Annual rates of new HIV infections among men who have sex with men (MSM) in the United States continue to grow rapidly, despite stability or decline among other groups. This trend highlights the ongoing importance of developing new tools to fight the continued expansion of the HIV epidemic among MSM. Although a number of sex risk reduction interventions exist for MSM, important limitations have restricted their impact. These include barriers to dissemination and/or implementation, such as lengthy treatment protocols, the need for highly- trained interventionists, and confining delivery only to healthcare settings. Interventions have also failed to address pivotal factors that lead to high-risk behavior specifically heavy drinking. Research testing the efficacy of interventions to reduce heavy drinking among MSM is scarce, and has mostly only explored lengthier treatment protocols that span several weeks or months. Single-exposure intervention approaches for reducing heavy drinking based on the principles of motivational interviewing (MI), commonly referred to as Personalized Feedback Interventions, have been developed and tested in other populations with success. Similar brief interventions for HIV-risk reduction based on stages of change and MI-principles, such as Personalized Cognitive Counseling, have also been shown to produce meaningful reductions in unprotected sex among these individuals. These parallel lines of research highlight the opportunity for developing a brief, combined intervention for reducing both alcohol use and sex risk among MSM. Adapting and delivering these interventions via a technology-based or mHealth format would also begin to allow the extension of interventions beyond the traditional interactions and settings, potentially improving efficacy, flexibility, and scalability. As such, the proposed research will serve as the foundation for a research program focusing on developing technology-assisted tools that can be easily delivered to high-risk individuals. This three-year project aims to develop and pilot test a brief, combined intervention for reducing heavy drinking and unprotected sex among MSM based on principles of MI. This combined intervention will be adapted to a tablet- based format and developed specifically for use with high-risk MSM in community-based settings. The research involves two phases: Phase 1 involves conducting qualitative research to (1) integrate alcohol use and sex risk intervention components, (2) adapt them to a technology-based format, and (3) understand and address challenges in implementation, feasibility, and acceptability. Phase 2 entails conducting a randomized- controlled pilot test of the intervention among MSM seeking HIV testing in community-based settings to explore its potential impact on alcohol and HIV-related behavioral outcomes. This research will ultimately produce a combined, theory-based, and technology-delivered intervention for heavy drinking and sex risk that is fully portable and has been preliminarily tested for efficacy in community settings where high-risk MSM engage with prevention services.
The proposed research aims to develop a tablet-based intervention based on principles of motivational interviewing for use in community settings to help high-risk men who have sex with men (MSM) reduce heavy drinking and sex risks. These tools will help MSM at high-risk for HIV acquisition to evaluate their current behavior, consider options for change, and develop a plan for reducing harm. The research will thus provide prevention personnel with an evidence-based, low-cost, high-fidelity tool for reducing risk among high-risk MSM that present for voluntary HIV testing and counseling.
| Wray, Tyler B; Adia, Alexander C; Pérez, Ashley E et al. (2018) Timeline: A web application for assessing the timing and details of health behaviors. Am J Drug Alcohol Abuse :1-10 |
| Wray, Tyler B; Chan, Philip A; Celio, Mark A et al. (2018) HIV Testing Among Men Who Have Sex with Men in the Northeastern United States. AIDS Behav 22:531-537 |
