A Randomized Trial of an Online Risk Reduction Intervention for Young Black MSM.

HealthMpowerment.org (HMP), is a mobile optimized, online intervention to reduce sexual risk behaviors among HIV-positive and HIV-negative young Black men who have sex with men (BMSM) by providing information and resources, fostering social support, and including game-based elements. A randomized controlled trial with 474 young BMSM compared HMP to an information-only control website. The rate of self-reported condomless anal intercourse (CAI) at 3-months was 32% lower in the intervention group compared to the control group (IRR 0.68, 95% CI 0.43, 0.93), however this effect was not sustained at 12 months. Among HIV-positive participants, the rate of CAI at 3-month follow-up was 82% lower among participants with detectable viral loads in the intervention group compared to the control group (IRR 0.18, 95% CI 0.04, 0.32). In a secondary analysis, when we limited to those who used HMP for over 60 min during the 3-month intervention period (n = 50, 25.8%), we estimated 4.85 (95% CI 2.15, 7.53) fewer CAI events than we would have expected in control participants, had they used the intervention at the same rate as the intervention group. Findings suggest that exposure to an online intervention can reduce the rate of CAI among young BMSM, at least in the short term. Given the stronger effect seen among those participants who complied with HMP, additional intervention engagement strategies are warranted.

A six-month intervention with two different types of micronutrient-fortified complementary foods had distinct short- and long-term effects on linear and ponderal growth of Vietnamese infants.

Traditional complementary foods (CF) with a low nutrient density have been implicated in growth faltering, stunting, and other adverse outcomes in children. The efficacy of 2 types of locally produced, micronutrient-fortified CF to prevent stunting of infants living in rural Vietnam was evaluated. In a village-randomized controlled study, 426 infants, 5 mo of age, received for 6 mo a fortified CF, either as an instant flour (FF) or a food complement (FC) in village canteens, or traditional CF at home (C). After 6 mo of intervention, weight, length, length-for-age Z-score (LAZ) and weight-for-age Z-score were greater in the 2 intervention groups compared with the C group, with an estimated effect of +0.22 LAZ for the FF group and +0.21 LAZ for the FC group. At the last follow-up, 18 mo after the intervention, there was no significant difference in height-for-age Z-score (HAZ) between the groups, even though the HAZ in the FF group was 0.17 greater than that in the C group (P = 0.18). In contrast, the weight-for-height Z-score and BMI Z-score, indices of ponderal growth, were greater in the FF group (-0.49 and -0.26, respectively) than in the FC group (-0.73 and -0.49, respectively), with Z-scores in the C group intermediate and not significantly different from the others. This study shows that regular provision of locally produced CF fortified with micronutrients partly stopped growth faltering in Vietnamese infants, with differential effects on long-term length and ponderal growth. Providing only micronutrients instead of a complete array of nutrients might result in only short-term length growth benefits.

Adequacy of Some Locally Produced Complementary Foods Marketed in Benin, Burkina Faso, Ghana, and Senegal.

Adequate complementary foods are needed to help reduce the high prevalence of stunting in children in many Low and Middle Income Countries (LMICs). We assessed the availability, affordability, and nutrient adequacy of imported and locally produced processed cereal-based blends (PCBBs), marketed as complementary food for young children in Benin, Burkina Faso, Ghana, and Senegal. In total, 19 local producers and 275 points of sale in the four countries were surveyed to evaluate the quantities and accessibility of PCBBs. In addition, 32 PCBBs were analysed for their nutritional composition and packaging information. The results showed that only 7 out of 32 PCBBs could be classified as nutritionally satisfactory. Access to the products was insufficient in all surveyed settings. At the points of sale, the PCBB market was dominated by imported products, even though two out of four imported PCBBs were not nutritionally satisfactory. Imported PCBBs were two to three times more expensive than locally produced PCBBs. Labelling of the PCBBs was inadequate in many aspects. Technical support should be offered to local PCBB producers to ensure the adequate formulation and supply of an appropriate vitamin and mineral premix. The development of national specific regulations on PCBB composition and labelling is strongly recommended in these countries.