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Development and testing of smartphone apps for HIV prevention delivery has the potential to engage YMSM in HIV prevention programming, which can be tailored based on use patterns and motivations for use. Centers for Disease Control and Prevention CDC data suggests that over two-thirds of adolescents between the ages of 13 and 29 who are living with HIV were infected through male-to-male sexual contact 1.
For example, surveillance and prevention data show that in general, older men who have sex with men MSM are over-represented in clinical- or research-based HIV prevention programs 3 – 5. However, those programs that have been specifically tailored to YMSM indicate that such targeted interventions can be effective in reducing HIV risk behavior 9 – With such widespread access, the internet is an added resource for sexual health information.
In fact, YMSM have been found to heavily utilize internet search engines, gay-friendly chat rooms, and pornography websites to gain information on sex behavior, sexuality, and sexual health 16 – Although there is no clear consensus in the extant literature regarding the association between meeting sexual partners online and increased HIV risk behaviors 23 – 30 Dragowski and colleagues 31 hypothesize that the internet may be a facilitator of multiple partnerships and other HIV risk behaviors for men who already engage in such behavior, rather than a catalyst for the behavior itself.
HIV practitioners have developed interventions that use the internet to reach diverse populations, including men who have sex with men 32 – Common within these interventions are features such as virtual scenarios and simulations, decision-making with virtual characters, and detailed answers or feedback following knowledge tests. For example, Bowen et al.
Results indicated a decrease in anal sex and an increase in condom use, as well as significant increases in HIV knowledge, condom self-efficacy, and outcome expectancies regarding safer sex. Another study, which used an online video intervention designed to promote disclosure of HIV status among MSM, was effective in increasing the odds of HIV status disclosure at last intercourse and decreasing the odds of intercourse with a casual partner at follow-up compared to baseline Yet another study using the internet as a platform for an HIV IMBS intervention found that the online program, which consisted of risk assessment and feedback, motivational exercises, and skills training, yielded more reductions in sexual risk behaviors with high risk partners as compared to a control group Mobile phone-based HIV prevention interventions that incorporate text messaging delivery have also been used with some success with MSM.
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