Learn how a HIV/STI test locator with LGBT and youth competency was developed for young men who have sex with men - matching their needs with the best sites in the area. Presented by José A. Bauermeister of the University of Michigan at YTH Live 2014 session "Advances in STD Diagnosis and Results."

1. Get
Connected:
A
Tailored
web
intervention
for
young
MSM
José
A.
Bauermeister,
MPH,
PhD
Center
for
Sexuality
&
Health
Disparities
(SexLab)
University
of
Michigan
April
7,
2014

2. Research
Team
Secret
Shoppers

3. CHCR

4. YAB

5. CAB

6. Are
all
HIV/STI
sites
created
equal?

7. * Listing
of
HIV/STI
sites
&
coordinated
calendar
* For
most
sites,
2
secret
shoppers
visited
each
site
at
different
dates/times.
Exceptions:
* Forced
Testing
* Sites
demanding
ID
* Sites
costing
more
than
$60
* Not
included
in
assessment:
* Sites
identified
post-­‐June
(not
on
CDC
directory
or
Google)
* Satellites
sites
using
the
same
counselor
from
an
HIV/STI
agency
*
* 86.8%
of
all
Sites
Visited:
46
(out
of
53)
* Included
43
of
46
in
Test
Locator
Secret
Shoppers

8. Checklist
* Offsite
Accessibility
* Onsite
Accessibility
* Onsite
LGBT
Friendliness
* Waiting
Room
Characteristics
* Waiting
Room
Youth
Friendliness
* Waiting
Room
Privacy
* Waiting
Room
Environment
* Provider
LGBT
Friendly
* Provider
Followed
Protocol
* Provider
Privacy/Confidentiality
* Provider
STI
&
Safer
Sex
Knowledge
* Provider
Involvement
* Provider-­‐Patient
Characteristics
Locations
and
Type
(55
items)

9. Development
Criteria
Raters’
Scores
* Site
is
Youth
Friendly
* Site
is
LGBTQ
Inclusive
* Provider
is
LGBT
Friendly
* Provider
is
Sex
Positive
* Goal
Setting
* Diversity
Ideal/Best
Practices
* Confidentiality
* IPV
* Explored
Motivations
* Pressure
to
Adopt
RR
Structural
Characteristics
• Days/Hours
• Walk-­‐Ins
• Location
• Close
to
Bus
Route
• Phone
Appointment
• Walk-­‐In
Appointment
• Session
Speed
(In
&
Out)
• Testing
Services
Offered
• Provides
Sliding
Scale
Fee
• Requires
insurance
• Accepts
insurance

10. Judgment
1
1.5
2
2.5
3
3.5
4
The
provider
made
me
feel
uncomfortable.
Provider
was
judgmental
about
the
kind
of
sex
I
have
(e.g.,
anal/receptive/penetrative,
etc.).
Provider
was
judgmental
about
how
many
partners
I
have
had.
Provider
was
judgmental
about
how
I
met
my
partners
(e.g.
through
sex
work,
internet
sites,
bars,
etc.).
Median
Mean
1=Strongly
Agree;
4
=
Strongly
Disagree

11. Test
Site
Admin
Console

14. * Ages
15-­‐24
* Cis-­‐male
* Live
in
5
Southeast
Michigan
Counties
* Sex
with
male
partner
in
prior
6
months
Eligibility
Criteria

15. * Outreach
at
Pride
Events
* Facebook
Ads
* OutPost
Magazine
* Bar
Outreach
* Individualized
Emails
* Individualized
Phone
Calls
Recruitment

16. FB
Recruitment
Ads
We
need
your
help!
Test
our
new
website
and
give
us
feedback
to
make
it
better.
Earn
$30.
Let
your
voice
be
heard!
Test
our
new
website
and
help
us
make
it
useful
for
our
community.
SexLab
is
testing
a
new
STI
testing
locator
website.
Help
make
it
better!
Earn
$30.
Want
to
know
your
HIV/STI
status?
Test
our
new
HIV/STI
test
locator
website.
Give
us
your
feedback
and
earn
$30.

17. Magazine
Ads

18. Study
Enrollment
Contacted
• 444
individuals
contacted
• 62
were
not
interested
Screened
• 382
individuals
screened
• 180
eligible
and
invited
• 50:
14
stopped
at
consent;
36
never
entered
Consented
• 130
completed
intervention
• 104
completed
follow-­‐up

19. Money
76
(59.4%)
Had
STI
4(3.1%)
Bad
Test
Experience
4(3.1%)
Looking
for
Right
Site
32(25.0%)
Want
to
get
tested
7(5.5%)
Bad
test
locators
7(5.5%)
Community
91(71.1%)
Test
with
Partner
6(4.7%)
Im
at
risk
46(35.9%)
Why
did
you
enroll
in
GC?

20. * Median
age:
21
years
* 84%
identify
as
gay
* Race/Ethnicity
* White:
84
(65.6%)
* Black:
25
(19.5%)
* Latino:
12
(9.4%)
* Middle
Eastern:
10
(7.8%)
* API:
8
(6.3%)
* 92%
completed
HS
* 73%
reported
working
* Health
Insurance:
80%
* Relationship
Status:
45.6%
Sample
Characteristics
(N=130)

21. * HIV
negative
* 70.8%
* Media
time:
6mo.
* HIV
positive
* 3.0%
* HIV
unknown
* 26.2%
* STIs
* 62%
prior
STI
testing
* 60.5%
reported
prior
STI
* Media
time:
5.5
months
Sample
Characteristics
(N=130)

22. Randomization
Baseline
Tailored
Content
+
Test
Locator
Site
Feedback
30
day
Follow-­‐Up
Baseline
Test
Locator
Site
Feedback
30
day
Follow-­‐up
Study
Design

23. * Age
* Race/Ethnicity
* Sexual
Identity
* HIV
Testing
* STI
Testing
* Structural
Struggles
* Sources
of
Support
* Values
What
is
the
Site
Tailored
On?

24. * Spiritual
* Religious
* Perseverant/Able
to
bounce
back
from
difficult
time
* Attractive
* Responsible
* Disciplined
* Popular
* Sexy
* Respected
at
school
* Supportive
* On
top
of
things
* Successful
* In
control
* A
good
family
member
* A
good
parent
* Loved
* Respected
at
home
* A
good
community
member
* Strong
* Being
real
* Athletic
* A
good
friend
* A
good
partner
* In
an
intimate
and
committed
relationship
* Other
(Specify)
Values

25. Image
Tailoring
Age
Values
Race/Ethnicity

26. Get
Connected
Working
Version
A

27. A
case
study
Case
1
* 19
years
old
* Black
* Single
* Never
tested
for
HIV
or
STIs
* Barriers:
* Cost
* Fear
it
will
hurt
* Doesn’t
seem
urgent
* Values:
* Sexy
* Strong
* Successful

35. Visit
Resource

36. Feasibility
&
Acceptability
Tailored
Intervention
(n=86)
Test
Locator
(n=44)
t
value
Cohen’s
d
Overall,
I
am
very
satisfied
with
Get
Connected.a
6.16(1.08)
6.00(.77)
.97
.18
Using
Get
Connected
is
very
frustrating.
a
2.09(1.27)
2.19(1.44)
-­‐.40
-­‐.07
I
would
recommend
Get
Connected
to
my
friends.
a
6.00(1.21)
5.74(.99)
1.21
.22
Get
Connected
is
easy
to
use.a
6.29(.96)
6.24(1.01)
.28
.06
Get
Connected
provided
me
accurate
information.
a
6.35(.88)
5.74(1.15)
2.99**
.55
How
likely
would
you
be
to
continue
using
Get
Connected
if
it
were
available?
b
5.77(1.30)
5.79(.93)
-­‐.06
-­‐.06
Notes.
a
Items
are
scored
on
a
1-­‐7
scale
(1=Strongly
Disagree;
7=Strongly
Agree).
b
Item
is
scored
on
a
1-­‐7
scale
(1=Very
Unlikely;7=Very
Likely).
**p<.01

37. Have
you
visited
an
HIV
or
STI
provider
in
the
past
30
days?
* Yes
* TL+Tailoring:
22
(73.3%)
* TL:
8
(26.7%)
* No
* TL+Tailoring:
46
(62.2%)
* TL:
28
(37.8%)
Testing
Behavior
22(21.2%)
8(7.7%)
46(44.2%)
28(26.9%)
TL+Tailoring
Test
Locator
Yes
No

38. Sexual
Behavior
Baseline
Follow-­‐up
t
value
Differential
gain
Cohen’s
d
Number
of
Male
Sexual
Partners
1.84(2.02)
1.39(1.44)
2.26*
.41
.21
Number
of
RAI
Partners
.80(1.00)
.56(.80)
2.43*
.08
.08
Number
of
URAI
Partners
.46(.59)
.29(.48)
2.90*
.01
.02
Notes.
*p<.05.
No
mean
differences
over
time
were
observed
across
treatment
conditions.
RAI=Receptive
Anal
Intercourse;
URAI=Unprotected
Receptive
Anal
Intercourse

39. Changes
in
Self-­‐Efficacy
Baseline
Follow-­‐up
t
value
Differential
gainb
Cohen’s
d
Tell
your
partner
that
you
want
him
to
get
tested
for
HIV.a
3.39(1.22)
3.70(1.07)
2.73**
.03**
.50
Convince
your
partner
to
get
an
HIV
test
before
you
start
having
anal
sex
with
each
other.a
3.29(1.24)
3.59(1.09)
2.63**
.71**
.64
Persuade
your
partner
to
go
with
you
to
get
an
HIV
test.a
3.59(1.12)
3.75(1.04)
1.51
.67**
.63
Tell
your
partner
that
you
want
him
to
get
tested
for
STIs.a
3.39(1.22)
3.66(1.13)
2.44*
.38
.33
Convince
your
partner
to
get
a
STI
test
before
you
start
having
anal
sex
with
each
other.a
3.19(1.23)
3.63(1.00)
4.59***
.32‡
.37
Persuade
your
partner
to
go
with
you
to
get
a
STI
test.a
3.54(1.14)
3.74(1.03)
2.01*
.39‡
.39
Notes.
a
Items
are
scored
on
a
5-­‐point
scale
(1=Very
Difficult;
5=Very
Easy).
b
Net
gains
compare
changes
in
self-­‐efficacy
across
tailored
intervention
relative
to
the
test
locator
only
condition.
‡
p
<
.10;
*p<.05;
**p<.01;
**p<.001

40. * Pursue
R01
funding
to
test
efficacy
of
GC
among
YMSM
in
different
cities
* Record
tailored
video
responses
to
reduce
text
heaviness
* Extend
platform
to
mobile-­‐based
system
* Collect
greater
number
of
time
points
post-­‐intervention
Moving
forward

41. Acknowledgments
Dr.
Patricia
Dittus
(CDC)
Ms.
Gretchen
Weiss
(NACCHO)
Dr.
Keith
Horvath
Study
Participants

42. Questions?
For
more
information:
José
A.
Bauermeister,
MPH,
PhD
jbauerme@umich.edu