The study is a pragmatic, randomized controlled trial design to evaluate an online video series developed by a community-based organization in Singapore for gay, bisexual and queer men. A total of 300 HIV-negative, gay, bisexual and queer men in Singapore aged 18 to 29 years old will be recruited with the assistance of the partner community-based organization (CBO), Action for AIDS Singapore. Recruitment will utilize both online and offline channels, and with the help of other CBOs in Singapore. Participants should also not have watched the video prior to their participation in this study, which will be ascertained through a questionnaire. Participants will subsequently be randomized into the intervention arm (n=150) and the control arm (n=150). The treatment group (n=150) will be assigned the intervention along with sexual health information via a pamphlet, while the control group (n=150) will be assigned only the sexual health information via a pamphlet. This will be conducted through block randomization.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
300
People Like Us miniseries incorporates key sexual health messages to: 1. Increase viewers' knowledge and perceptions of HIV and other STI risk; 2. Address homophobia and sexual orientation disclosure; 3. Increase safer-sex negotiation self-efficacy; 4. Promote positive attitudes towards condom use and other safe sex behaviors; 5. Build skills and self-efficacy for practicing safer sex; 6. Provide information on HIV and other STI testing and its benefits; 7. Provide information on resources for HIV/STI testing and other mental health services; 8. Model appropriate behaviors around practicing safer sex. Each video in the six-part series ends with an educational video segment featuring the managers of Action for AIDS and Gayhealth.sg, who provide a brief synopsis of the episode and cover key points relevant to mental and sexual health for GBQ men.
The control group will be provided with an e-pamphlet on sexual wellness catered to GBMSM. This e-pamphlet has been developed by the National Skin Centre and Department of Sexually Transmitted Infections Clinic specifically for information on sexual wellness among GBMSM. It comprises segments on HIV/STI symptoms, etiology, information on how to seek help for HIV/STI, behavioral and biomedical methods of HIV prevention.
National University of Singapore
Singapore, Singapore
Change in intention to test for HIV at 3 months
Participants are asked: "How likely are you to get tested for HIV in the next three months?"; to which they may respond: 1. Extremely unlikely to get tested 2. Very unlikely to get tested 3. Somewhat unlikely to get tested 4. Somewhat likely to get tested 5. Very likely to get tested 6. Extremely likely to get tested
Time frame: 3 months
Change in intention to test for HIV at 6 months
Participants are asked: "How likely are you to get tested for HIV in the next three months?"; to which they may respond: 1. Extremely unlikely to get tested 2. Very unlikely to get tested 3. Somewhat unlikely to get tested 4. Somewhat likely to get tested 5. Very likely to get tested 6. Extremely likely to get tested
Time frame: 6 months
Change in intention to test for Syphilis at 3 months
Participants are asked: "How likely are you to get tested for Syphilis in the next three months?"; to which they may respond: 1. Extremely unlikely to get tested 2. Very unlikely to get tested 3. Somewhat unlikely to get tested 4. Somewhat likely to get tested 5. Very likely to get tested 6. Extremely likely to get tested
Time frame: 3 months
Change in intention to test for Syphilis at 6 months
Participants are asked: "How likely are you to get tested for Syphilis in the next three months?"; to which they may respond: 1. Extremely unlikely to get tested 2. Very unlikely to get tested 3. Somewhat unlikely to get tested 4. Somewhat likely to get tested 5. Very likely to get tested 6. Extremely likely to get tested
Time frame: 6 months
Change in intention to test for Chlamydia and Gonorrhea at 3 months
Participants are asked: "How likely are you to get tested for Chlamydia and Gonorrhea in the next three months?"; to which they may respond: 1. Extremely unlikely to get tested 2. Very unlikely to get tested 3. Somewhat unlikely to get tested 4. Somewhat likely to get tested 5. Very likely to get tested 6. Extremely likely to get tested
Time frame: 3 months
Change in intention to test for Chlamydia and Gonorrhea at 6 months
Participants are asked: "How likely are you to get tested for Chlamydia and Gonorrhea in the next three months?"; to which they may respond: 1. Extremely unlikely to get tested 2. Very unlikely to get tested 3. Somewhat unlikely to get tested 4. Somewhat likely to get tested 5. Very likely to get tested 6. Extremely likely to get tested
Time frame: 6 months
HIV testing at 3 months
Participants are asked: "When did you go for you last (most recent) voluntary HIV test?"; to which they may respond: 1. Never 2. In the last 3 months 3. In the last 6 months 4. 6 to 12 months ago 5. More than 1 year ago
Time frame: 3 months
HIV testing at 6 months
Participants are asked: "When did you go for you last (most recent) voluntary HIV test?"; to which they may respond: 1. Never 2. In the last 3 months 3. In the last 6 months 4. 6 to 12 months ago 5. More than 1 year ago
Time frame: 6 months
Syphilis testing at 3 months
Participants are asked: "When did you go for you last (most recent) voluntary Syphilis test?"; to which they may respond: 1. Never 2. In the last 3 months 3. In the last 6 months 4. 6 to 12 months ago 5. More than 1 year ago
Time frame: 3 months
Syphilis testing at 6 months
Participants are asked: "When did you go for you last (most recent) voluntary Syphilis test?"; to which they may respond: 1. Never 2. In the last 3 months 3. In the last 6 months 4. 6 to 12 months ago 5. More than 1 year ago
Time frame: 6 months
Chlamydia and Gonorrhea testing at 3 months
Participants are asked: "When did you go for you last (most recent) voluntary Chlamydia or Gonorrhea test?"; to which they may respond: 1. Never 2. In the last 3 months 3. In the last 6 months 4. 6 to 12 months ago 5. More than 1 year ago
Time frame: 3 months
Chlamydia and Gonorrhea testing at 6 months
Participants are asked: "When did you go for you last (most recent) voluntary Chlamydia or Gonorrhea test?"; to which they may respond: 1. Never 2. In the last 3 months 3. In the last 6 months 4. 6 to 12 months ago 5. More than 1 year ago
Time frame: 6 months
Self-reported regularity of HIV testing at 3 months
Participants are asked: "On average, how regularly do you test for HIV?"; to which they may respond: 1. I do not test regularly 2. Once every few years 3. Once a year 4. Once every 6 months 5. Once every 3 months 6. Once a month
Time frame: 3 months
Self-reported regularity of HIV testing at 6 months
Participants are asked: "On average, how regularly do you test for HIV?"; to which they may respond: 1. I do not test regularly 2. Once every few years 3. Once a year 4. Once every 6 months 5. Once every 3 months 6. Once a month
Time frame: 6 months
Self-reported regularity of Syphilis testing at 3 months
Participants are asked: "On average, how regularly do you test for Syphilis?"; to which they may respond: 1. I do not test regularly 2. Once every few years 3. Once a year 4. Once every 6 months 5. Once every 3 months 6. Once a month
Time frame: 3 months
Self-reported regularity of Syphilis testing at 6 months
Participants are asked: "On average, how regularly do you test for Syphilis?"; to which they may respond: 1. I do not test regularly 2. Once every few years 3. Once a year 4. Once every 6 months 5. Once every 3 months 6. Once a month
Time frame: 6 months
Self-reported regularity of Chlamydia and Gonorrhea testing at 3 months
Participants are asked: "On average, how regularly do you test for Chlamydia and Gonorrhea?"; to which they may respond: 1. I do not test regularly 2. Once every few years 3. Once a year 4. Once every 6 months 5. Once every 3 months 6. Once a month
Time frame: 3 months
Self-reported regularity of Chlamydia and Gonorrhea testing at 6 months
Participants are asked: "On average, how regularly do you test for Chlamydia and Gonorrhea?"; to which they may respond: 1. I do not test regularly 2. Once every few years 3. Once a year 4. Once every 6 months 5. Once every 3 months 6. Once a month
Time frame: 6 months
Risk perception for HIV
Risk perception is measures through a questions (slider scale) that asks participants: "How much risk do you think you are at of getting HIV?". Participants will rate this from 0 to 10 (0=no risk at all; 10=very high risk)
Time frame: 3 months and 6 months
Risk perception for other sexually transmitted infections
Risk perception is measures through a questions (slider scale) that asks participants: "How much risk do you think you are at of getting other sexually transmitted infections?". Participants will rate this from 0 to 10 (0=no risk at all; 10=very high risk)
Time frame: 3 months and 6 months
Knowledge of HIV Pre-Exposure Prophylaxis
Participants are tested on their knowledge of HIV Pre-Exposure Prophylaxis by providing a response (1=True; 2=False; 3=I do not know) to two questions: "HIV Pre-Exposure Prophylaxis is an effective means of preventing HIV infection". The correct answer is "True". "HIV Pre-Exposure Prophylaxis can also reduce the chances of acquiring other STIs". The correct answer is "False". Each correct answer provides a score of 1 point.
Time frame: 3 months and 6 months
Knowledge of risks associated with acquiring other sexually transmitted infections
Participants are tested on their knowledge of other sexually transmitted infections by providing a response (1=True; 2=False; 3=I do not know) to three questions: "Gonorrhea can be transmitted through oral sex". The correct answer is "True". "Chemsex, or the use of substances during sex, often increases a person's risk of engaging in risky sexual behavior and acquiring HIV or other STIs" The correct answer is "True". "There is a/are clinics in Singapore where I can test anonymously for HIV and Syphilis". The correct answer is "True". Each correct answer provides a score of 1 point.
Time frame: 3 months and 6 months
Knowledge of HIV
Participants are tested on their knowledge of HIV by providing a response (1=True; 2=False; 3=I do not know) to two questions: "An HIV-positive individual who has achieved viral suppression or an 'undetectable' viral load has almost zero chances of transmitting the virus to someone else through sexual intercourse". The correct answer is "True". "An HIV-positive individual on effective treatment can live a long, healthy, and productive life". The correct answer is "True". Each correct answer provides a score of 1 point.
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Time frame: 3 months and 6 months
Connectedness to LGBT Community
This is an 8-item scale adapted from Frost \& Meyer (2012) that measures a participant's self-perceived connectedness to the LGBT community on a 4-point Likert Scale. The measure is a sum score of all 8 items.
Time frame: 3 months and 6 months
Modified Self-Concealment Scale
This is a 7-item scale adapted from Scrimshaw (2013) that measures a participant's self-concealment of their sexual orientation on a 5-point Likert Scale. The measure is a sum score of all 7 items.
Time frame: 3 months and 6 months
Consistent condom use for anal sex with casual partners or sex workers
This is assessed by the question, "In the last 3 months, how often did you use a condom when having anal sex with a casual partner?" or "In the last 3 months, how often did you use a condom when having anal sex with a sex worker/money boy?" (Options are always, more than half the time, about half the time, less than half the time, never used a condom). Participants who give the answer 'Always' are classified as having consistent condom usage for anal sex with causal partners or sex workers.
Time frame: 3 months and 6 months
Incidence of sexually transmitted infections
This is defined as self-reporting a diagnosis of Syphilis, Chlamydia, Genital Herpes, Genital Warts, Hepatitis C, or Gonorrhea at the 3-month or 6-month follow-up.
Time frame: 3 months and 6 months
Perceived Homophobia
This is a 6-item scale adapted from Smolenski, Ross, Risser, and Rosser (2009) that measures a participant's self-concealment of their sexual orientation. The measure is a sum score of all 6 items.
Time frame: 3 months and 6 months
Internalized Homophobia
This is a 5-item scale adapted from Frost and Meyer (2013) that measures a participant's internalized homophobia on a 4-point Likert Scale. The measure is a sum score of all 5 items.
Time frame: 3 months and 6 months
HIV testing self-efficacy
This is a 10-item scale adapted from Jamil and colleagues (2015) that measures a participant's self-efficacy in HIV testing on a 5-point Likert Scale. The measure is a sum score of all 10 items.
Time frame: 3 months and 6 months
HIV testing social norms
This is a 9-item scale adapted from Pettifor and colleagues (2010) that measures a participant's perceptions on norms around HIV testing on a 4-point Likert Scale. The measure is a sum score of all 9 items.
Time frame: 3 months and 6 months