Objective: The primary objective of this study was to develop and test a highly interactive Internet-based HIV prevention intervention for men who have sex with men (MSM). MSM remain the group at highest risk for HIV/AIDS in the United States and similar countries. As the Internet becomes popular for seeking sex, online interventions to reduce sexual risk are critical. Given previous studies, a secondary objective was to demonstrate that good retention is possible in online trials.
Design: A randomized controlled trial with 3-month, 6-month, 9-month, and 12-month follow-up design was employed.
Methods: In 2008, 650 participants were randomized to an online, interactive sexual risk reduction intervention or to a waitlist null control.
Results: Retention was 76–89% over 12 months. At 3-month follow-up, results showed a 16% reduction in reported unprotected anal intercourse risk among those in the treatment condition versus control [95% confidence interval (95% CI) of rate ratio: 0.70–1.01]. No meaningful differences were observed at 12-month follow-up.
Conclusion: Internet-based, persuasive computing programs hold promise as an effective new approach to HIV prevention for MSM, at least in the short term. Further, online trials can be conducted with acceptable retention provided strong retention protocols are employed. Four directions for future research are identified.
aDivision of Epidemiology and Community Health, University of Minnesota School of Public Health, USA
bDepartment of Computer Science and Engineering, University of Minnesota Institute of Technology, Minneapolis, Minnesota, USA
cDepartment of Learning and Performance Systems, Penn State University College of Education, University Park, Pennsylvania, USA.
Received 8 December, 2009
Revised 12 May, 2010
Accepted 19 May, 2010
Correspondence to B.R. Simon Rosser, PhD, MPH, LP, HIV/STI Intervention and Prevention Studies, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA. Tel: +1 612 624 0358; fax: +1 612 624 0315; e-mail: firstname.lastname@example.org