Reducing HIV Vulnerability Through A Multilevel Life Skills Intervention For Adolescent Men
Condition: HIV Infections; Sexually Transmitted Diseases; Sexual Behavior; Adolescent Behavior; Homosexuality
MeSH terms: Sexually Transmitted Diseases
Study type: Interventional

Summary: 
      The investigators propose to deliver and test a life skills intervention targeting the key
      domains that fuel HIV disparities among adolescent (ages 13-18) same-sex attracted men in the
      United States. This RCT will yield important information regarding the delivery of a
      developmentally-appropriate HIV prevention program that reaches racial/ethnic and
      socioeconomically diverse sample of adolescent men across four regions in the United States.
    

Detailed description: 
      From 2000-2010, the annual number of new HIV diagnoses among MSM aged 13-24 years old more
      than doubled. There are stark racial and ethnic disparities in the incidence of new HIV
      infections among YMSM; 13- 24 year old racial and ethnic minority MSM now represent a rapidly
      growing share of all new HIV infections. Although the likelihood of HIV acquisition is
      greater at older ages, many of the cognitive and behavioral risk factors that contribute to
      the risk of HIV infection rates develop in adolescence. As adolescent MSM (AMSM; 13-18 years
      old) begin to develop and express gender and sexual identities, to experiment and begin
      sexual behaviors, and to begin to establish a sense of self, there is the opportunity to
      parallel this period of growth with targeted, tailored interventions that equip AMSM with the
      life skills they need to reduce their vulnerability to HIV risk and to establish the life
      skills necessary to manage risk. The investigators developed a mobile-friendly WebApp
      intervention focused on life skills training with links to local resources. In the proposed
      activities, the investigators will adapt the life skills intervention for four U.S regions
      heavily impacted by HIV, and revise the content to include materials that are age-appropriate
      for 13 to 18 year-olds. Given the role that stigma and social isolation plays in the lives of
      many AMSM, the investigators also propose to embed a peer-to-peer motivational interviewing
      component, allowing participants to access motivational interviewing counseling via VSee
      video-chat. With a large and diverse sample (n=500), the investigators will test the efficacy
      of the intervention, now referred to as iCON+, on cognitive and behavioral HIV-related
      outcomes using a two-arm randomized control design. In addition, the investigators examine
      whether structural characteristics in a region (e.g., race/ethnicity segregation, HIV
      prevalence) influence the efficacy of the proposed intervention.

      The following Specific Aims are proposed:

        1. Adapt a multilevel, online life skills intervention to address HIV vulnerability among
           AMSM living in four heavily impacted regions constituting diverse racial/ethnic and
           geographic areas (Chicago-Detroit; Atlanta-Washington, DC; Memphis- New Orleans; San
           Francisco-San Diego) in the US.

        2. Test the efficacy of our intervention, as compared to a delayed intervention condition,
           to improve cognitive (e.g., comfort discussing sexuality; HIV prevention attitudes,
           norms, self-efficacy, behavioral intentions) and behavioral (e.g., condom use, HIV
           testing, PrEP use) factors using a prospective RCT design.

        3. Examine the differential efficacy of our intervention in improving psychosocial
           mediators (e.g., personal competency) associated with our outcomes; and,

        4. Examine how socio-ecological determinants at the individual (e.g., race/ethnicity,
           urbanity) and regional (e.g., socioeconomic disadvantage, HIV prevalence) level are
           associated with intervention efficacy.
    

Intervention name(s): Life Skills Coaching; Community Resources
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The investigators designed the intervention to help participants increase their HIV risk awareness, promote self-appraisal and increase motivation for engaging in prevention services, problem solving barriers to accessing care, and locating culturally-sensitive providers. Intervention content is customized based on participants' socio-demographic characteristics and geographic location.; The investigators will provide a resource locator as the attention-control condition. The resource locator provides a list of health (e.g., HIV testing) and social (e.g., support groups) resources across study regions.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Prevention; Internet; Adolescence; LGBT; Sexuality