Reality Check: An HIV Risk Reduction Serial Drama
Condition: HIV (Human Immunodeficiency Virus); Sexually Transmitted Diseases
MeSH terms: Acquired Immunodeficiency Syndrome; HIV Infections; Sexually Transmitted Diseases; Immunologic Deficiency Syndromes
Study type: Interventional

Summary: 
      African Americans have considerably higher rates of HIV infections than do White, Hispanic,
      Asian, and Native Americans. African Americans accounted for 59% of all diagnoses of HIV
      infection among youth (13-24 years of age) in the United States. Young African Americans also
      have disproportionately high rates of other sexually transmitted infections (STIs).
      Therefore, the broad, long-term objective of this research is to identify interventions to
      reduce the risk of HIV and other STIs among young African Americans. Entertainment-education
      refers to narrative interventions designed to change behavior while providing entertainment.
      Several studies have evaluated the impact of media content on HIV risk behavior. One study
      found that exposure to an entertainment-education based HIV testing campaign was associated
      with increases in HIV testing among sexually active teens 12 months post exposure. Similarly,
      a radio soap opera called "Twende na Wakati" became the most popular television show in
      Tanzania and was highly successful in reducing the number of sexual partners and increasing
      condom use. A narrative video intervention study in STI clinic waiting rooms in three U.S.
      cities found a significant reduction in STI re-infection among patients visiting during
      months when the video was shown compared with patients visiting during months when it was not
      shown. Although these studies show that entertainment-education can be a promising medium for
      behavior change, none of them evaluated the efficacy of a tailored online
      entertainment-education intervention specifically designed for African American youth. To
      address this gap in the literature, this study tested the preliminary efficacy of an
      innovative, theory-based HIV risk-reduction serial drama intervention, Reality Check,
      specifically tailored to young African Americans. We used a randomized controlled trial,
      allocating African Americans 18 to 24 years of age to Reality Check, or an attention-control
      intervention promoting physical activity. Each intervention was delivered as a series of
      videos streamed online and accessible via any Internet-capable device. Participants completed
      surveys online at baseline, immediately post intervention, and 3 months post intervention. We
      hypothesized that, Reality Check would reduce condomless sex during the 3-month
      post-intervention period compared with the attention-matched control group, adjusting for
      baseline of the criterion.
    

Detailed description: 
      African Americans have considerably higher rates of HIV infections than do White, Hispanic,
      Asian, and Native Americans. African Americans accounted for 59% of all diagnoses of HIV
      infection among youth (13-24 years of age) in the United States. Young African Americans also
      have disproportionately high rates of other sexually transmitted infections (STIs).
      Therefore, the broad, long-term objective of this research is to identify interventions to
      reduce the risk of HIV and other STIs among young African Americans. Entertainment-education
      refers to narrative interventions designed to change behavior while providing entertainment.
      Several studies have evaluated the impact of media content on HIV risk behavior. One study
      found that exposure to an entertainment-education based HIV testing campaign was associated
      with increases in HIV testing among sexually active teens 12 months post exposure. Sabido and
      colleagues used "telenovelas" in Mexico to increase participation in a national literacy
      campaign and promote birth control use. Similarly, a radio soap opera called "Twende na
      Wakati" became the most popular television show in Tanzania and was highly successful in
      reducing the number of sexual partners and increasing condom use. A narrative video
      intervention study in STI clinic waiting rooms in three U.S. cities found a significant
      reduction in STI re-infection among patients visiting during months when the video was shown
      compared with patients visiting during months when it was not shown. Although these studies
      show that entertainment-education can be a promising medium for behavior change, none of them
      evaluated the efficacy of a tailored online entertainment-education intervention specifically
      designed for African American youth. To address this gap in the literature, this study tested
      the preliminary efficacy of an innovative, theory-based HIV risk-reduction serial drama
      intervention, Reality Check, specifically tailored to young African Americans and aimed at
      decreasing the frequency of condomless sex and promoting HIV testing among young adult
      African Americans. We used a randomized controlled trial, allocating African Americans 18 to
      24 years of age to Reality Check, or an attention-control intervention promoting physical
      activity. Each intervention was delivered as a series of videos streamed online and
      accessible via any Internet-capable device (e.g., smartphone, laptop or tablet). This mode of
      delivery was well suited to young African Americans because high percentages of young African
      Americans own and use Internet enabled mobile phones as their primary way to consume online
      content. We recruited participants through Facebook and Instagram, flyers posted on college
      campuses, college mailing lists, and referrals from participants. Participants completed
      surveys online at baseline, immediately post intervention, and 3 months post intervention. We
      hypothesized that, Reality Check would reduce the frequency of condomless sex during the
      3-month post-intervention period compared with the attention-matched control group, adjusting
      for baseline of the criterion.
    

Intervention name(s): Reality Check; Physical Activity Attention Control
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Human immunodeficiency virus; Sexually transmitted disease; African Americans; Young adults; Behavioral intervention; Entertainment-Education; Serial drama; Sexual behavior; HIV testing; Homophobia; Social cognitive theory