An informative HIV risk reduction website targeted at young black men who have sex with men (BMSM).
HealthMPowerment.org was iteratively developed with feedback from young BMSM to fill the need for information about wellbeing and HIV risk reduction resources for young BMSM. HealthMPowerment.org engages young BMSM using social, informational, and self-reflective features that address HIV risk behaviors, health, and wellbeing, including quizzes, articles, user-made videos, resources, Q&A, decisional balance exercises, journal writing activities, user reviews of gay-friendly businesses and health services, a discussion forum, self-report risk assessments, and an events calendar. Users accumulate points by using the site that can be redeemed in a site store.
Integrated Model of Behavior Theory
HIV Risk Behaviors
Young Adults (18-30)
Summary: Young BMSM were recruited using online ads, listservs, fliers and clinician referral. To be eligible to participate men had to be between the ages of 18 and 30, identify as black or African American, and report having had anal or oral intercourse with another man in the past year. Three focus groups of 5 to 8 participants were conducted to gain insight on risk behaviors and service needs. Focus groups included discussion of sexual communication, barriers to safer sex, HIV prevention, and methods of HIV prevention. Eight participants were also interviewed to review existing HIV/STI websites. Focus group participants felt that there was a lack of education about gay sexuality when they were growing up, and that the Internet was an important source of information for them. Participants also noted that scare tactics are not effective educational tools, that facts and statistics are more suitable teaching tools, and that the aesthetics of a website are important determinants of whether they will continue to use the website. Interview participants that reviewed existing websites described language was not relevant, designs that were not engaging, and content not properly targeted to BMSM. Participants who were interviewed also assisted researchers in picking a name and logo for HealthMPowerment.org.
Seven participants were recruited to use the final HealthMPowerment.org program to provide feedback.
Participants the web-based program favorably, particularly the customizable avatar and the private journals. Participants liked that quizzes were based on a relatable subculture and found them engaging and informative. Based on usability feedback, researchers streamlined the set-up process, added more avatar customization options, edited the design to be more appealing, and added a second layer of security for personal journals and new content areas.
Take Away: Users found HealthMPowerment.org acceptable in the first rounds of user testing and provided feedback that informed changes to the web-based program for future testing.
HealthMPowerment.org: Feasibility and acceptability of delivering an internet intervention to young black men who have sex with men.
Summary: Researchers used fliers, online postings, referrals from clinicians, and community outreach to enroll 50 young BMSM to examine the feasibility and acceptability of HealthMPowerment.org. Eligible participants were men aged 18 and 30 years who reported having had sex with another man in the past year, and identified as black or African American. Participants were randomized to use the website or to receive a list of alternative informative HIV/STI websites. Participants were instructed to use the website for at least 30 minutes a week for four weeks and complete a log of the time they spent using the website each week. Participants completed a baseline assessment and follow-up assessments at one and three months after baseline. Assessments included questions about participants’ internet usage, sexual behavior, intentions and motivation to use condoms, self-efficacy, HIV/AIDS knowledge, and depressive symptoms. At the one-month follow-up participants who had used the website were asked about their satisfaction with and suggestions for the website. Retention was 78% at 3-month follow-up. Participants reported being satisfied with the website and finding it easy to use. Participants reported that the website filled a gap in prevention materials for young BMSM. Though participants were also satisfied with the alternative websites, participants indicated that they did not feel these materials were targeted to BMSM. Participants suggested that the websites include social networking functions, more interactive functions, and mobile access. Participants in both groups reported increases in condom usage and reductions in numbers of male sex partners one month after baseline.
Take Away: Participants reported that HealthMPowerment.org was acceptable and usable, but there were no differences in change in HIV risk behaviors between the intervention and control group.
HealthMPowerment.org: Building community through a mobile optimized, online health promotion intervention.
Summary: This pilot evaluated the feasibility, acceptability, and preliminary effectiveness of HealthMPowerment.org with young BMSM and transgender women. Researchers used fliers and posts on Facebook and Craigslist to recruit 15 participants. Eligible participants were people born biologically male aged 18 and 30 years who reported having had sex with another man in the past year, identified as black or African American, and had access to a mobile device with text, Internet, or mobile application capabilities. Two participants self-identified in a baseline demographics survey as a transgender or transitioning woman. Participants were asked to use the website for at least an hour a week for four weeks. At baseline and post-intervention participants completed assessments of HIV status, risk behaviors, internet usage behaviors, condom use self-efficacy, attitudes towards condom use and safe sex norms, socials support and isolation, depressive symptoms, and internalized homophobia. Participants’ evaluation and satisfaction with the website were also evaluated. Researchers tracked participants’ use of the website and collected aggregate use data. Researchers achieved 100% retention at the four-week follow up. The website was visited 544 times during the four-week study and participants spent an average of 9:21 minutes on the site and visited an average of 20 pages per visit. Seven participants continued using the site for a week after the 4-week study period until their usernames expired. There were significant improvements in participants’ reported social support, social isolation, and depressive symptoms. Other indicators, including HIV risk indicators, did not statistically improve.
Take Away: HealthMPowerment.org was feasible and acceptable to young BMSM and transgender women and may have improved mental health indicators that affect HIV risk behavior.