Online interventions to address HIV and other sexually transmitted and blood‐borne infections among young gay, bisexual and other men who have sex with men: a systematic review

Abstract

IntroductionGlobally, young gay, bisexual and other men who have sex with men (gbMSM) continue to experience disproportionately high rates of HIV and other sexually transmitted and blood‐borne infections (STBBIs). As such, there are strong public health imperatives to evaluate innovative prevention, treatment and care interventions, including online interventions. This study reviewed and assessed the status of published research (e.g. effectiveness; acceptability; differential effects across subgroups) involving online interventions that address HIV/STBBIs among young gbMSM.MethodsWe searched Medline, Embase, PsycINFO, CINAHL, and Google Scholar to identify relevant English‐language publications from inception to November 2016. Studies that assessed an online intervention regarding the prevention, care, or treatment of HIV/STBBIs were included. Studies with <50% gbMSM or with a mean age ≥30 years were excluded.ResultsOf the 3465 articles screened, 17 studies met inclusion criteria. Sixteen studies assessed interventions at the “proof‐of‐concept” phase, while one study assessed an intervention in the dissemination phase. All of the studies focused on behavioural or knowledge outcomes at the individual level (e.g. condom use, testing behaviour), and all but one reported a statistically significant effect on ≥1 primary outcomes. Twelve studies described theory‐based interventions. Twelve were conducted in the United States, with study samples focusing mainly on White, African‐American and/or Latino populations; the remaining were conducted in Hong Kong, Peru, China, and Thailand. Thirteen studies included gay and bisexual men; four studies did not assess sexual identity. Two studies reported including both HIV+ and HIV− participants, and all but one study included one or more measure of socio‐economic status. Few studies reported on the differential intervention effects by socio‐economic status, sexual identity, race or serostatus.ConclusionWhile online interventions show promise at addressing HIV/STBBI among young gbMSM, to date, little emphasis has been placed on assessing: (i) potential differential effects of interventions across subgroups of young gbMSM; (ii) effectiveness studies of interventions in the dissemination phase; and (iii) on some “key” populations of young gbMSM (e.g. those who are: transgender, from low‐income settings and/or HIV positive). Future research that unpacks the potentially distinctive experiences of particular subgroups with “real world” interventions is needed.

Effectiveness, Acceptability, and Feasibility of Digital Health Interventions for LGBTIQ+ Young People: Systematic Review

“…To date, however, there has not been a comprehensive review summarizing the scope and use of digital health interventions that currently exist for this population. Knight et al [ 54 ] recently reviewed web-based interventions for HIV or sexually transmitted infection (STI) risk reduction in young men who have sex with men (MSM); however, this review did not capture digital health interventions that are delivered through other digital modalities (eg, mobile apps), those that address other health issues, or those that target women, gender-diverse individuals, or individuals with intersex variations. There have also been several recent reviews focused on the mental health of LGBTIQ+ young people [ 55 , 56 ] and adults [ 57 ], which have referenced a combined total of 4 digital interventions for this population.…”

Do combination HIV prevention programmes result in increased empowerment, inclusion and agency to demand equal rights for marginalised populations in low-income and middle-income countries? A systematic review

“…However, these important intermediate outcomes are not always measured in the evaluations of combination prevention programmes, which limit our understanding of how and why they work 6 10. One reason may be that it can be more challenging to measure empowerment, for example, than to measure traditional HIV prevention outcome such as HIV incidence, protected intercourse and recent HIV testing 11 13–19. Besides, there are no widely accepted or standardised methods to measure broad concepts such as improved agency to demand human rights and increased experiences of inclusion despite being core components of a programme’s overall strategy 18 19.…”

Seizing opportunities for intervention: Changing HIV-related knowledge among men who have sex with men and transgender women attending trusted community centers in Nigeria

“…A 2017 systematic review of 17 internet-based interventions that targeted HIV knowledge and risk behaviors among young MSM, demonstrated that all except one reported statistically significant changes in at least one primary outcome, indicating that such interventions showed promise to affect change among this population. [36].…”