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AIDS and Behavior
Published in: AIDS and Behavior 6/2019

01-06-2019 | Human Immunodeficiency Virus | Original Paper

A Preliminary Randomized Controlled Trial of Game Plan, A Web Application to Help Men Who Have Sex with Men Reduce Their HIV Risk and Alcohol Use

Authors: Tyler B. Wray, Christopher W. Kahler, Erik M. Simpanen, Don Operario

Published in: AIDS and Behavior | Issue 6/2019

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Abstract

Alcohol use is a key risk factor for HIV infection among men who have sex with men (MSM). Past studies show that brief motivational interventions (BMI) can increase the use of prevention methods (e.g., condoms), reduce alcohol use, and can be adapted for web-based delivery. However, few studies have explored these interventions’ effects in MSM. Forty high-risk, heavy drinking MSM who sought rapid HIV testing were randomly assigned to receive either (1) standard post-test counseling (SPC) alone, or (2) SPC plus Game Plan (GP), a tablet tablet-based BMI for alcohol use and HIV risk. Over three months of follow-up, GP participants reported 24% fewer heavy drinking days, 17% fewer alcohol problems, and 50% fewer new anal sex partners than controls. GP participants also reported fewer high-risk condomless anal sex events than controls, but these differences were not significant. These initial results suggest that web-based BMIs may be promising tools to help MSM reduce health risk behaviors.
Literature
1.
2.
Centers for Disease Control and Prevention. HIV among African American gay and bisexual men. Atlanta: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; 2017.
3.
4.
5.
Punyacharoensin N, Edmunds WJ, De Angelis D, Delpech V, Hart G, Elford J, et al. Effect of pre-exposure prophylaxis and combination HIV prevention for men who have sex with men in the UK: a mathematical modelling study. Lancet HIV. 2016;3(2):e94–104.PubMedCrossRef
6.
7.
Siegler A, Mouhanna F, Giler R, McCallister S, Yeung H, Jones J, et al., editors. Distribution of active PrEP prescriptions and the PrEP-to-need ratio, US, Q2 2017. Conference on Retroviruses and Opportunistic Infections (CROI); 2018; Boston.
8.
Reece M, Herbenick D, Schick V, Sanders SA, Dodge B, Fortenberry JD. Condom use rates in a national probability sample of males and females ages 14 to 94 in the United States. J Sex Med. 2010;7(s5):266–76.PubMedCrossRef
9.
Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med. 2016;375(9):830–9.PubMedPubMedCentralCrossRef
10.
Garofalo R, Herrick A, Mustanski BS, Donenberg GR. Tip of the iceberg: young men who have sex with men, the Internet, and HIV risk. Am J Public Health. 2007;97(6):1113.PubMedPubMedCentralCrossRef
11.
Gold RS, Skinner MJ, Grant PJ, Plummer DC. Situational factors and thought processes associated with unprotected intercourse in gay men. Psychol Health. 1991;5(4):259–78.CrossRef
12.
Blumenthal J, Mulvihill DE, Jain S, Graber S, Hanashiro M, Ellorin E, et al., editors. HIV risk perception among men who have sex with men: A randomized controlled trial. Conference on Retroviruses and Opportunistic Infections (CROI); March, 2018; Boston.
13.
MacKellar DA, Valleroy LA, Secura GM, Behel S, Bingham T, Celentano DD, et al. Unrecognized HIV infection, risk behaviors, and perceptions of risk among young men who have sex with men: opportunities for advancing HIV prevention in the third decade of HIV/AIDS. JAIDS. 2005;38(5):603–14.PubMed
14.
MacKellar DA, Valleroy LA, Secura GM, Behel S, Bingham T, Celentano DD, et al. Perceptions of lifetime risk and actual risk for acquiring HIV among young men who have sex with men. AIDS Behav. 2007;11(2):263–70.PubMedCrossRef
15.
Koblin BA, Husnik MJ, Colfax G, Huang Y, Madison M, Mayer K, et al. Risk factors for HIV infection among men who have sex with men. AIDS. 2006;20(5):731–9.PubMedCrossRef
16.
Sander PM, Cole SR, Stall RD, Jacobson LP, Eron JJ, Napravnik S, et al. Joint effects of alcohol consumption and high-risk sexual behavior on HIV seroconversion among men who have sex with men. AIDS (London, England). 2013;27(5):815.PubMedCentralCrossRef
17.
Baliunas D, Rehm J, Irving H, Shuper P. Alcohol consumption and risk of incident human immunodeficiency virus infection: a meta-analysis. Int J Public Health. 2010;55(3):159–66.PubMedCrossRef
18.
Rehm J, Shield KD, Joharchi N, Shuper PA. Alcohol consumption and the intention to engage in unprotected sex: systematic review and meta-analysis of experimental studies. Addiction. 2012;107(1):51–9.PubMedCrossRef
19.
Scott-Sheldon LA, Carey KB, Cunningham K, Johnson BT, Carey MP, Team MR. Alcohol use predicts sexual decision-making: a systematic review and meta-analysis of the experimental literature. AIDS Behav. 2016;20(1):19–39.PubMedCentralCrossRef
20.
Maisto SA, Palfai T, Vanable PA, Heath J, Woolf-King SE. The effects of alcohol and sexual arousal on determinants of sexual risk in men who have sex with men. Arch Sex Behav. 2012;41(4):971–86.PubMedCrossRef
21.
Shuper PA, Joharchi N, Monti PM, Loutfy M, Rehm J. Acute alcohol consumption directly increases HIV transmission risk: a randomized controlled experiment. J Acquir Immune Defic Syndr. 2017;76(5):493–500.PubMedPubMedCentralCrossRef
22.
Kahler CW, Wray TB, Pantalone DW, Kruis RD, Mastroleo NR, Monti PM, et al. Daily associations between alcohol use and unprotected anal sex among heavy drinking HIV-positive men who have sex with men. AIDS Behav. 2015;19(3):422–30.PubMedPubMedCentralCrossRef
23.
Vosburgh HW, Mansergh G, Sullivan PS, Purcell DW. A review of the literature on event-level substance use and sexual risk behavior among men who have sex with men. AIDS Behav. 2012;16(6):1394–410.PubMedCrossRef
24.
Noar SM. Behavioral interventions to reduce HIV-related sexual risk behavior: review and synthesis of meta-analytic evidence. AIDS Behav. 2008;12(3):335–53.PubMedCrossRef
25.
Johnson WD, Holtgrave DR, McClellan WM, Flanders WD, Hill AN, Goodman M. HIV intervention research for men who have sex with men: a 7–year update. AIDS Educ Prev. 2005;17(6):568–89.PubMedCrossRef
26.
Johnson WD, Diaz RM, Flanders WD, Goodman M, Hill AN, Holtgrave D, et al. Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database Syst Rev. 2008;3(3).
27.
Moyer A, Finney JW, Swearingen CE, Vergun P. Brief interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations. Addiction. 2002;97(3):279–92.PubMedCrossRef
28.
Bien TH, Miller WR, Tonigan JS. Brief interventions for alcohol problems: a review. Addiction. 1993;88(3):315–35.PubMedCrossRef
29.
Carey KB, Scott-Sheldon LA, Carey MP, DeMartini KS. Individual-level interventions to reduce college student drinking: a meta-analytic review. Addict Behav. 2007;32(11):2469–94.PubMedPubMedCentralCrossRef
30.
Vasilaki EI, Hosier SG, Cox WM. The efficacy of motivational interviewing as a brief intervention for excessive drinking: a meta-analytic review. Alcohol Alcohol. 2006;41(3):328–35.PubMedCrossRef
31.
Hasin DS, Aharonovich E, O’leary A, Greenstein E, Pavlicova M, Arunajadai S, et al. Reducing heavy drinking in HIV primary care: a randomized trial of brief intervention, with and without technological enhancement. Addiction. 2013;108(7):1230–40.PubMedPubMedCentralCrossRef
32.
Aharonovich E, Hatzenbuehler ML, Johnston B, O’Leary A, Morgenstern J, Wainberg ML, et al. A low-cost, sustainable intervention for drinking reduction in the HIV primary care setting. AIDS Care. 2006;18(6):561–8.PubMedCrossRef
33.
Monti PM, Mastroleo NR, Barnett NP, Colby SM, Kahler CW, Operario D. Brief motivational intervention to reduce alcohol and HIV/sexual risk behavior in emergency department patients: a randomized controlled trial. J Consult Clin Psychol. 2016;84(7):580.PubMedPubMedCentralCrossRef
34.
Kahler CW, Pantalone DW, Mastroleo NR, Liu T, Bove G, Ramratnam B, et al. Motivational interviewing with personalized feedback to reduce alcohol use in HIV-infected men who have sex with men: a randomized controlled trial. J Consult Clin Psychol. 2018;86(8):645.PubMedPubMedCentralCrossRef
35.
Coates TJ, Richter L, Caceres C. Behavioural strategies to reduce HIV transmission: how to make them work better. Lancet. 2008;23(372):669–84.CrossRef
36.
Higa DH, Crepaz N, Marshall KJ, Kay L, Vosburgh HW, Spikes P, et al. A systematic review to identify challenges of demonstrating efficacy of HIV behavioral interventions for gay, bisexual, and other men who have sex with men (MSM). AIDS Behav. 2013;17(4):1231–44.PubMedPubMedCentralCrossRef
37.
Lustria ML, Cortese J, Noar SM, Glueckauf RL. Computer-tailored health interventions delivered over the Web: review and analysis of key components. Patient Educ Couns. 2009;74(2):156–73.PubMedCrossRef
38.
Miller MB, Leffingwell T, Claborn K, Meier E, Walters S, Neighbors C. Personalized feedback interventions for college alcohol misuse: an update of Walters & Neighbors (2005). Psychol Addict Behav. 2013;27(4):909–20.PubMedCrossRef
39.
40.
Wagener TL, Leffingwell TR, Mignogna J, Mignogna MR, Weaver CC, Cooney NJ, et al. Randomized trial comparing computer-delivered and face-to-face personalized feedback interventions for high-risk drinking among college students. J Subst Abuse Treat. 2012;43(2):260–7.PubMedCrossRef
41.
Carey KB, Carey MP, Henson JM, Maisto SA, DeMartini KS. Brief alcohol interventions for mandated college students: comparison of face-to-face counseling and computer-delivered interventions. Addiction. 2011;106(3):528–37.PubMedCrossRef
42.
Pedersen ER, Parast L, Marshall GN, Schell TL, Neighbors C. A randomized controlled trial of a web-based, personalized normative feedback alcohol intervention for young-adult veterans. J Consult Clin Psychol. 2017;85(5):459–70.PubMedPubMedCentralCrossRef
43.
Carey KB, Scott-Sheldon LA, Elliott JC, Garey L, Carey MP. Face-to-face versus computer-delivered alcohol interventions for college drinkers: a meta-analytic review, 1998 to 2010. Clin Psychol Rev. 2012;32(8):690–703.PubMedPubMedCentralCrossRef
44.
Rooke S, Thorsteinsson E, Karpin A, Copeland J, Allsop D. Computer-delivered interventions for alcohol and tobacco use: a meta-analysis. Addiction. 2010;105(8):1381–90.PubMedCrossRef
45.
Schnall R, Travers J, Rojas M, Carballo-Diéguez A. eHealth interventions for HIV prevention in high-risk men who have sex with men: a systematic review. J Med Internet Res. 2014;16(5):e134.PubMedPubMedCentralCrossRef
46.
Barnett NP, Monti PM, Wood MD. Motivational interviewing for alcohol-involved adolescents in the emergency room. Innov Adolesc Subst Abuse Interv. 2001;143–68.
47.
Barnett NP, Goldstein AL, Murphy JG, Colby SM, Monti PM. “I’ll never drink like that again”: characteristics of alcohol-related incidents and predictors of motivation to change in college students. J Stud Alcohol. 2006;67(5):754.PubMedPubMedCentralCrossRef
48.
Mun EY, White HR, Morgan TJ. Individual and situational factors that influence the efficacy of personalized feedback substance use interventions for mandated college students. J Consult Clin Psychol. 2009;77(1):88.PubMedPubMedCentralCrossRef
49.
Carey KB, Scott-Sheldon LA, Garey L, Elliott JC, Carey MP. Alcohol interventions for mandated college students: a meta-analytic review. J Consul Clin Psychol. 2016;84:619.CrossRef
50.
Walton MA, Goldstein AL, Chermack ST, McCammon RJ, Cunningham RM, Barry KL, et al. Brief alcohol intervention in the emergency department: moderators of effectiveness. J Stud Alcohol Drugs. 2008;69(4):550–60.PubMedCrossRef
51.
Mimiaga MJ, Goldhammer H, Belanoff C, Tetu AM, Mayer KH. Men who have sex with men: perceptions about sexual risk, HIV and sexually transmitted disease testing, and provider communication. Sex Transm Dis. 2007;34(2):113–9.PubMedCrossRef
52.
Spielberg F, Branson BM, Goldbaum GM, Lockhart D, Kurth A, Celum CL, et al. Overcoming barriers to HIV testing: preferences for new strategies among clients of a needle exchange, a sexually transmitted disease clinic, and sex venues for men who have sex with men. J Acquir Immune Defic Syndr. 2003;32(3):318–27.PubMedCrossRef
53.
Kellerman SE, Lehman JS, Lansky A, Stevens MR, Hecht FM, Bindman AB, et al. HIV testing within at-risk populations in the United States and the reasons for seeking or avoiding HIV testing. J Acquir Immune Defic Syndr. 2002;31(2):202–10.PubMedCrossRef
54.
Centers for Disease Control and Prevention. Revised guidelines for HIV counseling, testing, and referral. MMWR Recomm Rep. 2001;50(RR-19):1.
55.
Kamb ML, Dillon BA, Fishbein M, Willis KL. Quality assurance of HIV prevention counseling in a multi-center randomized controlled trial. Project RESPECT Study Group. Public Health Rep. 1996;111(Suppl 1):99–107.PubMedPubMedCentral
56.
Metsch LR, Feaster DJ, Gooden L, Schackman BR, Matheson T, Das M, et al. Effect of risk-reduction counseling with rapid HIV testing on risk of acquiring sexually transmitted infections: the AWARE randomized clinical trial. JAMA. 2013;310(16):1701–10.PubMedPubMedCentralCrossRef
57.
Wray TB, Kahler CW, Simpanen EM, Operario D. Game plan: a web application to help men who have sex with men reduce their HIV risk and alcohol use. JMIR Formative Res. 2018.
58.
Cooper A, Reimann R, Cronin D. About Face 3: The Essentials of Interaction Design. Indianapolis: Wiley; 2007.
59.
Goodwin K. Designing for the digital age: how to create human-centered products and services: John Wiley & Sons; 2011.
60.
Noar SM, Black HG, Pierce LB. Efficacy of computer technology-based HIV prevention interventions: a meta-analysis. AIDS. 2009;23(1):107–15.PubMedCrossRef
61.
Moore CG, Carter RE, Nietert PJ, Stewart PW. Recommendations for planning pilot studies in clinical and translational research. Clin Transl Sci. 2011;4(5):332–7.PubMedPubMedCentralCrossRef
62.
Whitehead AL, Julious SA, Cooper CL, Campbell MJ. Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable. Stat Methods Med Res. 2016;25(3):1057–73.PubMedCrossRef
63.
64.
Miller WR, Rollnick S. Motivational interviewing: preparing people to change addictive behavior. New York: Guilford Press; 1991.
65.
66.
Sobell L, Sobell M. Timeline followback user’s guide: a calendar method for assessing alcohol and drug use. Toronto: Addiction Research Foundation; 1996.
67.
Sobell LC, Sobell MB. Timeline follow-back. Measuring alcohol consumption. Berlin: Springer; 1992. p. 41–72.CrossRef
68.
Schroder KE, Johnson CJ, Wiebe JS. Interactive voice response technology applied to sexual behavior self-reports: a comparison of three methods. AIDS Behav. 2007;11(2):313–23.PubMedCrossRef
69.
Carey MP, Carey K, Maisto S, Gordon C, Weinhardt L. Assessing sexual risk behaviour with the Timeline Followback (TLFB) approach: continued development and psychometric evaluation with psychiatric outpatients. Int J STD AIDS. 2001;12(6):365–75.PubMedPubMedCentralCrossRef
70.
Wray TB, Adia AC, Perez AE, Simpanen E, Woods L-A, Celio MA, et al. Timeline: a web application for assessing the timing and details of health behaviors. Am J Drug Alcohol Abuse 2018.
71.
Kahler CW, Hustad J, Barnett NP, Strong DR, Borsari B. Validation of the 30-day version of the Brief Young Adult Alcohol Consequences Questionnaire for use in longitudinal studies. J Stud Alcohol Drugs. 2008;69(4):611–5.PubMedCrossRef
72.
Little R, Yau L. Intent-to-treat analysis for longitudinal studies with drop-outs. Biometrics. 1996;52:1324–33.PubMedCrossRef
73.
Kuerbis AN, Schaumberg K, Davis CM, Hail L, Morgenstern J. Unpacking personalized feedback: an exploratory study of the impact of its components and the reactions it elicits among problem drinking men who have sex with men. Subst Use Misuse. 2014;49(4):383–94.PubMedCrossRef
74.
Rounsaville BJ, Carroll KM, Onken LS. A stage model of behavioral therapies research: getting started and moving on from stage I. Clin Psychol Sci Pract. 2001;8(2):133–42.CrossRef
75.
Hjorthøj CR, Fohlmann A, Larsen AM, Arendt M, Nordentoft M. Correlations and agreement between delta-9-tetrahydrocannabinol (THC) in blood plasma and timeline follow-back (TLFB)-assisted self-reported use of cannabis of patients with cannabis use disorder and psychotic illness attending the CapOpus randomized clinical trial. Addiction. 2012;107(6):1123–31.PubMedCrossRef
76.
Hjorthøj CR, Hjorthøj AR, Nordentoft M. Validity of timeline follow-back for self-reported use of cannabis and other illicit substances: systematic review and meta-analysis. Addict Behav. 2012;37(3):225–33.PubMedCrossRef
77.
Simons JS, Wills TA, Emery NN, Marks RM. Quantifying alcohol consumption: self-report, transdermal assessment, and prediction of dependence symptoms. Addict Behav. 2015;50:205–12.PubMedPubMedCentralCrossRef
78.
Wray TB, Kahler CW, Monti PM. Using ecological momentary assessment (EMA) to study sex events among very high-risk men who have sex with men (MSM). AIDS Behav. 2016;20(10):2231–42.PubMedPubMedCentralCrossRef
79.
Viel G, Boscolo-Berto R, Cecchetto G, Fais P, Nalesso A, Ferrara SD. Phosphatidylethanol in blood as a marker of chronic alcohol use: a systematic review and meta-analysis. Int J Mol Sci. 2012;13(11):14788–812.PubMedPubMedCentralCrossRef
80.
Stewart SH, Law TL, Randall PK, Newman R. Phosphatidylethanol and alcohol consumption in reproductive age women. Alcohol Clin Exp Res. 2010;34(3):488–92.PubMedCrossRef
81.
Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW, Lyss SB, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. Morb Mortal Week Rep. 2006;55(14):1–4.
82.
Scott-Sheldon LA, Carey KB, Johnson BT, Carey MP, Team MR. Behavioral interventions targeting alcohol use among people living with HIV/AIDS: a systematic review and meta-analysis. AIDS Behav. 2017;21(2):126–43.PubMedPubMedCentralCrossRef
Metadata
Title
A Preliminary Randomized Controlled Trial of Game Plan, A Web Application to Help Men Who Have Sex with Men Reduce Their HIV Risk and Alcohol Use
Authors
Tyler B. Wray
Christopher W. Kahler
Erik M. Simpanen
Don Operario
Publication date
01-06-2019
Publisher
Springer US
Published in
AIDS and Behavior / Issue 6/2019
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-019-02396-w

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