Love, Sex & Choices: A Web Series on Mobile Devices to Reduce Black Women's HIV Risk
Condition: HIV; Sexual Behavior; Women's Role; Risk Behavior; Chlamydia
MeSH terms: Chlamydia Infections
Study type: Interventional

Summary: 
      This study tests a 12-episode Internet-based, guide enhanced Love, Sex, & Choices (LSC) HIV
      prevention soap opera video series for smartphones or computers, in a randomized clinical
      trial among predominately at-risk African American urban women.

      The following hypotheses are to be tested: 1) The LSC treatment arm will show lower
      unprotected sex risk, meaning lower frequency of unprotected sex (vaginal + anal) with high
      risk partners at 6 months post intervention compared to an attention control arm 2) The LSC
      treatment arm will show higher participation in HIV testing at 6 months post intervention
      compared to the control.

      If effective, this video intervention could be rapidly implemented and brought to scale at
      low cost via the Internet, widely reaching young urban women with the goal of reducing HIV
      risk behavior and increasing HIV testing.
    

Detailed description: 
      Love, Sex, and Choices (LSC) is an engaging 12-episode video series to reduce HIV risk in
      young, adult predominately Black women. A peer video guide was added to the end of LSC
      episodes to provoke viewers to question their own sex scripts and consider their own need for
      change. The investigators propose to conduct a two-arm clinical trial of the guide enhanced
      LSC impact on reducing unprotected sex with high risk partners and increasing HIV testing in
      Black women in high HIV prevalence neighborhoods. Undiagnosed HIV is a significant factor
      fueling the epidemic. The Control is a 12-episode popular web miniseries with a storyline
      that promotes respectful relationships. A previous online pilot study was conducted to
      evaluate the guide enhanced LSC acceptability, the feasibility of Facebook® advertising, and
      streaming the guide enhanced LSC to smartphones. This pilot study indicated 43.6% went for
      HIV testing within 30 days post viewing. The guide enhanced LSC was associated with sex risk
      reduction. Recruitment and retention of Black women in online HIV prevention research remain
      understudied.

      AIM 1 is to conduct a RCT to evaluate the effect of the guide enhanced LSC on HIV sex risk
      behavior compared to a true attention control.

      AIM 2 is to evaluate effect of the guide enhanced LSC on HIV testing. AIM 3 is to compare the
      reach, meaning enrollment, engagement, retention, risk behaviors, and demographics of high
      risk, young urban Black women recruited online to those obtained by conventional recruitment:
      with and without research team assistance, to determine whether online recruitment reaches
      subgroups not reached in conventional recruitment. Data from Facebook© ads, QR codes, site
      specific URL on flyers, tracking video viewing, retention data, and risk behaviors will help
      evaluate efforts to reach and retain high risk women.

      AIM 4 is to specify a model of the effect of the guide enhanced LSC series on high risk sex
      scripts and sex risk. Storytelling can promote behavior change but the study of the mechanism
      of effect is still young, and entertainment-education concepts of effective film are not yet
      well integrated into HIV prevention science. Identification with film characters and
      transportation, characterized by emotional and cognitive empathy and merging, are known to
      mediate cognitive shifts.

      The following hypotheses are to be tested in a RCT in predominately young urban Black women
      [1) The guide enhanced LSC treatment arm will show lower unprotected sex risk, meaning lower
      frequency of unprotected sex (vaginal + anal) with high risk partners at 6 months post
      intervention compared to an attention control arm (2) The guide enhanced LSC treatment arm
      will show higher participation in HIV testing at 6 months post intervention compared to the
      control. Investigators will learn by secondary analyses, whether (3) there are differences in
      reach by Facebook© compared to conventional recruitment, and 4) Retention of at risk women
      recruited online will be similar to those recruited in the field and 5) whether
      identification and transportation will lower high risk sex scripts as a mediator of lower USR
      and greater HIV testing.
    

Intervention name(s): Love, Sex, & Choices
Intervention type(s): Behavioral
Intervention description(s): Investigators propose to conduct a two-arm clinical trial of guide enhanced LSC impact on reducing unprotected sex with high risk partners and increasing HIV testing in Black women in high HIV prevalence neighborhoods. Undiagnosed HIV is a significant factor fueling the epidemic. Recruitment into the study will be via Facebook or traditional on the ground.
Other intervention name(s): guide enhanced Love, Sex, & Choices
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention