This study will test the effectiveness of a text message-based intervention on human immunodeficiency virus (HIV) testing behaviors among adolescent (13-19 year old). To test the effectiveness on HIV testing behaviors we will randomize participants to the treatment or an attention matched information only control arm and asses our primary effectiveness outcome of objective HIV testing (e.g., photo of test results).
Adolescents (ages 13-19) are disproportionately affected by HIV, accounting for 21% of all new infections in the U.S. in 2019. Although CDC and USPTF recommend HIV screening among adolescents, testing rates are very low (\<10% have ever been tested). Furthermore, in the U.S., 44% of 13-24-year-olds who are HIV-positive are unaware of their status - the highest percentage of undiagnosed infections of all age groups. As such there is a need for interventions that aim to increase HIV testing in adolescents. This study builds upon the work of a previous text-based sexual health intervention program called G2G. The G2G pilot randomized controlled trial showed adolescents in the active treatment arm were \>3x more likely to report being tested for HIV at follow-up compared to those in the control arm. Given the success of HIV testing behaviors in G2G this current study will aim to update G2G with the latest HIV prevention and testing science, tailor the intervention content so it is modern and inclusive of all adolescents, and test its effectiveness on the outcome of validated HIV testing (e.g., photo of HIV test result). We will test this in a nationwide randomized controlled trial with 360 adolescents aged 13-19. The primary efficacy outcome measure is HIV/STI testing via self report and objective evidence (e.g., photo of their test results) at 3 month and 6 month follow up surveys. Our study hypothesizes that participants assigned to the treatment arm of the intervention will have higher odds of having received an HIV test at 3 and 6 month follow up compared to those in the control arm. Ultimately, increased HIV testing in this group will mitigate transmission rates and improve the HIV prevention and care continua in this population.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
360
Our intervention will be an updated version of (Guy2Guy) G2G, a 2014 text messaging-based healthy sexuality and HIV prevention program specifically for adolescent males. The treatment arm of G2G was guided by the Information-Motivation-Behavioral Skills (IMB) model and proved to be efficacious at increasing HIV testing in 13-18 year old adolescent males. In this updated version we will continue to utilize the IMB model, but modernize the content to include updated HIV prevention information (e.g., novel methods of HIV testing, PrEP, PEP) and tailor the text-message content to meet the needs of all adolescents.
This information only control arm will consist of content and text messages focused on health behavior information, including mood, sexual health, substance use, and other health behaviors. It will be identical in length to the intervention arm.
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
RECRUITINGHIV/STI testing
Participants asked to self-report their history of HIV testing; scale item (No, I have never been tested for HIV/Yes, I have been tested HIV/ I do not know or not sure)
Time frame: Baseline, 3-months post-intervention, 6-months post-intervention
Most recent HIV test
Participants asked to provide date (open-ended) and outcome of most recent HIV test (scale item: negative/positive/I did not get the result)
Time frame: Baseline, 3-months post-intervention, 6-months post-intervention
Objective proof of HIV testing
Participants are asked to upload image of proof of most recent HIV test; open-ended (upload image)
Time frame: through study completion, an average of 9 months, 3-months post-intervention, 6-months post-intervention
Lifetime STI testing
Participants asked to self-report their history of STI testing; outcomes assessed via scale items (No, I have never been tested for any STI/Yes, I have been tested for at least one STI/ I do not know or not sure)
Time frame: Baseline, 3-months post-intervention, 6-months post-intervention
Lifetime number of sexual partners someone has had condom-less sex with
Incidence of Condomless Sex
Time frame: baseline, 3-months post-intervention, 6-months post-intervention
Ever taken PrEP
Binary-scale item (yes/no)
Time frame: baseline, 3-months post-intervention, 6-months post-intervention
Currently taking PrEP
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Binary-scale item (yes/no)
Time frame: baseline, 3-months post-intervention, 6-months post-intervention
Sexual Health Communications Scale
This is a 7-item select all that apply question which asks participants about their communicative experiences as an adolescent receiving services from medical healthcare providers, specifically around HIV testing, PrEP, STI and HIV prevention. Question adapted from the Sexual Health Communications Scale (Fisher et al., 2018). More selected options indicate better outcomes.
Time frame: baseline, 3-months post-intervention, 6-months post-intervention