ther. 2014 Jul;39(7):491-520. PMID: 25083128; PMCID: PMC4103576.
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