Adapting HIV Interventions for Targeting MSM Online Populations


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Adapting HIV Interventions for Targeting MSM Online Populations

  1. 1. Adapting HIV Interventions forTargeting MSM Online Populations Joshua Fegley, LCSW NO/AIDS Task Force New Orleans, LA
  2. 2. PurposeDiscuss agency’s experience withadapting “real world” interventions toonline environment Outreach Popular Opinion Leader RESPECTDiscuss Lessons Learned
  3. 3. IssuesThere is a need to adapt HIV prevention tochanging technologiesAt-risk populations are onlineNo EBIs designed to reach thesepopulations
  4. 4. Adaptation ComponentsCore ElementsKey CharacteristicsAdaptationTailoring‘Fidelity’ vs. ‘Reinvention’
  5. 5. OutreachNO/AIDS began online outreach in 2000Conducted 20-30 conversations per weekApproximately 100 people per year camein to get tested because of encounter withonline outreachBetween 2000 – 2004 approximately 150first-time testers came in because ofencounter with online outreach
  6. 6. OutreachNot an EBIOnline outreach must still maintain fidelityto outreach modelsNO/AIDS developed online outreachprotocol based on literature and agencyknowledge
  7. 7. OutreachMust create an agency online protocol Can use National Guidelines for Internet- based STD/HIV Prevention – Outreach as a guide administrators will ask to reviewyour protocol before you can set up anoutreach/health profile
  8. 8. Popular Opinion LeaderCommunity Level InterventionBased on Diffusion of Innovation Theory“Friends Influencing Friends to Instill aRisk Reduction Norm Among Themselves”
  9. 9. Popular Opinion LeaderNO/AIDS funded for POL starting in 2004Forced to take a break in late summer of2005Online trainings started in Summer 200710 POLs trained in first year Approximately 60 conversations submitted in first year
  10. 10. Popular Opinion LeaderCore Elements Identifiable target population Ethnographic techniques used to identify Popular Opinion Leaders (POLs) 15% of target population trained Teach POLs characteristics of effective behavior change communication messages
  11. 11. Popular Opinion LeaderCore Elements Small group, weekly training sessions POLs set goals to engage in risk-reduction conversations with friends & acquaintances POL conversations are reviewed, discussed, reinforced at subsequent training sessions Logos or symbols used as conversation starters for POL
  12. 12. Popular Opinion LeaderOnline POL maintained fidelity to coreelements Target population: MSM who frequent chat rooms in the Gulf South Staff observed chat rooms and documented observations Goal was to train 15% of chat room users Used POL training guide
  13. 13. Chat Room Estimation Report Chat Room User EstimationStart Time: End Time: Date: Observer name:Each session one-hour observationCreate a folder for each session: Nomenclature: Date-start time to end timeIf a chat room is not accessible, please observe a different chat room and make a note of the same in this sheet.Check the chat rooms you are rooms: New Orleans LA Statewide Houston AtlantaDo the observation through ChattageMaximum chat room users allowed ___Number of users in Chat room: start, every 30 minutes, endScreen Shot (use print screen on the key board and copy paste to a WORD document): start, every 30 minutes,endSave the chat transcript: via Chattage Nomenclature: website-chatroom- Date-start time to end time initialsRead the transcript.Write a summary of what was being discussed (relevant to the project).After reading the saved transcript do you think any one can be a POL Focus Group Key InformantWhy? Check all that apply Screen Name A Screen Name B Screen Name CGreeted most oftenGreets others often“The life of the party”Trusted and well-liked bytheir network of friendsSought out for adviceThe center of what’s happeningSpoken of respectfully by othersInteracts with one primary social networkInteracts with multiple social networksElicits apparent interest from othersAppears to enjoy the company of othersOthers appear to enjoy his companyOthers in the chat room ask him for opinionsOthers ask him about available HIV servicesOthers ask him about available referral servicesOthers ask him for information/discuss hurricanesOther ____________________________________ and of users and individuals: Copy and Paste into WORD document number of individuals in New Orleansarea: start, every 30 minutes, and end.
  14. 14. Popular Opinion LeaderOnline POL maintained fidelity to coreelements Conducted online, small group, weekly training sessions using distance learning platform POLs attempted 10 conversations per month POLs used online form to submit conversation summary Used symbol for conversation starter
  15. 15. Popular Opinion Leader
  16. 16. Popular Opinion Leader POL POPULAR OPINION LEADER CONVERSATION CONTACT FORM My POL/Screen Name is _______ __________________________First Name or Screen Name: Date of Conversation: Place of Contact:Age Race/EthnicitySummary of Conversation :First Name or Screen Name: Date of Conversation: Place of Contact:Age Race/EthnicitySummary of Conversation :First Name or Screen Name: Date of Conversation: Place of Contact:Age Race/EthnicitySummary of Conversation :First Name or Screen Name: Date of Conversation: Place of Contact:Age Race/EthnicitySummary of Conversation :First Name or Screen Name: Date of Conversation: Place of Contact:Age Race/EthnicitySummary of Conversation :First Name or Screen Name: Date of Conversation: Place of Contact:Age Race/EthnicitySummary of Conversation :
  17. 17. Popular Opinion LeaderInitially had great successOnline community excited aboutinterventionTrained 10 POLsPOLs were having conversationsAnd then two things happened…
  18. 18. Popular Opinion LeaderEvacuation for Hurricane Gustav: “TheMother of All Storms” - Mayor C. Ray radically revamped their platform
  19. 19. Popular Opinion LeaderAs a result Users unable to get online Users quickly abandoned Once users left, no place to conduct interventionEquivalent of only gay bar in town closing
  20. 20. RESPECTFunded in 2010Agency decided there was still a need foronline interventionPOL no longer viable option for agencyILI ideal for instant message, private chatformat
  21. 21. RESPECTIndividual Level InterventionBrief, 2-session interventionFocuses on client’s personal riskCounselor uses prompts to help guidesession
  22. 22. RESPECTCore Elements 1:1 counseling, using RESPECT Prompts Teachable moments Explore circumstances and context of recent risk behavior Negotiate achievable step which supports larger risk-reduction goal Implement & maintain quality assurance
  23. 23. RESPECTOnline RESPECT maintains fidelity toCore Elements 1:1 sessions, using prompts, will be conducted in chat room in secure, project website Use teachable moments Explore recent risk behavior Negotiate achievable step Quality Assurance plan in place
  24. 24. RESPECT
  25. 25. RESPECTGoals for Year 2 200 MSM, age 18+ who find sexual partners online will complete the 2 RESPECT sessions 100 MSM, age 18+ will access HIV testing via referrals from RESPECT
  26. 26. Lessons LearnedInterventions can be adapted successfullyfor use onlineMust carefully consider Core Elements ofEBI
  27. 27. Lessons LearnedMust work closely with websiteadministrators Websites have different requirements for setting up outreach/health profileDo not expect to have an outreach profileestablished in just a few days
  28. 28. Lessons LearnedMoney/Cost Must have up to date technology Cost for Outreach Profile on some sites Do you need a project specific website?Staff must know how to use thetechnologyInclude in your budget or find way to getequipment and/or time donated
  29. 29. Lessons LearnedInteraction technology changes fast Chat rooms  IM  Mobile AppsOnline room/site/app that was hot todaymay be abandoned very quickly Users in Gulf South quickly left in 2008, switched to Manhunt & GrindrNot all online venues equally popular in allgeographic areas
  30. 30. Lessons LearnedYou will have the same challenges onlinethat you have in “real world” Recruitment participants Retaining participants Record Keeping
  31. 31. Lessons LearnedNeed to establish legitimacyMust build trust and rapportLet people know you and your agency arefor real
  32. 32. Lessons LearnedIt takes timeWith knowledge, initiative, and know howinterventions can be successful online
  33. 33. Contact InformationJoshua Fegley, LCSW – CAN ProjectCoordinator joshf@noaidstf.orgJean Redmann – Director of Prevention