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Interactive Intervention Protocol for Risk Reduction in MSM: An Efficacy Test in a Prospective RCT

This study presents a new intervention protocol aimed at reducing non-premeditated risk-taking behaviors in MSM through an interactive e-animation. The protocol focuses on increasing vigilance and control to promote safer sexual encounters. The research, conducted as a prospective randomized controlled trial, involved recruiting 1,720 diverse MSM participants online. Results indicated a reduction in unplanned risk behaviors by 17.5% with the interactive intervention, showcasing potential effectiveness in risk reduction strategies. The study highlights the importance of planning and preparation in reducing risk behaviors and emphasizes the need for innovative approaches in behavioral prevention. Contact j.dewit@unsw.edu.au for more information.

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Interactive Intervention Protocol for Risk Reduction in MSM: An Efficacy Test in a Prospective RCT

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  1. Reducing non-premeditated risk-taking in MSM:a new intervention protocol to increase vigilance and control tested for efficacy in a prospective RCT John BF de Wit & Philippe CG Adam

  2. Acknowledgements • Antonio Alexandre, SNEG Prevention, France • Thierry Troussier, Ministry of Health, France • Nathalie Lydié, INPES, France

  3. A resurging HIV epidemic in MSM • North-America • CDC, 2003 • Europe • Hamers & Phillip, 2008 • Australia • Guy et al., 2008 • Low and middle income countries • Baral et al., 2007

  4. Preparing for ‘the heat of the moment’ • Most MSM remain motivated to prevent HIV • Studies on treatment optimism • Range of risk reduction strategies • Risk with casual partners is mostly unpremeditated • Intending ≠ doing ; willingness in conducive situations • In love, aroused, alcohol/drugs, feeling low, no condoms, …. • Self-regulation perspective of health behavior • Understanding factors and processes related to (sustained) change • e.g. De Ridder & De Wit (2006) • Strategies for action initiation/maintenance • Awareness and preparation ahead of time

  5. Interactive e-animation (< 5 min.) WWW.HISTOIRESDEMECS.ORG/SECRET.HTML • Awareness of possible sexual encounter; preparation for safer sex • Importance of awareness, commitment to safer sex and preparation • Commitment to safer sex, how to be prepared; negotiating partners • Thinking through personally relevant situation

  6. Study design and participants • Recruitment via major websites for diverse MSM • 1,720 participants complete data to follow-up • 1,339 men had casual partners to follow-up • Online randomized controlled trial with 3 arms • Interactive (n=435), comparison (n=548) and control group (n=737) • Immediate post-test and 6 month follow-up • Assessments via self-report questionnaires and email notification • Sample characteristics • Mean age 34 years; 65% university education; 80% excl. gay • 84% tested for HIV; 7.7% HIV positive • Average of 15 casual partners; 46% (also) had steady partner

  7. Pre-intervention risk with casual partners

  8. Preparation for casual sex # p<.10; * p<.05; ** p<.01; *** p<.001

  9. Unprotected sex casual partners # p<.10; * p<.05; ** p<.01; *** p<.001

  10. Moderation of behavioral impact

  11. Conclusions and discussion • Risk-taking with casual partners was very high • For almost half condom use depended on situation • Potential sample bias; high-risk (relevant) sample • Planning increased preparation for casual sex • Interactive intervention stronger than ‘classic’ postcard • Promoting planning significantly buffered risk-taking • Reduction in MSM who engaged in unplanned risk (17.5% ↓) • Effect size seems limited; high potential effectiveness • Duration only < 5 minutes; novel outreach; reach to date > 1M • Illustration of potential of behavioral prevention • Theory-based; up-to-date theorizing

  12. j.dewit@unsw.edu.au

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