Does a Choice of Condoms Impact Sexually Transmitted Infection Incidence? A Randomized, Controlled Trial

BACKGROUND Gay, bisexual and other men who have sex with men (GBMSM) are at disproportionately higher risk of acquiring HIV and other sexually transmitted infections (STI). While HIV/STI testing rates among GBMSM are increasing worldwide, they remain suboptimal in a variety of settings. While many studies have attempted to evaluate the efficacy of a variety of community-based campaigns, including peer and reminder-based interventions on HIV/STI testing, however few have attempted to do so for a web drama series. OBJECTIVE This study evaluates the effectiveness of a popular web drama video series developed by a community-based organization in Singapore for GBMSM on HIV and other STI testing behaviors. METHODS The study is a pragmatic, randomized controlled trial to evaluate a popular web drama video series developed by a community-based organization in Singapore for GBMSM. A total of 300 HIV-negative, GBMSM men in Singapore aged 18 to 29 years old were recruited and block-randomized into the intervention (n=150) and control arms (n=150). Primary outcomes included changes in self-reported intention to test for, actual testing for, and regularity of testing for HIV, Syphilis, Chlamydia or Gonorrhoea, while secondary outcomes include changes in a variety of other knowledge-based and psychosocial measures at the end of the study period. RESULTS Overall, 125 out of 150 participants (83.3%) in the intervention arm completed the proof of completion survey, compared to 133 out of 150 participants (88.7%) in the control arm. We found statistically significant differences in self-reporting as a regular (at least yearly) tester for HIV (15.9% difference, 95%CI [3.2%, 28.6%]), as well as chlamydia or gonorrhoea (15.5% difference, 95%CI [4.2%, 26.9%]), indicating that the intervention had positively impacted these outcomes compared to the control condition. We also found statistically significant differences in participants’ intentions to test for HIV (16.6% difference, 95%CI [4.3%, 28.9%]), syphilis (14.8% difference, 95%CI [3.2%, 26.4%]), as well as chlamydia or gonorrhoea (15.4% difference, 95%CI [4.2%, 26.6%]), in the next three months, indicating that the intervention was effective in positively impacting intention for HIV and other STI testing among participants. CONCLUSIONS There are clear benefits for promoting intentions to test regularly and prospectively on a broad scale through this intervention. This intervention also has potential to reach GBMSM who may not have access to conventional HIV and other STI prevention messaging, which have typically been implemented at sex-on-premises venues, bars, clubs, and in sexual health settings frequented by GBMSM. When coupled with community or population-wide structural interventions, the overall impact on testing will likely be significant. CLINICALTRIAL Clinicaltrials.gov, NCT04021953 INTERNATIONAL REGISTERED REPORT RR2-http://dx.doi.org/10.1136/bmjopen-2019-033855

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A randomized controlled trial evaluating combination detection of HIV in Malawian sexually transmitted infections clinics

Journal of the International AIDS Society ◽

10.1002/jia2.25701 ◽

2021 ◽

Vol 24 (4) ◽

Author(s):

Jane S Chen ◽

Mitch Matoga ◽

Brian W Pence ◽

Kimberly A Powers ◽

Courtney N Maierhofer ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Sexually Transmitted Infections ◽

Controlled Trial ◽

Sexually Transmitted ◽

Randomized Controlled

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Randomized Controlled Pilot Study of Antiretrovirals and a Behavioral Intervention for Persons With Acute HIV Infection: Opportunity for Interrupting Transmission

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy341 ◽

2018 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

William C Miller ◽

Sarah E Rutstein ◽

Sam Phiri ◽

Gift Kamanga ◽

Dominic Nsona ◽

...

Keyword(s):

Pilot Study ◽

Hiv Infection ◽

Behavioral Intervention ◽

Sexually Transmitted Infection ◽

Health Benefit ◽

Acute Hiv Infection ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Randomized Controlled ◽

Acute Hiv

Abstract Background Persons with acute HIV infection (AHI) have heightened transmission risk. We evaluated potential transmission reduction using behavioral and biomedical interventions in a randomized controlled pilot study in Malawi. Methods Persons were randomized 1:2:2 to standard counseling (SC), 5-session behavioral intervention (BI), or behavioral intervention plus 12 weeks of antiretrovirals (ARVs; BIA). All were followed for 26–52 weeks and, regardless of arm, referred for treatment according to Malawi-ARV guidelines. Participants were asked to refer partners for testing. Results Among 46 persons (9 SC, 18 BI, 19 BIA), the average age was 28; 61% were male. The median viral load (VL) was 5.9 log copies/mL at enrollment. 67% (10/15) of BIA participants were suppressed (<1000 copies/mL) at week 12 vs 25% BI and 50% SC (P = .07). Although the mean number of reported condomless sexual acts in the past week decreased from baseline across all arms (1.5 vs 0.3 acts), 36% experienced incident sexually transmitted infection by 52 weeks (12% SC, 28% BI, 18% BIA). Forty-one percent (19/46) of participants referred partners (44% SC, 44% BI, 37% BIA); 15 of the partners were HIV-infected. Conclusions Diagnosis of AHI facilitates behavioral and biomedical risk reduction strategies during a high-transmission period that begins years before people are typically identified and started on ARVs. Sexually transmitted infection incidence in this cohort suggests ongoing risk behaviors, reinforcing the importance of early intervention with ARVs to reduce transmission. Early diagnosis coupled with standard AHI counseling and early ARV referral quickly suppresses viremia, may effectively change behavior, and could have tremendous public health benefit in reducing onward transmission.

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