Skip to main content

Advertisement

SpringerLink
Log in

The Effect of a Text Messaging Based HIV Prevention Program on Sexual Minority Male Youths: A National Evaluation of Information, Motivation and Behavioral Skills in a Randomized Controlled Trial of Guy2Guy

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

There is a paucity of literature documenting how the constructs of the Information–Motivation–Behavioral Skills (IMB) model are affected by exposure to technology-based HIV prevention programs. Guy2Guy, based on the IMB model, is the first comprehensive HIV prevention program delivered via text messaging and tested nationally among sexual minority adolescent males. Between June and November 2014, 302 14–18 year old gay, bisexual, and/or queer cisgender males were recruited across the US on Facebook and enrolled in a randomized controlled trial testing Guy2Guy versus an attention-matched control program. Among sexually inexperienced youth, those in the intervention were more than three times as likely to be in the “High motivation” group at follow-up as control youth (aOR = 3.13; P value = 0.04). The intervention effect was not significant when examined separately for those who were sexually active. HIV information did not significantly vary by experimental arm at 3 months post-intervention end, nor did behavioral skills for condom use or abstinence vary. The increase in motivation to engage in HIV preventive behavior for adolescent males with no prior sexual experience is promising, highlighting the need to tailor HIV prevention according to past sexual experience. The behavioral skills that were measured may not have reflected those most emphasized in the content (e.g., how to use lubrication to reduce risk and increase pleasure), which may explain the lack of detected intervention impact.

Clinical Trial Registration: ClinicalTrials.gov ID# NCT02113956.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. HIV among youth. Atlanta, GA: U.S. Department of Health & Human Services; 2015. http://www.cdc.gov/hiv/group/age/youth/index.html. Accessed 12 Jan 2016.

  2. Centers for Disease Control and Prevention. HIV Surveillance report, 2013. Atlanta, GA: U.S. Department of Health & Human Services; 2015. http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-vol-25.pdf. Accessed 24 Aug 2016.

  3. Johnson WD, Diaz RM, Flanders WD, et al. Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database Syst Rev. 2008. https://doi.org/10.1002/14651858.CD001230.pub2.

    Article  PubMed  Google Scholar 

  4. Lenhart A. Teens, social media, & technology overview 2015. Washington, DC: Pew Internet & American Life Project; 2015. http://www.pewinternet.org/2015/04/09/teens-social-media-technology-2015/. Accessed 28 May 2015.

  5. Bauermeister JA, Pingel ES, Jadwin-Cakmak L, et al. Acceptability and preliminary efficacy of a tailored online HIV/STI testing intervention for young men who have sex with men: the Get Connected! program. AIDS Behav Oct. 2015;19(10):1860–74.

    Article  Google Scholar 

  6. Aliabadi N, Carballo-Dieguez A, Bakken S, et al. Using the Information-Motivation-Behavioral Skills Model to guide the development of an HIV prevention smartphone application for high-risk MSM. AIDS Educ Prev. 2015;27(6):522–37.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Hightow-Weidman LB, Fowler B, Kibe J, et al. Healthmpowerment.org: development of a theory-based HIV/STI website for young black msm. AIDS Educ Prev. 2011;23(1):1–12.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Solorio R, Norton-Shelpuk P, Forehand M, Martinez M, Aguirre J. HIV prevention messages targeting young Latino immigrant MSM. AIDS Res Treat. 2014;2014:12.

    Google Scholar 

  9. Fonner VA, Dalglish SL, Kennedy CE, et al. Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS. 2016;30(12):1973–83.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Fisher JD, Fisher WA. Changing AIDS-risk behavior. Psychol Bull. 1992;111(3):455–74.

    Article  CAS  PubMed  Google Scholar 

  11. Fisher JD, Fisher WA. Theoretical approaches to individual-level change in HIV risk behavior. In: Peterson JL, DiClemente RJ, editors. Handbook of HIV prevention. New York, NY: Kluwer Academic/Plenum Press; 2000. p. 3–55.

    Chapter  Google Scholar 

  12. Fisher CM. Adapting the Information-Motivation-Behavioral Skills Model: predicting HIV-related sexual risk among sexual minority youth. Health Educ Behav. 2012;39(3):290–302.

    Article  PubMed  Google Scholar 

  13. Bazargan M, Stein JA, Bazargan-Hejazi S, Hindman DW. Using the Information-Motivation Behavioral Model to predict sexual behavior among underserved minority youth. J Sch Health. 2010;80(6):287–95.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Fisher JD, Fisher WA, Williams SS, Malloy TE. Empirical tests of an Information-Motivation-Behavioral Skills Model of AIDS-preventive behavior with gay men and heterosexual university students. Health Psychol. 1994;13(3):238–50.

    Article  CAS  PubMed  Google Scholar 

  15. Fisher JD, Fisher WA. The Information-Motivation-Behavioral Skills Model. In: DiClemente RJ, Crosby RA, Kegler MC, editors. Emerging theories in health promotion practice and research. 1st ed. San Francisco, CA: Jossey-Bass; 2002. p. 40–70.

    Google Scholar 

  16. Walsh J, Senn T, Scott-Sheldon L, Vanable P, Carey M. Predicting condom use using the Information-Motivation-Behavioral Skills (IMB) model: a multivariate latent growth curve analysis. Ann Behav Med. 2011;42(2):235–44.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Anderson ES, Wagstaff DA, Heckman TG, et al. Information-Motivation-Behavioral Skills (IMB) Model: testing direct and mediated treatment effects on condom use among women in low-income housing. Ann Behav Med. 2006;31(1):70–9.

    Article  PubMed  Google Scholar 

  18. Fisher CM. Are Information, Motivation, and Behavioral Skills linked with HIV-related sexual risk among young men who have sex with men? J HIV AIDS Soc Ser. 2011;10(1):5–21.

    Article  Google Scholar 

  19. Bowen AM, Williams ML, Daniel CM, Clayton S. Internet based HIV prevention research targeting rural MSM: feasibility, acceptability, and preliminary efficacy. J Behav Med. 2008;31(6):463–77.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Mustanski B, Garofalo R, Monahan C, Gratzer B, Andrews R. Feasibility, acceptability, and preliminary efficacy of an online HIV prevention program for diverse young men who have sex with men: the Keep It Up! intervention. AIDS Behav. 2013;17(9):2999–3012.

    Article  PubMed  Google Scholar 

  21. Fisher JD, Fisher WA, Bryan AD, Misovich SJ. Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth. Health Psychol. 2002;21(2):177–86.

    Article  PubMed  Google Scholar 

  22. Lemieux AF, Fisher JD, Pratto F. A music-based HIV prevention intervention for urban adolescents. Health Psychol. 2008;27(3):349–57.

    Article  PubMed  Google Scholar 

  23. Fortenberry JD. Puberty and adolescent sexuality. Horm Behav. 2013;64(2):280–7.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Ponton LE, Judice S. Typical adolescent sexual development. Child Adolesc Psychiatr Clin N Am. 2004;13(3):497–511.

    Article  PubMed  Google Scholar 

  25. Steinberg L. A social neuroscience perspective on adolescent risk-taking. Dev Rev. 2008;28(1):78–106.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Sherman SE, Takahaski N, Kalra P, et al. Care coordination to increase referrals to smoking cessation telephone counseling: a demonstration project. Am J Manag Care. 2008;14(3):141–8.

    PubMed  Google Scholar 

  27. Ybarra ML, Prescott TL, Phillips GL II, Bull SS, Parsons JT, Mustanski B. Pilot RCT results of an mHealth HIV prevention program for sexual minority male adolescents. Pediatrics. 2017;140(1):e20162999.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Mustanski B. Ethical and regulatory issues with conducting sexuality research with LGBT adolescents: a call to action for a scientifically informed approach. Arch Sex Behav. 2011;40(4):673–86.

    Article  PubMed  Google Scholar 

  29. Ybarra ML, Prescott TL, Phillips GL II, Parsons JT, Bull SS. B M. Ethical considerations in recruiting online and implementing a text messaging-based HIV prevention program with gay, bisexual, and queer adolescent males. J Adolesc Health. 2016;59(1):44–9.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Ybarra ML, Prescott TL, Phillips GL II, Bull SS, Parsons JT, Mustanski B. Iteratively developing an mHealth HIV prevention program for sexual minority adolescent men. AIDS Behav. 2016;20(6):1157–72.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Phillips GL II, Ybarra ML, Prescott TL, Parsons JT, Mustanski B. Low rates of human immunodeficiency virus testing among adolescent gay, bisexual, and queer men. J Adolesc Health. 2015;57(4):407–12.

    Article  PubMed  PubMed Central  Google Scholar 

  32. United States Census Bureau. Selected characteristics of the native and foreign-born populations. 2013. http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_13_1YR_S0501&prodType=table. Accessed 16 June 2015.

  33. Carey MP, Schroder KEE. Development and psychometric evaluation of the brief HIV knowledge questionnaire. AIDS Educ Prev. 2002;14(2):172–82.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Misovich SJ, Fisher WA, Fisher JD. A measure of AIDS prevention: information, motivation, behavioral skills, and behavior. In: Davis CM, Yarber WL, Bauserman R, Schreer G, Davis SL, editors. Handbook of sexuality-related measures. Thousand Oaks, CA: SAGE Publications, Inc.; 1998. p. 328–37.

    Google Scholar 

  35. Misovich SJ, Fisher WA, Fisher JD, Bryan AD. Information-motivation-behavioral skills HIV prevention program evaluation materials. Storrs, CT: University of Connecticut Center for HIV Intervention and Prevention (submitted for publication).

  36. Mplus [computer program]. Version 6.12. Los Angeles, CA: Muthén & Muthén, 1998-2012.

  37. Kaplan D. An overview of Markov chain methods for the study of stage-sequential developmental processes. Dev Psychol. 2008;44(2):457–67.

    Article  Google Scholar 

  38. Arbuckle JL. Full information estimation in the presence of incomplete data. In: Marcoulides GA, Schumacker RE, editors. Advanced structural equation modeling: issues and techniques. Mahwah, NJ: Erlbaum; 1996. p. 243–77.

    Google Scholar 

  39. Schafer J, Graham J. Missing data: our view of the state of the art. Psychol Methods. 2002;7(2):147–77.

    Article  PubMed  Google Scholar 

  40. Long JS. Regression models for categorical and limited dependent variables, vol. 7. 1st ed. Thousand Oaks, CA: SAGE Publications, Inc; 1997.

    Google Scholar 

  41. Selvin S. Statistical analysis of epidemiologic data. New York, NY: Oxford University Press; 1996.

    Google Scholar 

  42. Nylund KL, Asparouhov T, Muthén BO. Deciding on the number of classes in latent class analysis and growth mixture modeling: a Monte Carlo simulation study. Struct Equ Model. 2007;14(4):535–69.

    Article  Google Scholar 

  43. Shafii T, Stovel K, Davis R, Holmes K. Is condom use habit forming? Condom use at sexual debut and subsequent condom use. Sex Transm Dis. 2004;31(6):366–72.

    Article  PubMed  Google Scholar 

  44. Shafii T, Stovel K, Holmes K. Association between condom use at sexual debut and subsequent sexual trajectories: a longitudinal study using biomarkers. Am J Public Health. 2007;97(6):1090–5.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Robertson A, Levin ML. AIDS knowledge, condom attitudes, and risk-taking sexual behavior of substance-abusing juvenile offenders on probation or parole. AIDS Educ Prev. 1999;11(5):450–61.

    CAS  PubMed  Google Scholar 

  46. Lawrence JS, Scott CP. Examination of the relationship between African American adolescents’ condom use at sexual onset and later sexual behavior: implications for condom distribution programs. AIDS Educ Prev. 1996;8(3):258–66.

    CAS  PubMed  Google Scholar 

  47. Hendriksen ES, Pettifor A, Lee SJ, Coates T, Rees H. Predictors of condom use among young adults in South Africa: the Reproductive Health and HIV Research Unit National Youth Survey. Am J Public Health. 2007;97(7):1241–8.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Janulis P, Newcomb ME, Sullivan P, Mustanski B. Evaluating HIV knowledge questionnaires among men who have sex with men: a multi-study item response theory analysis. Arch Sex Behav. 2017;47(1):107–19.

    Article  PubMed  Google Scholar 

  49. Fenton KA. Time for change: rethinking and reframing sexual health in the United States. J Sex Med. 2010;7:250–2.

    Article  PubMed  Google Scholar 

  50. Mustanski B, DuBois ZD, Prescott TL, Ybarra ML. A mixed-methods study of condom use and decision making among adolescent gay and bisexual males. AIDS Behav. 2014;18(10):1955–69.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Dubois LZ, Macapagal KR, Rivera Z, Prescott TL, Ybarra ML, Mustanski B. To have sex or not to have sex? An online focus group study of sexual decision making among sexually experienced and inexperienced gay and bisexual adolescent men. Arch Sex Behav. 2015;44(7):2027–40.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23(9):1153–62.

    Article  Google Scholar 

  53. Mustanski BS, Newcomb ME, Clerkin EM. Relationship characteristics and sexual risk-taking in young men who have sex with men. Health Psychol. 2011;30(5):597–605.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors thank the entire study team at the Center for Innovative Public Health Research and the IMPACT Program at Northwestern University for their contributions to the research and the participants for their time in the study. We also thank Drs. Sheana Bull and Jeff Parsons for their consultation on the project.

Funding

The project described is supported by Award Number R01 MH096660 from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health.

Author information

Authors and Affiliations

  1. Center for Innovative Public Health Research, 555 El Camino Real #A347, San Clemente, CA, 92672, USA

    Michele L. Ybarra & Tonya L. Prescott

  2. NORC at the University of Chicago, Chicago, IL, USA

    Weiwei Liu

  3. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Gregory Phillips II & Brian Mustanski

Authors
  1. Michele L. Ybarra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Weiwei Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tonya L. Prescott
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gregory Phillips II
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Brian Mustanski
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michele L. Ybarra.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest relevant to this article to disclose.

Ethical Approval

All procedures involving human participants were in accordance with the ethical standards of the institutional review boards of record and with the 1964 Helsinki declaration and its later amendments.

Informed Consent

Informed assent/consent was obtained from all individual participants included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Electronic supplementary material 1 (DOCX 179 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ybarra, M.L., Liu, W., Prescott, T.L. et al. The Effect of a Text Messaging Based HIV Prevention Program on Sexual Minority Male Youths: A National Evaluation of Information, Motivation and Behavioral Skills in a Randomized Controlled Trial of Guy2Guy. AIDS Behav 22, 3335–3344 (2018). https://doi.org/10.1007/s10461-018-2118-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-018-2118-1

Keywords

Search

Navigation