Developing an mHealth program to improve HIV care continuum outcomes among young Black gay and bisexual men.

BACKGROUND: Young Black gay and bisexual men (YBGBM) in the United States face significant disparities in HIV care outcomes. Mobile health (mHealth) interventions have shown promise with improving outcomes for YBGBM across the HIV care continuum. METHODS: We developed an mHealth application using human-centered design (HCD) from 2019-2021 in collaboration with YBGBM living with HIV and with HIV service providers. Our HCD process began with six focus groups with 50 YBGBM and interviews with 12 providers. These insights were used to inform rapid prototyping, which involved iterative testing and refining of program features and content, with 31 YBGBM and 12 providers. We then collected user feedback via an online survey with 200 YBGBM nationwide and usability testing of a functional prototype with 21 YBGBM. RESULTS: Focus groups and interviews illuminated challenges faced by YBGBM living with HIV, including coping with an HIV diagnosis, stigma, need for social support, and a dearth of suitable information sources. YBGBM desired a holistic approach that could meet the needs of those newly diagnosed as well as those who have been living with HIV for many years. Program preferences included video-based content where users could learn from peers and experts, a range of topics, a community of people living with HIV, and tools to support their health and well-being. Providers expressed enthusiasm for an mHealth program to improve HIV care outcomes and help them serve clients. Rapid prototyping resulted in a list of content topics, resources, video characteristics, community features, and mHealth tools to support adherence, retention, goal setting, and laboratory results tracking, as well as tools to help organization staff to support clients. Online survey and usability testing confirmed the feasibility, acceptability, and usability of the content, tools, and features. CONCLUSIONS: This study demonstrates the potential of a video-based mHealth program to address the unique needs of YBGBM living with HIV, offering support and comprehensive information through a user-friendly interface and videos of peers living with HIV and of experts. The HCD approach allowed for continuous improvements to the concept to maximize cultural appropriateness, utility, and potential effectiveness for both YBGBM and HIV service organizations.

Overcoming Health Information Inequities: Valley fever Information Repertoires Among Vulnerable Communities in California.

Although Valley fever represents a growing public health challenge for Central and Southern Californian residents, awareness remains severely limited. The California Department of Public Health (CDPH) ran a cross-platform campaign to mitigate this awareness gap and impact prevention behavior. This study evaluates exposure to the CDPH campaign, followed by an examination of the information consumption patterns associated with key health outcomes. Results suggest that the CDPH campaign successfully improved knowledge accuracy, reduced misperceptions, and increased the likelihood of prevention behavior. Using an information repertoire lens revealed a more nuanced account. Most information repertoires positively influenced accurate knowledge retention and prevention behavior compared to those who were not exposed. The most diverse information repertoire, including interpersonal and media channels, was associated with increased knowledge accuracy, affective risk concerns, personal susceptibility, and prevention behavior. However, exposure to this repertoire was also associated with greater misperceptions. In addition, medical professional and radio-based repertoires positively influenced personal susceptibility perceptions. Overall, this research illustrates the importance of examining not only the general outcomes of health campaigns but also the patterns of information acquisition - particularly when working with underserved communities whose health information consumption preferences may not be comprehensively reflected in the literature.

From Watching to Calling: Linking Variations in an Entertainment-Education Storyline with Calls to a Health Hotline.

Substantial gaps exist in the theoretical conceptualization and practical development of entertainment-education, as studies often fail to account for the ways in which intrinsic message characteristics influence subsequent behavior. These gaps served as the impetus for an international collaborative project that evaluated Vencer el Miedo ("Overcome the Fear"), a Spanish-language program that aired in Mexico from January to March 2020. The telenovela was produced with the aim of improving sexual and reproductive health knowledge and behaviors by modeling effective ways to discuss and negotiate safer sex practices. The show was accompanied by a telephone hotline called OrientaSEX operated by professional counselors from MEXFAM, Planned Parenthood's Mexican affiliate. Utilizing an interrupted time series analysis of calls made to OrientaSEX (N = 11,878) and focusing on changes in the volume of calls and the identity of callers following key moments in the storyline, the findings support the central role played by transitional characters and their similarity to audience members. Implications of these results for the theory and practice of entertainment-education are discussed.

Integrated Multicultural Media Campaign to Increase COVID-19 Education and Vaccination Among Californians, 2021.

Despite the availability of safe, effective COVID-19 vaccines, many remain unvaccinated or partially vaccinated. In 2021, the California Department of Public Health launched a California-wide integrated multicultural vaccine media campaign. The campaign was evaluated in two waves through online surveys with adults (n = 1594; n = 1575). Campaign exposure was associated with looking for vaccine information, visiting a state vaccine Web site, and becoming fully vaccinated during the campaign. Higher campaign exposure was associated with greater odds of vaccine engagement. (Am J Public Health. 2022;112(10):1389-1393. https://doi.org/10.2105/AJPH.2022.306974).

Overcome the Fear (Vencer el Miedo): using entertainment education to impact adolescent sexual and reproductive health and parent-child communication in Mexico.

BACKGROUND: Adolescents in Mexico experience high pregnancy and birth rates. A collaboration with Grupo Televisa led to the development of an entertainment-education telenovela intervention, Overcome the Fear (OTF), which aired in 2020 to a national audience and addressed adolescent sexual and reproductive health (SRH) topics. This study details the development and evaluation of OTF's impact on adolescent contraceptive practices and parent-adolescent SRH communication in Mexico. METHODS: We conducted cross-sectional survey interviews (street-intercept and telephone) with 12-19-year-olds (n = 1640) and parents of adolescent children (n = 820) post-broadcast across Mexico's five most-populated metropolitan zones. Quotas were implemented for gender, zone, and OTF viewership (viewer vs. non-viewer). Bivariate statistics and multivariable binary logistic regression models assessed the relationship between OTF viewership (including parent-adolescent co-viewing) and adolescent contraceptive practices and parent-adolescent SRH communication. Adolescent and parent data are not dyadic and were analyzed separately. RESULTS: Nearly half of adolescents (47.9%) and parents (47.7%) were viewers. Among adolescents, bivariate analyses suggest that viewers had less negative attitudes towards contraception (p < .001). Logistic regression models suggest that adolescent viewers were more likely to seek out information about contraception (p < .001) and unhealthy romantic relationships (p = .019), and to use contraception other than condoms (p = .027) and dual contraception (p = .042) in the last 3 months. Among parents, bivariate analyses suggest that non-viewers had more positive attitudes towards abstinence (p = .045) and more negative attitudes towards contraception and communication with adolescents about sex (p = .001). Logistic regression models suggest that parent viewers were more likely to have talked with adolescent children about sexual relations (p < .001), contraceptive methods (p = .01), condoms (p = .002), and abstinence (p = .002) in the last 3 months. Parent-adolescent co-viewing of OTF was also significantly related to certain outcomes in bivariate analyses. CONCLUSIONS: This study suggests that viewership of a high-quality entertainment-education telenovela informed by extensive formative research is related to adolescent health outcomes and to parent-adolescent SRH communication on a country-wide scale in Mexico. Entertainment-education remains an underutilized public health strategy, despite its promise to engage viewers and motivate healthful behaviors.

Development and evaluation of a social marketing campaign to address methamphetamine use in Los Angeles County.

BACKGROUND: This study describes the development and impact of a social marketing campaign in early 2020 intended to prevent and reduce methamphetamine use in Los Angeles County (LAC). We used social marketing principles and the transtheoretical model to design the campaign, which was intended to avoid stigmatization of methamphetamine users and communicate compassion, empathy, and support. METHODS: To evaluate its impact, we collected cross-sectional online survey data post-campaign (n = 1,873) from LAC residents in population segments considered higher risk for methamphetamine use. We examine associations between campaign exposure and outcomes using bivariate analyses and binary logistic regression models, which control for the impact of the COVID-19 pandemic on methamphetamine use or likelihood of use. RESULTS: The analyses revealed that campaign exposure was associated with having more negative attitudes toward methamphetamine, calling LAC's substance abuse service helpline, using methamphetamine fewer days, and considering abstaining. Frequency of exposure to campaign advertisements was positively associated with calling the helpline, suggesting a campaign dose effect. COVID-19-related factors were associated with using methamphetamine in the past 30 days. CONCLUSIONS: Social marketing campaigns hold promise for impacting methamphetamine prevention and cessation behaviors. This study adds to the limited literature on mass marketing interventions to address this major health issue.

Drama, Intrigue, and Discussion: The Role of Telenovelas in Facilitating Conversations about Reproductive Health in Mexican Households.

This study examines the role of an entertainment-education intervention in informing Mexican adolescents and parents about sexual and reproductive health-related discussion and information-seeking. A survey of young adult (N = 491) and parent (N = 223) viewers of the Spanish-language program Vencer el Miedo assessed the influence of exposure to the telenovela's storylines regarding these issues. Heavy viewing of the program predicted adolescent information-seeking about contraceptives via three distinct channels. Additionally, some effects were recorded for parent viewers, and parent-child co-viewing emerged as a significant moderator of communication about one reproductive health topic. Overall, these findings suggest that entertainment-education programs tailored to Mexican culture and the experiences of Mexican families can bring about attitudinal and behavioral changes across the age spectrum, an outcome that is particularly important given the relatively low rates of contraceptive knowledge and use among adolescents across the country.

The Effect of an Entertainment-Education Intervention on Reproductive Health of Young Women of Color.

While teen pregnancy rates in the United States have been declining for decades, they remain the highest of all western countries. Within the U.S., Black and Latina teens experience disproportionate rates of unplanned pregnancy. Plan A is an entertainment-education video intervention that was developed to help address these disparities, in part by emphasizing the ability of young cisgender women to control when they become pregnant by using an effective contraception method. The intervention was developed in close collaboration with the target audience (Black and Latina women aged 18-19) to ensure that it was relevant, engaging, and motivational. We conducted an online study to: (a) investigate the effects of Plan A on attitudes toward the contraception methods covered in the video; (b) whether these effects varied by race/ethnicity or age, and; (c) if identification with characters in the video mediated these effects. The study used a posttest-only design where participants were randomly assigned to watch Plan A or to a neutral control condition. The sample included Black, Latina, and non-Latina White women aged 16 to 19 (N= 242), with younger and White women included for comparison purposes. Results indicated that exposure to Plan A significantly improved attitudes toward long-acting reversible contraceptives (LARCs) among all age groups and among young Black and Latina women, but not White women. These findings may be explained by participant's identification with the Black and Latina lead characters - both of whom model positive reproductive health behaviors.

Isolation typology through accessibility measures considering rurality and armed conflict. A case study in Caldas, Colombia.

INTRODUCTION: Colombia's rural areas have suffered from government neglect, exacerbating their difficulties in relation to geographic isolation and meeting basic needs. These were some of the main reasons for guerrillas to initiate an armed conflict in the 1960s, trying to expand their forces and control through the rural and remote areas of the country. In this sense, it is necessary to construct new categories of rurality in Colombia, considering the armed conflict and the typology of isolation as variables that help policymakers and planners to make better decisions. METHODS: Based on 27 municipalities in the department of Caldas in Colombia, three accessibility measures were assessed to define isolated areas: geographical accessibility, access to health facilities and access to higher education. Health facilities were measured in three scenarios according to the flow of health care defined by the government. Higher education scenarios were defined according to Ministry of Education levels. Travel time was used as an attribute to calculate the isolation index of municipalities and was calculated using the Google Distance Matrix API using Python v3.7. As a measure of accessibility, a travel time limit was defined to delimit isolated areas. This variable was then added to the categories of rurality and armed conflict to produce the isolation typology by municipality. RESULTS: A strong correlation was found between all variables. Considering geographical accessibility, 20.3% of Caldas' population is isolated. The isolated population rises from 12.2% at the first level of health care to 43.2% of the population at the third level, and 39.5% of the inhabitants are far from universities. The municipalities highly affected by the armed conflict are more isolated in terms of travel time to health care and higher education facilities than those that were not affected. CONCLUSION: The isolation typology complements the Colombian rurality categories and can help governments make decisions about investments in road infrastructure, health, and education. In addition, some non-rural municipalities were found to be isolated, showing low accessibility to health and higher education, and the government should pay more attention to these areas. The government's neglect of municipalities highly affected by the armed conflict is shown by their continued isolation rates. The government should invest more and better in these areas taking into account this method of decision making. The typology of isolation could help the government to better plan care pathways for patients with complex health needs. In addition, it could help determine the investment for upgrading an existing hospital or building a new one, taking into account underserved areas. In terms of higher education, the isolation typology could help to understand where the community is underserved and initiate investment policies to improve access to higher education for its population.

Test4HepC: Promoting Hepatitis C Testing to Baby Boomers Using Social Media.

Individuals born between 1945 and 1965 ("baby boomers") account for an estimated three quarters of all hepatitis C (HCV) infections in the United States. This article describes the evaluation of Test4HepC, a program that uses social media and a website to promote HCV testing to baby boomers in Los Angeles County, California. The first 16 months of Test4HepC were evaluated using an online survey (n = 302), qualitative interviews (n = 20), website and social media analytics, and records of free testing offered though the program. Test4HepC.org had 6,919 visitors; 48 individuals used the free testing offered. Within 1 month of visiting the website, 24.5% (74) of survey participants tested for HCV, 67.6% (50) received a negative HCV antibody test result, 2.7% (2) received a positive HCV antibody test result, and 25.7% (19) had not received their results as of taking the survey. Most of those not tested (60.5%) reported intention to test. In multivariable analysis, male sex and high perceived usefulness of the program website were associated with HCV testing. Qualitative interviews suggested that Test4HepC increased baby boomers' HCV risk perception and encouraged testing. Social media is a promising strategy for promoting HCV testing to baby boomers. Expanding Test4HepC to other areas and prioritizing the highest risk baby boomers could enable many people with HCV to benefit from new treatments.

Developing a Video Intervention to Prevent Unplanned Pregnancies and Sexually Transmitted Infections Among Older Adolescents.

Older adolescent African American and Latina females have disproportionately high rates of unintended pregnancies and sexually transmitted infections (STIs). This article describes the development of a new video intervention for this population, modeled on Safe in the City (SITC), an evidence-based STI prevention video. Plan A was created from 2015 to 2016, using a systematic process similar to SITC. This included forming a project team with reproductive health experts, hiring a video production company and screenwriter, conducting a clinic staff survey (n = 8), and soliciting priority population input using three focus groups (n = 41) followed by a review panel (n = 9). The expert input, clinic staff survey, focus groups, and review panel informed the content and format of Plan A. The 23-minute video includes three interconnected stories with relatable characters and two animated sequences. Topics covered include condoms, long-acting reversible contraception, emergency contraception, STI prevention and testing, and patient-provider communication. SITC provided a model to create a new entertainment-education intervention for a different audience and to address pregnancy prevention as well as STIs. Sustained priority population involvement, input from stakeholders, and a highly iterative process were vital to developing Plan A, which is currently being evaluated in a randomized controlled trial.

The Break Up: Evaluation of an Anti-Smoking Educational Campaign for Lesbians, Gays, and Bisexuals in Los Angeles County.

Lesbian, gay, and bisexual (LGB) adults in the United States have a higher prevalence of smoking than their heterosexual counterparts. In 2013, the Los Angeles County Department of Public Health launched a social marketing and outreach campaign called Break Up to reduce the prevalence of smoking in LGB communities. Break Up was evaluated using cross-sectional, street-intercept surveys before and near the end of campaign. Surveys measured demographics, campaign awareness, and self-reported smoking-related outcomes. Bivariate statistics and logistic regression models were used to identify whether campaign awareness was associated with smoking-related outcomes. Calls by LGB persons to a smokers' helpline were also measured. Among those interviewed at endline, 32.7% reported Break Up awareness. Awareness was associated with thinking of quitting smoking and ever taking steps to quit but not with smoking cessation (defined as not smoking in the past 30 days among those who had smoked in the past 6 months). There was a 0.7% increase in the percentage of weekly calls by LGB persons to the helpline in the year after the campaign. Break Up reached about a third of its intended audience. The campaign was associated with smoking cessation precursors and may have led to an increase in helpline utilization, but there is no evidence it affected quit attempts. This study adds to the limited literature on tobacco programs for LGB persons and, as far as we know, is one of the first to evaluate tobacco-free social marketing in this important yet understudied population.

Acceptable interventions to reduce syphilis transmission among high-risk men who have sex with men in Los Angeles.

OBJECTIVES: We examined perceptions of and attitudes toward existing and potential syphilis interventions, including case management and Web-based programs, to increase syphilis testing among high-risk men who have sex with men (MSM). METHODS: Between October 2010 and June 2011, we conducted in-depth interviews with 19 MSM in Los Angeles, California, with repeat early syphilis infections (primary, secondary, and early latent syphilis) within the previous 5 years. We analyzed the interviews inductively to determine the most acceptable potential interventions. RESULTS: Experiences with health department and community-based standard of care case management were generally positive. The most popular interventions among respondents included a Web site providing information on syphilis and syphilis testing, automated Web reminders to test, being paid to test, free online home testing kits, and preexposure prophylactic medication. Respondents' beliefs that they would continue to practice high-risk sexual behaviors reinforced their reasons for wanting increased accessibility and convenient testing strategies. CONCLUSIONS: Public health officials should consider participant responses to potential interventions for syphilis, which suggest that high-risk MSM would consider testing more often or using other interventions.

Check Yourself: a social marketing campaign to increase syphilis screening in Los Angeles County.

BACKGROUND: In 2007, the Los Angeles County Department of Public Health launched Check Yourself, a new social marketing campaign, as part of ongoing efforts to address the persistent syphilis epidemic among men who have sex with men (MSM) in the county. The goals of the campaign were to increase syphilis testing and knowledge among MSM. Check Yourself was planned with careful attention to the principles of social marketing, including formative research, market segmentation, and an emphasis on building a strong brand. METHODS: A cross-sectional survey using a time-location sample was conducted in 2009 for the evaluation. The survey assessed demographics, syphilis knowledge, and recent syphilis testing as well as unaided awareness, aided awareness, and confirmed awareness, meaning that a person had both awareness of the campaign and could correctly identify that the campaign was about syphilis. The total sample size was 306. RESULTS: Unaided awareness for Check Yourself was 20.7%, and aided awareness was 67.5%, bringing total campaign awareness to 88.2%; confirmed awareness was 30.4%. Unaided campaign awareness was associated with syphilis knowledge and important risk behaviors for syphilis, indicating that the campaign reached an appropriate audience. Total awareness was not associated with recent syphilis testing in a multivariate model. However, MSM with confirmed awareness were more than 6 times more likely to have been recently tested. CONCLUSIONS: The evaluation of Check Yourself found that the campaign had a very strong brand among MSM. Although total awareness was not associated with syphilis testing, confirmed awareness, a more robust measure, was strongly associated.

There's no place like home: first-year use of the "I Know" home testing program for chlamydia and gonorrhea.

In response to high chlamydia and gonorrhea morbidity, particularly among young African American and Latina women, the Los Angeles County Department of Public Health launched a free home testing program for Chlamydia trachomatis and Neisseria gonorrhoeae. The primary objectives were to increase chlamydia and gonorrhea testing by removing key barriers and to motivate young women to screen routinely for these sexually transmitted diseases (STDs). The program was promoted with a social marketing campaign urging women to order home collection kits online or by telephone. In the program's first year, 2927 kits were ordered and 1543 testable specimens returned; 131 women (8.5%) had a positive test result. The strong response, high morbidity, and program scalability indicated strong potential as a new tool for STD control.

Evaluation of inSPOTLA.org: an Internet partner notification service.

BACKGROUND: This article presents an evaluation of inSPOTLA.org, a sexually transmitted disease partner notification Web site in Los Angeles County primarily targeting men who have sex with men (MSM). Since its launch in 2005, this Web site has received more than 400,000 visitors and resulted in nearly 50,000 e-mail postcards sent. However, there have been limited quantitative data concerning use of the service for actual partner notification. This study investigated awareness and use of inSPOTLA among MSM, as well as the effect of an advertising campaign. METHODS: Data from 2 cross-sectional surveys using time-location samples were used for the evaluation, with a baseline survey conducted in 2007 and a follow-up conducted in 2009. The advertising campaign was implemented between the surveys in 2008. RESULTS: Awareness of inSPOTLA was 15.8% in the baseline survey and 14.4% in the follow-up survey, with no statistically significant difference. Reported use of inSPOTLA for partner notification was less than 2% in both surveys, again with no significant difference. In addition to the surveys, a high-volume sexual health clinic that serves the MSM population in Los Angeles collected data on reason for visit, including referrals from inSPOTLA, from all patients from 2007 through 2009. In 3 years, 2 individuals stated having received an inSPOTLA e-card as the reason for their visit. CONCLUSIONS: While website user statistics seemed to indicate an impressive level of use, our evaluation of inSPOTLA found very limited evidence of program effectiveness for the purpose of actual partner notification among MSM in Los Angeles County.

Stop the sores: the making and evaluation of a successful social marketing campaign.

Los Angeles County has experienced a rapid increase in early syphilis among men who have sex with men (MSM) in recent years, with the number of cases rising from 126 in 2000 to 809 in 2005. As part of the public health response to this outbreak, a sustained social marketing campaign was launched in 2002, with the objectives of increasing syphilis testing, knowledge, and awareness among MSM in Los Angeles. This campaign, as implemented, exemplified key principles of social marketing, including market research, audience segmentation, and branding. A cross-sectional study conducted in 2004 to evaluate the campaign found that those MSM who were aware of the campaign were nearly twice as likely to have tested for syphilis in the past 6 months as those MSM who were not aware of the campaign. Those MSM who were aware of the campaign also had more syphilis awareness and knowledge in key areas.

[Surgical approach of traumatic urethral injury in children. Experience at San Vicente of Paul Universitary Hospital. Medellín 1987-2007]. / Experiencia en reconstrucción postraumática de uretra posterior en niños. Hospital Universitario San vicente de Paúl. Medellín 1987-2007.

OBJECTIVE: In order to evaluate the efficacy of different surgical techniques for the correction of traumatic lesions of the urethra, we performed a retrospective study in those patients, and evaluated different complications such as postsurgical stenosis of the urethra, incontinence and impotence (erectile dysfunction). METHODS: A retrospective study was conducted, reviewing the clinical charts of 43 patients admitted to the San Vicente of Paul Hospital, with diagnosis of traumatic rupture of the posterior urethra from 1987 to 2007. We analyzed different demographic data, type of surgical correction, early and late complications. RESULTS: The average age of the patients was 7.7 years, the average follow up was 30.6 months, and all the patients were male with a posterior urethral rupture. 27 Patients underwent a primary urethral repair (63%), 13 patients underwent a cistostomy with later urologic reconstruction (30%), in 3 patients (7%) other surgical procedures were made. Overall complication rate was 39.5%. These complications were: Urethral stenosis, 26 patients (60.5%), urinary retention secondary to obstruction, 10 patients (23.3%), incontinence 10 patients (23.3%) and impotence 7 patients (16.3%). Patients treated with a primary urethral repair presented a significantly less development of infection, obstruction and stenosis, (p<0.05). Patients with pelvis fracture associated to urethral trauma had a significant higher risk of developing stenosis and impotence. (p<0.05). CONCLUSIONS: Both different surgical techniques compared showed a similar complication and morbidity rates in middle follow up. Each procedure should be selected according to clinical condition of the patient, the extension of the urethral damage, the associated traumatic lesions and the surgeon's expertise. In our searched patients, treated with a primary urethral repair we found a significantly less development of infection, obstruction and stenosis.

Effects of a brief video intervention on treatment initiation and adherence among patients attending human immunodeficiency virus treatment clinics.

BACKGROUND: Persons with human immunodeficiency virus (HIV) who get and keep a suppressed viral load are unlikely to transmit HIV. Simple, practical interventions to help achieve HIV viral suppression that are easy and inexpensive to administer in clinical settings are needed. We evaluated whether a brief video containing HIV-related health messages targeted to all patients in the waiting room improved treatment initiation, medication adherence, and retention in care. METHODS AND FINDINGS: In a quasi-experimental trial all patients (N = 2,023) attending two HIV clinics from June 2016 to March 2017 were exposed to a theory-based, 29-minute video depicting persons overcoming barriers to starting treatment, taking medication as prescribed, and keeping medical appointments. New prescriptions at index visit, HIV viral load test results, and dates of return visits were collected through review of medical records for all patients during the 10 months that the video was shown. Those data were compared with the same variables collected for all patients (N = 1,979) visiting the clinics during the prior 10 months (August 2015 to May 2016). Among patients exposed to the video, there was an overall 10.4 percentage point increase in patients prescribed treatment (60.3% to 70.7%, p< 0.01). Additionally, there was an overall 6.0 percentage point improvement in viral suppression (56.7% to 62.7%, p< 0.01), however mixed results between sites was observed. There was not a significant change in rates of return visits (77.5% to 78.8%). A study limitation is that, due to the lack of randomization, the findings may be subject to bias and secular trends. CONCLUSIONS: Showing a brief treatment-focused video in HIV clinic waiting rooms can be effective at improving treatment initiation and may help patients achieve viral suppression. This feasible, low resource-reliant video intervention may be appropriate for adoption by other clinics treating persons with HIV. TRIAL REGISTRATION: http://www.ClinicalTrials.gov (NCT03508310).

Brief Report: PrEP Uptake, Adherence, and Discontinuation Among California YMSM Using Geosocial Networking Applications.

We investigated pre-exposure prophylaxis (PrEP) uptake, adherence, and discontinuation among young app-using men who have sex with men in California (N = 761). Approximately, 9.7% of participants had ever used PrEP; 87% of those deemed good candidates for screening (indicated by a Centers for Disease Control and Prevention risk index score ≥10) were not current or past users. PrEP use was associated with higher income [adjusted odds ratio (aOR): 4.13; confidence interval (CI): 1.87 to 9.12], receptive condomless anal sex (aOR: 3.41; CI: 1.71 to 6.78), HIV-positive sex partners (aOR: 2.87; CI: 1.53 to 5.38), popper use (aOR: 3.47; CI: 1.96 to 6.13), and recent sexually transmitted infection diagnosis (aOR: 2.90; CI: 1.64 to 5.13). Some users (41.5%) wanted help remembering to take PrEP. The top reason for discontinuation was concern about long-term side effects (33.0%). Young men who have sex with men app users are prime candidates for PrEP, despite low uptake. Apps may be useful tools for PrEP information dissemination, adherence monitoring, and support.