5 year NIH/NIMH Funded Grant GOAL: Develop and Implement an INTERNET based HIV prevention for Rural MSM Years 1 & 2: Assessment Study Qualitative and Quantitative Assessment of rural MSM risk Years 3-5: PROJECT HOPE Develop and Pilot an Internet delivered HIV Prevention
Completers vs. Drop-outs No Differences: Age, Sexual Orientation, Ethnicity, Religion Education, Student or Work status, Income Completers: # Sex partners last 30d (Zero, One, > 2) One significant difference More of the non-students were monogamous
HIV Knowledge Self-efficacy Mechanical Emotional Refusal Outcome Expectancies Negative Fell Safer Willingness to engage in safer sex practices Behavior (Q1 & Q4 only) # sex partners Frequency of anal sex Frequency of condom use
One Intervention Knowledge Intervention: Knowledge, SE- mech All Interventions: OE-safe, SE-emot., & SE-refusal Three Interventions INTERVENTION ORDER didn’t matter ALL outcome variables changed significantly
Number of sex partners at Q1 Main Effect of time Paired Comparisons Zero p<.001 1 p<.001 >=2 p<.001Eta 2 Knowledge+++.30 Outcome Expectancy Safe +++.12 Negative - +++.04 Self-efficacy Mech. +++.31 Emot. +++.23 Refusal +++.22
# Sex partners at Q1 ME Time Paired ComparisonsZero1>=2Eta 2 Limit sex partners to one per month +++.04 Condoms with new partners, always +++.06 Oral sex until monog. and text neg. +++.09 Condom until monog. and test neg. ++++.09
Number of sex partners at Q1 Zero1>=2 Number Sex Partners 0 1.0 0 1.0 1 1.7 5.3 3.9 Frequency of anal sex Na.18.104.22.168 Condom use for anal sex Na.22.214.171.124
Outcome Variables HIV Knowledge Willingness to engage in safer sex practices Self-efficacy ( Mechanical, Emotional, Refusal ) Outcome Expectancies ( Negative, Safer) Risk Behavior # sex partners Frequency of anal sex Frequency of condom use
BehaviorN Q1 M Q5 M 30d/# sex partners Anal Sex Index Condom use Index 69 48 a 3.36.69 b.52 c NS >> 3.81.63 b.72 c a Excludes participants reporting no sex partners at baseline. b Frequency of anal sex divided by number of sex partners. If no anal sex, index = 0. c Frequency of condom use divided by frequency of anal sex. If no anal sex, index = 1.0.
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Project Publications Bowen, A. M., Williams, M. L., Daniel, C. M., & Clayton, S. (2008). Feasibility, acceptability, and preliminary efficacy of Internet HIV prevention research: Targeting rural MSM. J. Behavioral Medicine., Online First Bowen, A. M., Daniel, C. M., Williams, M. L., & Baird, G. L. (2008). Identifying multiple submission in Internet research: Preserving data integrity. AIDS and Behavior, Online First. Clayton, S., *Daniel, C. & Bowen, A. (2008). The Internet: The New Frontier in HIV Prevention. In (Edgar, T., Noar, S. M., & Freimuth, V. S. Eds.) Communication perspectives on HIV/AIDS for the 21 st century. New York: Lawrence Erlbaum Associates Bowen, A. M., Horvath, K., & Williams, M. L. (2007). A randomized control trial of Internet- delivered HIV prevention targeting rural MSM. Health Education Research, 22(1), pp. 120-127. Horvath, K. J., Bowen, A. M., & Williams, M. L. (2006). Virtual and physical venues as contexts for HIV risk among rural MSM. Health Psychology, 25(2), pp. 237-242. Bowen, A. M. (2005). Internet sexuality research with rural MSM: Can we recruit and retain them? Journal of Sex Research, vol. 42(4), pp. 317-323. Williams, M., A. Bowen, and K. Horvath (2005). The social/sexual environment of gay men residing in a rural frontier state: Implications for the development of HIV prevention programs. Journal of Rural Health, 21(1), 48-55. Bowen, A. M., Williams, M. L., & Horvath, K. (2004). Using the Internet to recruit rural MSM for HIV risk assessment: Sampling issues. AIDS and Behavior, 8(3), pp.311-319.