Christine Khosropour, MPH     Rollins School of Public Health            Emory University            August 15, 20112011 N...
   Men who have sex with men (MSM) in the US    are at increased risk for HIV infection   Internet has emerged as a venu...
   Increase in interest in online HIV prevention    interventions   Well-designed HIV prevention studies:     Adequate ...
   Underrepresentation of black and Hispanic    study participants   Lack of biological outcomes on study    participant...
   Enrolled white, black, and Hispanic MSM in an    online 12-month longitudinal study     > 18 years old     Had a mal...
Bi-monthly FU                                                    Online FU                                         Baselin...
2010 Pew Internet and American Life Project Survey:                                                   Own Mobile          ...
Population      Prevalence of                                                                                   Prevalence...
896                               Completed                             Baseline Survey17.5%         157               62....
NEXTPRESENTATION!
Bi-monthly FU                                                    Online FU                                         Baselin...
   Automated reminder system     3 reminders sent via SMS or email   Choice of reminder modality     Online Group: Tex...
710         Enrolled in       12-month study   344                366   SMS               Online229 White           241 Wh...
Retention of Study Participants by Follow-Up GroupSurvival Probability                                    70%             ...
Retention of Study Participants by Race/EthnicitySurvival Probability                                                     ...
Retention of Study Participants by Follow-Up Group, Stratified by Race/Ethnicity                               White Onlin...
   Ability to enroll black and Hispanic MSM   85% cumulative retention at Month 6     High retention            Can ass...
   Research participants   Patrick Sullivan, DVM, PhD   Sullivan Research Team   Cyclogram   Emory Center for AIDS Re...
Recruitment and retention of racial/ethnic minorities in an online HIV behavioral risk study of MSM
Recruitment and retention of racial/ethnic minorities in an online HIV behavioral risk study of MSM
Recruitment and retention of racial/ethnic minorities in an online HIV behavioral risk study of MSM
Recruitment and retention of racial/ethnic minorities in an online HIV behavioral risk study of MSM
Recruitment and retention of racial/ethnic minorities in an online HIV behavioral risk study of MSM
Recruitment and retention of racial/ethnic minorities in an online HIV behavioral risk study of MSM
Recruitment and retention of racial/ethnic minorities in an online HIV behavioral risk study of MSM
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Recruitment and retention of racial/ethnic minorities in an online HIV behavioral risk study of MSM

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Recruitment and retention of racial/ethnic minorities in an online HIV behavioral risk study of MSM

  1. 1. Christine Khosropour, MPH Rollins School of Public Health Emory University August 15, 20112011 National HIV Prevention Conference Atlanta, GA
  2. 2.  Men who have sex with men (MSM) in the US are at increased risk for HIV infection Internet has emerged as a venue for MSM to meet sex partners online  High-risk sexual behavior linked to meeting partners online
  3. 3.  Increase in interest in online HIV prevention interventions Well-designed HIV prevention studies:  Adequate representation of racial/ethnic minorities  Biological outcomes  Adequate retention (> 70%)
  4. 4.  Underrepresentation of black and Hispanic study participants Lack of biological outcomes on study participants Inability to retain participants for a period sufficient to assess outcome measures  High attrition of black and Hispanic MSM
  5. 5.  Enrolled white, black, and Hispanic MSM in an online 12-month longitudinal study  > 18 years old  Had a male sex partner in past 12 months  Willing to complete an at-home HIV test  Had an SMS-enabled mobile phone Stratified randomization by race  Online vs SMS bi-monthly follow-up
  6. 6. Bi-monthly FU Online FU Baseline Month 12 Black Online Online Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV TestClick-through banner ad Bi-monthly FU Online FU Baseline Month 12 Screening Consent White Online Online Questions Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV Test Bi-monthly FU Online FU Baseline Month 12 Hispanic Online Online Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV Test
  7. 7. 2010 Pew Internet and American Life Project Survey: Own Mobile Send/Receive Phone SMSRace/Ethnicity (%) (%)White 80 68Black 87 79Hispanic 87 83Smith A. Mobile Access 2010. Available from: http://www.pewinternet.org/Reports/2010/Mobile-Access-2010.aspx.
  8. 8. Population Prevalence of Prevalence Location of prevalence black study RatioInternet Study study of blacks (%) participants (%)Grosskopf et al, NYC 25.1 17.9 .712010Chiasson et al, 2009 US 12.4 6.3 .51Rosser et al, 2009 US 12.4 16.4 1.3Berg et al, 2007 US 12.4 2.5 .20Mackellar et al, 2007 6 US cities 25.3 8.6 .34 US andChiasson et al, 2007 11.3 4.6 .41 CanadaBull et al, 2004 US 12.4 6.6 .53Hirshfield et al, 2004 US 12.4 2.0 .16Modified from: Sullivan et al, JMIR 2011
  9. 9. 896 Completed Baseline Survey17.5% 157 62.9% 564 19.5% 175 Black White Hispanic Pop Prev: Pop Prev: 12.9% 15.8% Prevalence Ratio = 1.4 Prevalence Ratio = 1.2
  10. 10. NEXTPRESENTATION!
  11. 11. Bi-monthly FU Online FU Baseline Month 12 Black Online Online Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV TestClick-through banner ad Bi-monthly FU Online FU Baseline Month 12 Screening Consent White Online Online Questions Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV Test Bi-monthly FU Online FU Baseline Month 12 Hispanic Online Online Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV Test
  12. 12.  Automated reminder system  3 reminders sent via SMS or email Choice of reminder modality  Online Group: Text message or Phone Call  SMS Group: Email or Phone Call Personal outreach  Phone call to participant
  13. 13. 710 Enrolled in 12-month study 344 366 SMS Online229 White 241 White46 Black 60 Black69 Hispanic 65 Hispanic
  14. 14. Retention of Study Participants by Follow-Up GroupSurvival Probability 70% Online P = .20 SMS Baseline Month 2 Month 4 Month 6 Follow-Up Time Point
  15. 15. Retention of Study Participants by Race/EthnicitySurvival Probability White Hispanic P = .007 Black Baseline Month 2 Month 4 Month 6 Follow-Up Time Point
  16. 16. Retention of Study Participants by Follow-Up Group, Stratified by Race/Ethnicity White Online Black SMS Hispanic SMS White SMS Hispanic OnlineSurvival Probability 70% Black Online White Online White SMS P = .87 Hispanic Online Hispanic SMS P = .88 Black Online Black SMS P = .03 Baseline Month 2 Month 4 Month 6 Follow-Up Time Point
  17. 17.  Ability to enroll black and Hispanic MSM 85% cumulative retention at Month 6  High retention Can assess outcomes  Difference in retention by race/ethnicity Utilize multiple data collection mechanisms Frequent follow-up and personal outreach increases retention of participants
  18. 18.  Research participants Patrick Sullivan, DVM, PhD Sullivan Research Team Cyclogram Emory Center for AIDS Research (CFAR)  P30 AI050409 NIH, National Center on Minority Health and Health Disparities  Grant # RC1MD004370

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