Home-Based HIV Testing and Counseling for Male Couples (Project Nexus): A Protocol for a Randomized Controlled Trial

Stephenson, Rob; Freeland, Ryan; Sullivan, Stephen; Riley, Erin A.; Johnson, Brent A.; Mitchell, Jason W.; McFarland, Deborah A.; Sullivan, Patrick S.

doi:10.2196/resprot.7341

Cited by 70 publications

(46 citation statements)

References 51 publications

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“…Jiang et al (2020) note the need to continue to provide HIV care during the COVID-19 epidemic [5]. Several recent studies have successfully implemented telehealth interventions to provide HIV prevention and care services to GBMBM throughout the US [18,19]. Hightow-Weidman et al [20] recently noted the potential for online delivered telehealth interventions to surmount many of the barriers to service delivery created by the COVID-19 epidemic.…”

Section: Discussionmentioning

confidence: 99%

Sex in the Time of COVID-19: Results of an Online Survey of Gay, Bisexual and Other Men Who Have Sex with Men’s Experience of Sex and HIV Prevention During the US COVID-19 Epidemic

et al. 2020

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This paper presents data from a recent cross-sectional survey of gay, bisexual and other men who have sex with men (GBMSM) in the US, to understand changes in sexual behavior and access to HIV prevention options (i.e. condoms and pre-exposure prophylaxis (PrEP)) during the COVID-19 lockdown period. The Love and Sex in the Time of COVID-19 survey was conducted online from April to May, 2020. GBMSM were recruited through advertisements featured on social networking platforms, recruiting a sample size of 518 GBMSM. Analysis considers changes three in self-reported measures of sexual behavior: number of sex partners, number of anal sex partners and number of anal sex partners not protected by pre-exposure prophylaxis (PrEP) or condoms. Approximately two-thirds of the sample reported that they believed it was possible to contract COVID-19 through sex, with anal sex reported as the least risky sex act. Men did not generally feel it was important to reduce their number of sex partners during COVID-19, but reported a moderate willingness to have sex during COVID-19. For the period between February and April-May 20,202, participants reported a mean increase of 2.3 sex partners during COVID-19, a mean increase of 2.1 anal sex partners (range − 40 to 70), but a very small increase in the number of unprotected anal sex partners. Increases in sexual behavior during COVID-19 were associated with increases in substance use during the same period. High levels of sexual activity continue to be reported during the COVID-19 lockdown period and these high levels of sexual activity are often paralleled by increases in substance use and binge drinking. There is a clear need to continue to provide comprehensive HIV prevention and care services during COVID-19, and telehealth and other eHealth platforms provide a safe, flexible mechanism for providing services.

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Section: Discussionmentioning

confidence: 99%

Sex in the Time of COVID-19: Results of an Online Survey of Gay, Bisexual and Other Men Who Have Sex with Men’s Experience of Sex and HIV Prevention During the US COVID-19 Epidemic

et al. 2020

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“…Users of HIVST have the autonomy to include other individuals in their testing experience such as their partners, friends, or family members. Given the growing evidence in support of couples HIV testing among MSM, the use of HIVST with main partners is being explored in multiple studies (Koblin et al, 2017;Neme, Goldenberg, Stekler, Sullivan, & Stephenson, 2015;Stephenson, Freeland, et al, 2017;Stephenson, Suarez, et al, 2017;Sullivan, Wall, et al, 2014;Wall et al, 2016). Partners can be a source of comfort and support during the HIV testing experience and can help mitigate the emotional distress that may occur after receiving a positive test result (Martinez et al, 2014).…”

mentioning

confidence: 99%

Perceptions of HIV Self-Testing Among Men Who Have Sex With Men in the United States: A Qualitative Analysis

Freeman

Sullivan

Higa

et al. 2018

AIDS Education and Prevention

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HIV testing is the gateway into both prevention and treatment services. It is important to understand how men who have sex with men (MSM) perceive HIV self-tests. We conducted focus groups and individual interviews to collect feedback on two HIV self-tests, and on a dried blood spot (DBS) specimen collection kit. Perceptions and attitudes around HIV self-testing (HIVST), and willingness to distribute HIV self-tests to others were assessed. MSM reported HIVST to be complementary to facility-based testing, and liked this approach because it offers privacy and convenience, does not require counseling, and could lead to linkage to care. However, they also had concerns around the accuracy of HIV self-tests, their cost, and receiving a positive test result without immediate access to follow-up services. Despite these issues, they perceived HIVST as a positive addition to their HIV prevention toolbox.

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“…TY will report data on the acceptability of the experimental arm at the end of the follow-up period. Two different assessments will be used to measure acceptability: (1) the Self-Evaluation Form (SEF) [ 44 ] and (2) the Client Satisfaction Questionnaire (CSQ-8) [ 45 ]. The SEF is a brief 13-item questionnaire that elicits information regarding the participant’s experience with the intervention (ie, was the intervention interesting, was it relevant to their life).…”

Section: Methodsmentioning

confidence: 99%

“…Allowing for 20% loss to follow-up, this approach will produce a sample of 200 TY who are expected to complete the prospective pilot RCT. As a comparison, an ongoing RCT of couples’ HIV counseling and testing in MSM [ 44 ] has a retention rate of 90-95%, making a 20% loss-to-follow-up a generous allowance. The sample size is calculated based on the detection of significant changes in each of the outcomes between the control and intervention groups.…”

Section: Methodsmentioning

confidence: 99%

Providing Home-Based HIV Testing and Counseling for Transgender Youth (Project Moxie): Protocol for a Pilot Randomized Controlled Trial

Stephenson¹,

Metheny²,

Sharma³

et al. 2017

JMIR Res Protoc

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BackgroundTransgender and gender nonconforming people experience some of the highest human immunodeficiency virus (HIV) rates in the United States, and experience many structural and behavioral barriers that may limit their engagement in HIV testing, prevention, and care. Evidence suggests that transgender and gender nonconforming youth (TY) are especially vulnerable to acquiring HIV, yet there is little research on TY and few services are targeted towards HIV testing, prevention, and care for this population. Telehealth presents an opportunity to mitigate some structural barriers that TY experience in accessing HIV testing, allowing TY to engage in HIV testing and counseling in a safe and nonjudgmental space of their choosing. Project Moxie is an HIV prevention intervention that pairs the use of HIV self-testing with remote video-based counseling and support from a trained, gender-affirming counselor. This study aims to offer a more positive HIV testing and counseling experience, with the goal of improving HIV testing frequency.ObjectiveProject Moxie involves a pilot randomized controlled trial (RCT) of 200 TY aged 15-24 years, who are randomized on a 1:1 basis to control or intervention arms. The aim is to examine whether the addition of counseling provided via telehealth, coupled with home-based HIV testing, can create gains in routine HIV testing among TY over a six-month follow-up period.MethodsThis study implements a prospective pilot RCT of 200 TY recruited online. Participants in the control arm will receive one HIV self-testing kit and will be asked to report their results via the study’s website. Participants in the experimental arm will receive one HIV self-testing kit and will test with a remotely-located counselor during a prescheduled video-counseling session. Participants are assessed at baseline, and at three and six months posttesting.ResultsProject Moxie was launched in June 2017 and recruitment is ongoing. As of August 21, 2017, the study had enrolled 130 eligible participants.ConclusionsCombining home-based HIV testing and video-based counseling allows TY, an often stigmatized and marginalized population, to test for HIV in a safe and nonjudgmental setting of their choosing. This approach creates an opportunity to reduce the high rate of HIV among TY through engagement in care, support, and linkage to the HIV treatment cascade for those who test positive.Trial RegistrationClinicalTrials.gov NCT03185975; https://clinicaltrials.gov/ct2/show/NCT03185975 (Archived by WebCite at http://www.webcitation.org/6vIjHJ93s)

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Home-Based HIV Testing and Counseling for Male Couples (Project Nexus): A Protocol for a Randomized Controlled Trial

Cited by 70 publications

References 51 publications

Sex in the Time of COVID-19: Results of an Online Survey of Gay, Bisexual and Other Men Who Have Sex with Men’s Experience of Sex and HIV Prevention During the US COVID-19 Epidemic

Sex in the Time of COVID-19: Results of an Online Survey of Gay, Bisexual and Other Men Who Have Sex with Men’s Experience of Sex and HIV Prevention During the US COVID-19 Epidemic

Perceptions of HIV Self-Testing Among Men Who Have Sex With Men in the United States: A Qualitative Analysis

Providing Home-Based HIV Testing and Counseling for Transgender Youth (Project Moxie): Protocol for a Pilot Randomized Controlled Trial

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