A Pilot Randomized Controlled Trial of an mHealth Intervention to Improve PrEP Adherence Among Young Sexual Minority Men.

This randomized controlled study assessed the feasibility, acceptability, and preliminary impact of the PrEP iT! mHealth intervention designed to improve PrEP adherence among young men who have sex with men (YMSM). A national sample of 80 YMSM in the U.S. (Mage = 25 years; 54% racial/ethnic minority), recruited through social media ads, were randomized to either the PrEP iT! or usual PrEP care conditions. Participants completed online surveys and submitted self-collected dried blood sample (DBS) data as measures of PrEP adherence. Differences in PrEP adherence across treatment arms and between participants with high versus low engagement in PrEP iT! were assessed. Retention was high at the three (94%) and six (93%) month assessment, and participants in PrEP iT! reported satisfactory acceptability of the intervention. There were no significant differences in self-reported or DBS-derived PrEP adherence between randomized groups. However, YMSM in the PrEP iT! group with high PrEP adherence (the equivalent of four or more doses/week through self-report and DBS-derived measures) demonstrated significantly higher engagement in the intervention than those with low PrEP adherence (the equivalent of 3 or fewer doses/week). Overall, the PrEP iT! intervention demonstrated strong feasibility and acceptability. The finding that high PrEP iT! intervention engagement was associated with protective levels of PrEP adherence suggests it is a viable adherence support tool that should be further evaluated in definitive trial among YMSM who need basic support, or as part of a more comprehensive adherence support package for those who need greater assistance.Trial registration Clinical Trials # NCT04509076 (registered August 10, 2020).

Digital location tracking in the parent/caregiver-college student dyad.

INTRODUCTION: As college students navigate new developmental milestones, many families rely on digital technology to stay connected and aid in the transition to adulthood. Digital location tracking apps allow for parental monitoring in new ways that may have implications for youth development. Although recent research has begun to examine prevalence and motivations for digital location tracking in adolescence, we know little about how and why families continue to track into the transition to college, and how this may relate to perceptions of helicopter and autonomy supportive parenting. METHODS: In a cross-sectional study of 706 community college and 4-year university students in the Southeastern United States, we describe prevalence and sociodemographic differences in parent/caregiver digital location tracking of their college student children, and how this may be associated with perceptions of helicopter parenting and parent/caregiver autonomy support. RESULTS: Findings suggest that digital location tracking is a fairly common practice among college students, with nearly half of the sample endorsing currently or previously being digitally location tracked by their parent/caregiver. Younger, White, and higher socioeconomic status students were more likely to be tracked. Those students who were currently being digitally location tracked tended to perceive their primary parent/caregiver as engaging in more helicopter parenting and as less supportive of their autonomy. CONCLUSIONS: This brief report provides preliminary insight into parent/caregiver digital location tracking of their college student children. It is our hope that future research will further examine how digital location tracking may be helping or hindering attainment of developmental milestones in the digital age.

Parent strategies to help emerging adults manage stress are associated with their mental health: A dyadic coping perspective.

Emerging adults (EAs) are at high risk for mental health challenges and frequently reach out to their parents for support. Yet little is known about how parents help emerging adults manage and cope with daily stressors and which strategies help and which hinder EA mental health. In this cross-sectional pilot study of students at a 2- and 4-year college (ages 18-25, N = 680, mean age = 19.0), we extend models of dyadic coping from intimate relationships to the parent-emerging adult relationship and test whether six specific parent strategies to help emerging adults manage stress are associated with EA mental health. Emerging adults with parents who provided problem and emotion-focused supportive dyadic coping, delegated dyadic coping, and common/joint dyadic coping reported fewer symptoms of anxiety and depression, as well as higher levels of psychological well-being. In contrast, college-attending emerging adults who reported higher levels of parent-provided negative dyadic coping reported higher levels of depressive and anxiety symptoms and lower psychological well-being. Parent-emerging adult dyadic coping is a fruitful area for future research and intervention development.

Attitudes Toward and Beliefs in the Effectiveness of Biomedical HIV Prevention Strategies Among Emerging and Young Adult Sexual Minority Men.

BACKGROUND: Pre-exposure prophylaxis (PrEP) and HIV treatment as prevention, which underlies the Undetectable = Untransmittable (U = U) campaign, are two effective biomedical approaches for HIV prevention among sexual minority men (SMM). Attitudes toward PrEP and U = U may differ between SMM emerging adults (EA: 18-24 years old) and young adults (YA: 25-29 years old) to drive differences in sexual behavior. However, to date, few studies assessed the degree to which YAs and EAs differ in their beliefs in the effectiveness of PrEP and U = U. METHOD: A national sample of 80 SMM in the USA (Mage = 25.1 years; 53.7% racial/ethnic minority; 38.8% EA; 61.3% YA) participated in a 6-month mHealth intervention for PrEP adherence. Non-parametric tests assessed differences in sexual behaviors and attitudes toward the effectiveness of PrEP and U = U between EAs and YAs using baseline data. RESULTS: Compared to EAs, higher proportions of YAs trusted PrEP's effectiveness and considered condom use unnecessary after taking PrEP. More YAs than EAs were willing to engage in sexual behaviors that they felt too risky before learning about U = U and were more comfortable having condomless sex with HIV-positive partners. Conversely, a greater proportion of EAs than YAs preferred to use condoms even when their partners are on anti-HIV medications. CONCLUSION: Overall, YAs trusted the effectiveness of U = U and PrEP more than EAs, underscoring developmental differences in SMM's perspectives on biomedical HIV prevention tools. Our findings underscore the importance of tailoring messages on biomedical HIV prevention options differently for EAs and YAs to optimize uptake.

Emerging adults' digital technology engagement and mental health during the COVID-19 pandemic.

Within the past decade, parents, scientists, and policy makers have sought to understand how digital technology engagement may exacerbate or ameliorate young people's mental health symptoms, a concern that has intensified amidst the COVID-19 pandemic. Previous research has been far from conclusive, and a lack of research consensus may stem in part from widely varying measurement strategies (including subjective and objective measurement) around digital technology engagement. In a cross-sectional study of 323 university students, the present study seeks to understand the ways in which youth engagement with digital technology - across subjective and objective measurements, weekday and weekend distinctions, and social and non-social uses - is associated with mental health (as measured by depression, loneliness, and multidimensional mood and anxiety). The present study also tested a differential susceptibility hypothesis to examine whether COVID-19 related social isolation might exacerbate the potential harms or helps of digital technology engagement. Results yielded few observed associations between digital technology engagement and mental health, with little evidence of detrimental effects of observed or perceived time spent on digital technology. Rather, those significant findings which did emerge underscore potential protections conferred by social connections with friends (both online and offline), and that the loneliest students may be the most likely to be reaching out for these types of connections. It is important that the field move beyond crude (largely self-reported) measures of screen time to instead understand how and to what effect youth are using digital technologies, especially during the social corridor of emerging adulthood.