Increasing Engagement and Improving HIV Outcomes Via HealthMPowerment
Condition: HIV Infections; Sexually Transmitted Diseases; Stigma, Social
MeSH terms: Sexually Transmitted Diseases
Study type: Interventional

Summary: 
      The overall goal of this 3-arm randomized trial is to test whether a network-driven online
      intervention tailored for intersectional stigma amelioration can elicit online social
      support, promote intervention engagement, and mitigate the impact of multiple stigmas on
      HIV-related outcomes among young Black and/or Latino men who have sex with men and
      transgender women.
    

Detailed description: 
      Multiple stigmas related to sexuality, race, and HIV infection negatively impact HIV testing,
      engagement in HIV care, and consistent viral suppression (VS) among young Black or Latino men
      who have sex with men and transgender women (YBLMT). At present, few interventions have
      addressed the effects of intersectional stigma among people living with HIV and HIV affected
      populations. This study tests whether an online intervention tailored for intersectional
      stigma amelioration can elicit online social support, promote intervention engagement, and
      mitigate the impact of multiple stigmas on HIV-related outcomes. This study will recruit and
      enroll 1,050 young (ages 15-29), racially and ethnically diverse men who have sex with men
      and transgender women affected by HIV across the United States. Using a HIV-status stratified
      randomized trial design, participants will be assigned into one of three conditions
      (information-only control, a researcher-driven social network intervention, or a peer-driven
      social network intervention). Behavioral assessments will occur at baseline, 3, 6, 9 and 12
      months; biomarkers (viral load) are scheduled for baseline, 6 and 12 months. The primary
      outcome is stratified by HIV status and defined as successful engagement in care (consistent
      VS for HIV-positive participants and routine testing for HIV-negative participants). The
      specific aims are: 1) Test whether an online intervention that promotes user-generated
      content and engagement to address intersectional stigma is associated with improvements in
      the HIV prevention and care continuum (HIV testing, antiretroviral adherence, VS) as compared
      to an information-only control arm; 2) Explore whether user engagement, as measured by
      quantitative and qualitative paradata, mediates the intervention's stigma- and HIV
      care-related outcomes; and, 3) Examine how changes in intersectional stigma and improvements
      across the HIV care continuum vary between the researcher-driven vs. peer-driven social
      network intervention conditions. The research study is innovative given its focus on
      intersectional stigma as a key target of intervention, and its ability to assess how
      different kinds of online social network structures influence participants' engagement over
      time, reduce experiences of intersectional stigma, and improve successful engagement in care.
      This research addresses a critical need to reduce the effects of multiple stigmas in a
      priority population using an intervention delivered through a highly appealing,
      widely-utilized technology. If effective, this form of stigma amelioration via online support
      can be broadly disseminated to reduce HIV transmission and improve care among YBLMT.
    

Intervention name(s): Information Resources; Social Support; HIV Testing
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The investigators will provide a HIV-related content as the attention-control condition.; The investigators will provide evidence-based answers to users' health questions, including linkage to care.; The investigators will provide opportunities for participants to get tested through HIV home test kits.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Prevention; Internet; Adolescence; LGBT; Sexuality; Young Adulthood