Reducing HIV risk behavior of men who have sex with men through persuasive computing: Results of the Men's INTernet Study-II

Objective: The primary Objective of this study was to develop and test a highly interactive Internet-based HIV prevention intervention for men who have sex with men (MSM). MSM remain the group at highest risk for HIV/AIDS in the United States and similar countries. As the Internet becomes popular for seeking sex, online interventions to reduce sexual risk are critical. Given previous studies, a secondary Objective was to demonstrate that good retention is possible in online trials. Design: A randomized controlled trial with 3-month, 6-month, 9-month, and 12-month follow-up design was employed. Methods: In 2008, 650 participants were randomized to an online, interactive sexual risk reduction intervention or to a waitlist null control. Results: Retention was 76-89% over 12 months. At 3-month follow-up, Results showed a 16% reduction in reported unprotected anal intercourse risk among those in the treatment condition versus control [95% confidence interval (95% CI) of rate ratio: 0.70-1.01]. No meaningful differences were observed at 12-month follow-up. Conclusion: Internet-based, persuasive computing programs hold promise as an effective new approach to HIV prevention for MSM, at least in the short term. Further, online trials can be conducted with acceptable retention provided strong retention protocols are employed. Four directions for future research are identified.