Technology-Based Interventions, with a Stepped Care Approach, for Reducing Sexual Risk Behaviors and Increasing PrEP Initiation Among Transgender and Gender Expansive Youth and Young Adults

IF 2.7 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

AIDS and Behavior Pub Date : 2024-09-20 DOI:10.1007/s10461-024-04513-w

Cathy J. Reback, Demetria Cain, Joshua A. Rusow, David Benkeser, Lindsey Schader, Bevin A. Gwiazdowski, Simone J. Skeen, Marissa Hannah, Marvin Belzer, Marne Castillo, Kenneth H. Mayer, Mary E. Paul, Jonathan Hill-Rorie, Nathan Dorcey Johnson, Julie McAvoy-Banerjea, Travis Sanchez, Lisa B. Hightow-Weidman, Patrick S. Sullivan, Keith J. Horvath

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Abstract

TechStep was a technology-based trial, with a stepped care approach, to reduce sexual risks and increase PrEP uptake among transgender and gender expansive youth and young adults (15–24 years old). From October 2019 to September 2021, 254 participants were randomized into: 1) Text (n = 82), or 2) Webapp (n = 87), or 3) Control (n = 85). At the 3-month follow-up assessment, those randomized to Text and Webapp and did not demonstrate improvement on primary outcomes were re-randomized to receive virtual eCoaching (Text + or Webapp +), or to remain in their initial condition without eCoaching. Results showed no effect on condomless encounters at 6-month, the primary endpoint, when comparing the Webapp + (0.33 decrease; 95%CI: -0.01, 0.67, p-value = 0.057) or the Text + (0.27 decrease; 95%CI: -0.13, 0.68, p-value = 0.181) conditions to the Control condition. However, in secondary analyses, condomless encounters were significantly reduced for Text compared to Control. The rate of PrEP uptake was low for all study arms.

Trial registration: Clinical Trials # NCT04000724 (registered June 26, 2019).

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基于技术的干预措施，采用阶梯式护理方法，减少变性和性别扩展青年及年轻成年人的性风险行为，提高 PrEP 的启动率。

TechStep 是一项以技术为基础的试验，采用阶梯式护理方法，旨在降低变性和性别扩展青年及年轻成人（15-24 岁）的性风险并提高 PrEP 的采用率。从 2019 年 10 月到 2021 年 9 月，254 名参与者被随机分为以下几组：1）文本（n = 82），或 2）网络应用（n = 87），或 3）对照组（n = 85）。在 3 个月的随访评估中，被随机分配到文本和 Web 应用程序且主要结果没有改善的参与者将被重新随机分配到接受虚拟电子辅导（文本 + 或 Web 应用程序 +），或保持初始状态而不接受电子辅导。结果显示，在 6 个月时，即主要终点，将 Webapp +（减少 0.33；95%CI：-0.01，0.67，p 值 = 0.057）或 Text +（减少 0.27；95%CI：-0.13，0.68，p 值 = 0.181）条件与对照条件进行比较，对无套性交没有影响。然而，在二次分析中，与 "对照组 "相比，"文本＋"条件下的无套性行为显著减少。所有研究臂的 PrEP 使用率都很低：临床试验 # NCT04000724（2019年6月26日注册）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AIDS and Behavior Multiple-

CiteScore

6.60

自引率

13.60%

发文量

382

期刊介绍： AIDS and Behavior provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews. provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews.5 Year Impact Factor: 2.965 (2008) Section ''SOCIAL SCIENCES, BIOMEDICAL'': Rank 5 of 29 Section ''PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH'': Rank 9 of 76