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Biomedical and behavioral outcomes of Keep It Up!: an ehealth HIV prevention program RCT.
Open accessAbstract
Introduction HIV diagnoses among young men who have sex with men are increasing, but few effective HIV prevention interventions exist for this population. An RCT was conducted of the online Keep It Up! intervention to determine if it significantly reduced condomless anal sex and sexually transmitted infections compared with an HIV knowledge condition.Study design From May 2013 to March 2017, a total of 901 participants were enrolled in a double-blinded RCT of Keep It Up! with 1-year follow-up. After completing baseline surveys and sexually transmitted infection testing, participants were randomized by an eHealth platform to the intervention or control condition.Setting/participants HIV-negative men who have sex with men reporting condomless anal sex, aged 18-29 years, were recruited through advertising and from HIV testing sites and outreach in Atlanta, Georgia; Chicago, Illinois; and New York, New York.Intervention Multimedia was used to address HIV knowledge and motivate safer behaviors. The control condition reflected existing online HIV information.Main outcome measures Primary outcomes were incident gonorrhea or chlamydia at 12-month follow-up and self-reported condomless anal sex with casual partners at 3-, 6-, and 12-month follow-up.Results In 2017, data were analyzed from 445 (49%) participants randomized to the intervention and 456 (51%) to the control. Participants were primarily racial/ethnic minorities (63%). Sexually transmitted infections at Month 12 was 40% lower for intervention participants (risk ratio=0.60, 95% CI=0.38, 0.95, p=0.01). For the primary behavioral outcome, both arms showed reductions over time with 44% of control and 37% of intervention participants reporting condomless anal sex at Month 12 (prevalence ratio=0.83, 95% CI=0.70, 0.99, p=0.04).Conclusions The Keep It Up! intervention resulted in significantly lower sexually transmitted infection incidence and a small but significant decrease in condomless anal sex 12 months post-intervention relative to an online HIV knowledge condition. In addition, this study demonstrated the feasibility and acceptability of at-home sexually transmitted infection testing as part of an eHealth intervention.Trial registration This study is registered at www.clinicaltrials.gov NCT01836445.
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“Brief, online, electronic-learning modules for young MSM have been reported to be effective in reducing incident STIs and offer a convenient client platform for effective interventions (10).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [10]
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Sexually Transmitted Infections Treatment Guidelines, 2021
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BackgroundNguyen, L. H., Tran, B. X., Rocha, L. E. C., Nguyen, H. L. T., Yang, P., Latkin, C. A., Thorson, A. E., & Strömdahl, S. K. (2019) · AIDS and Behavior · doi:10.1007/s10461-019-02626-1 · Cited by 101
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BackgroundMethodInfluentialPantalone, D. W., Nelson, K. M., Batchelder, A. W., Chiu, C., Gunn, H. A., & Horvath, K. J. (2020) · The Journal of Sex Research · doi:10.1080/00224499.2020.1728514 · Cited by 81
“However, with some notable successes (Mustanski et al., 2018), the effectiveness and eventual implementation of technology-based studies have not been fully determined.”
Background
Metadata
- Authors
- Mustanski, B., Parsons, J. T., Sullivan, P. S., Madkins, K., Rosenberg, E., & Swann, G.
- Affiliations
- Northwestern University (US)
- City University of New York (US)
- State University of New York (US)
- Corresponding author
- Mustanski, Brian
- ORCID
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2018-08
- Volume
- 55
- Issue
- 2
- Pages
- 151-158
- ISSN
- 0749-3797 (ISSN-L)
- PMC
- PMC6314292
- OpenAlex
- W2811047402
- Cited by
- 103
- References
- 43
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 13 · 2023: 9 · 2022: 15 · 2021: 13 · 2020: 23 · 2019: 13 · 2018: 2
- FWCI
- 9.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse
- Centers for Disease Control and Prevention
- Gilead Sciences
- National Institute of Mental Health (R01DA035145)
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Adolescent Sexual and Reproductive Health
- Keywords
- HIV prevention, young men who have sex with men, digital health interventions, condomless anal sex, sexually transmitted infections, gonorrhea, chlamydia, HIV/AIDS knowledge, HIV-negative men, online health interventions, sexual risk behavior, racial and ethnic minorities, intervention feasibility and acceptability, HIV prevention messaging
- MeSH terms
- Adult, Humans, Health Knowledge, Attitudes, Practice, Male, Surveys and Questionnaires, Sexually Transmitted Diseases, United States, HIV Infections, Telemedicine, Homosexuality, Male, Risk Reduction Behavior, Young Adult
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