Building on the efficacy of the CDC’s Project Connect Health Systems Intervention to link heterosexual adolescents to competent comprehensive sexual health care services,1 Get Connected (GC) was developed, a pilot RCT that employed individual and systems-level tailoring technology to reduce barriers to HIV prevention (e.g., HIV/STI testing, PrEP) for YMSM living in Southeast Michigan. The deployment of GC through a mobile-optimized WebApp sought to optimize the intervention’s acceptability, accessibility, availability, and long-term affordability among youth.2-4 GC was developed for YMSM (ages 15-24) through a community-based participatory research approach that included a rapid assessment of existing HIV services through a mystery shopper methodology, 5 and the creative input of scientists, service providers, and YMSM.
Get Connected 2.0 is a two-arm prospective RCT that will enroll a total of 480 men in Philadelphia, Atlanta, and Houston (n=160 in each city). The study has three objectives, each for Philadelphia, Atlanta, and Houston: 1) Examine the quality of HIV test counseling and PrEP-related referrals to YMSM within local HIV/STI testing sites through the use of mystery shoppers; 2) Test the efficacy of GC for increasing HIV-negative or HIV-unknown YMSM’s successful uptake of HIV prevention services (e.g., routine HIV/STI testing) and PrEP awareness and willingness, as compared to the attention-control condition over a 12-month period; and 3) Qualitatively assess testing sites’ satisfaction with the biannual performance assessments and their improvements in service delivery when working with YMSM across the three regions.
To examine the quality of HIV test counseling and PrEP-related referrals to YMSM, we will create a master list of HIV/STI testing sites in each city. We will then enroll and train ten mystery shoppers per city; each testing site will be visited and assessed by two different mystery shoppers. After each site visit, mystery shoppers will complete a site evaluation to record their perceptions of various measures including LGBT visibility and inclusivity, privacy and confidentiality, provider-patient interactions, and the clinic environment.
To test the efficacy of GC 2.0 for increasing successful update of HIV prevention services, participants will be randomized into a control or intervention condition. The control condition consists of the AIDSVu.org testing site locator and the intervention condition grants participants access to a WebApp with content tailored to their specific demographic characteristics (e.g., age, race/ethnicity, location, and relationship status), HIV/STI risk behaviors (e.g., HIV/STI testing history; substance use; communication with partners regarding status) and sociocultural context (e.g., homelessness, incarceration). Study assessments will occur at enrollment and one, three, six, nine, and twelve months post-enrollment.
To assess testing sites’ satisfaction with biannual performance assessments, site directors will be randomly selected from ten testing sites in each city for an interview to discuss the assessment reports and whether they affected service delivery with YMSM clients.
References
- Dittus PJ, De Rosa CJ, Jeffries Ra, et al. The Project Connect Health Systems Intervention: Linking Sexually Experienced Youth to Sexual and Reproductive Health Care. Journal of Adolescent Health. 2014.
- Allison S, Bauermeister Ja, Bull S, et al. The intersection of youth, technology, and new media with sexual health: moving the research agenda forward. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. 2012;51:207-212.
- Chavez NR, Shearer LS, Rosenthal SL. Use of digital media technology for primary prevention of STIs/HIV in youth. Journal of pediatric and adolescent gynecology. Oct 2014;27(5):244-257.
- 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. Current HIV/AIDS Reports. 2015.
- Bauermeister JA, Pingel ES, Jadwin-Cakmak L, et al. The use of mystery shopping for quality assurance evaluations of HIV/STI testing sites offering services to young gay and bisexual men. AIDS Behav. Oct 2015;19(10):1919-1927.