Background: To conduct a randomized control trial to evaluate the impact of a novel technology-based intervention on HIV/AIDS knowledge, self-perceived risk, condom use attitudes, self-efficacy intentions, sexual risks and condom use behaviors among Thai MSM.
Methods: The technology-based HIV risk reduction intervention was piloted by Adam''s Love (www.adamslove.org). Participants aged 18 years or above, and having engaged in unprotected sex in the past six months were enrolled and randomly assigned to control or intervention arm, and received private clinic-based HIV counseling and testing at baseline, month 6 and month 12. Intervention arm participants engaged in 12 monthly HIV/STI prevention and educational sessions delivered via Vialogues.com (using online time-based videos followed by time-stamped discussions around the video content with a health educator, focusing on applying knowledge and skills learned during the session in setting long-term goals to reduce sexual risks). The differences in behavioral outcomes between the arms over the 12-month period were assessed.
Results: Of 76 MSM enrolled, 37 were randomized to intervention and 39 to control arm. Median age was 28 (IQR 24-32) years. Of 37 intervention arm participants, 33 (89.2%) completed all 12 monthly Vialogues sessions. Mean session duration was 37.45 minutes. Retention rates at month 12 among intervention and control arms were 97.3% and 79.5%, respectively. At month 12, median percentage of condom use for anal intercourse was higher in the intervention versus control arm (100% vs. 93.3%, p=0.023). Over the 12-month period, intervention arm reported significant reduction in self-perceived risk for HIV (3.08 on 5-point LIKERT scale to 2.6, p=0.001), popper usage (29.7% to 13.9%, p=0.002), seeking sex online (59.5% to 44.4%, p=0.01), median number of sexual partners in the past three months (2 to 1, p=0.003), and increased median percentage of condom use (88.9% to 100%, p=0.006). Process measures yielded high participant satisfaction of Vialogues (mean 4.67 on a 5-point scale, SD 0.48).
Conclusions: Our study provides clear evidence that ''Vialogues'' intervention significantly reduced number of sexual partners and increased condom use rates among MSM. HIV program implementers are encouraged to harness the potential of free, online learning technologies used in this study.