Testing Makes Us Stronger™: Evaluating the correlation between exposure and intermediate outcomes targeted by the campaign's messages.

OBJECTIVES: To examine whether self-reported exposure to Testing Makes Us Stronger™ (TMUS), an HIV testing health communication campaign for black gay, bisexual, and other men who have sex with men (BMSM), was associated with key intermediate outcomes targeted by the campaign's messages. METHODS: Data from sexually active, HIV-negative or unknown status BMSM aged 18-44 (N = 590) were collected through an anonymous Web-based survey that measured sociodemographics, campaign exposure, attitudinal beliefs, normative beliefs, self-efficacy, and HIV testing intentions, among other variables. The association between exposure to TMUS and intermediate outcomes was evaluated using propensity-score weight adjusted correlations. RESULTS: Exposure to TMUS was high (43%) among the priority audience. Exposure to the campaign was correlated with 8 of 11 intermediate outcomes measured, including key attitudinal beliefs about the accessibility of the test and benefits to the individual, injunctive norms, self-efficacy, and HIV testing intention. CONCLUSION: Adhering to principles of effective campaign design, such as using theory as a conceptual foundation for message design, can increase a campaign's chances for successfully meeting its goals and objectives. PRACTICE IMPLICATIONS: Findings from this study can be used to inform message design for other communication efforts to promote HIV testing among BMSM.

An Interrupted Time Series Evaluation of the Testing Makes Us Stronger HIV Campaign for Black Gay and Bisexual Men in the United States.

Black gay, bisexual, and other men who have sex with men (BMSM) are the subpopulation most disproportionately affected by HIV in the United States. Testing Makes Us Stronger (TMUS), a communication campaign designed to increase HIV testing rates among BMSM ages 18 to 44, was implemented in the United States from December 2011 through September 2015. We used interrupted time series analysis (ITSA) to compare pre- and post-campaign trends in monthly HIV testing events among the priority audience in six of the implementation cities from January 2011 through December 2014. In the 11 months prior to the launch of TMUS, HIV testing events among BMSM in the six campaign implementation cities decreased by nearly 35 tests per month (p = .021). After the introduction of TMUS, the number of HIV testing events among BMSM in the same cities increased by more than 6 tests per month (p = .002). ITSA represents a quasi-experimental technique for investigating campaign effects beyond underlying time trends when serial outcome data are available. Future evaluations can be further strengthened by incorporating a comparison group to account for the effects of history and maturation on pre- and post-campaign trends.

Swipe Right: Dating Website and App Use Among Men Who Have Sex With Men.

This study explored the frequency of dating website and app usage among MSM to understand sub-group differences in use. Web-based survey data (N = 3105) were analyzed to assess the use of dating websites and apps. More than half (55.7%) of MSM in this sample were frequent users of dating websites and apps. Two-thirds (66.7%) of frequent users had casual partners only in the past 12 months and reported a high average number of casual sexual partners in the past 12 months (Mdn = 5.0) compared to never users (Mdn = 0.0; χ 2(2) = 734.94, adj. p < .001). The most frequently used dating website or app was Grindr, with 60.2% of the sample reporting some or frequent use. Adam4Adam (23.5%), Jack'd (18.9%) and Scruff (18.7%) were also frequently used. Dating websites and apps may be effective channels to reach a diverse group of MSM with HIV prevention messages.

CDC'S Testing Makes Us Stronger (TMUS) Campaign: Was Campaign Exposure Associated With HIV Testing Behavior Among Black Gay and Bisexual Men?

This study assessed exposure among Black gay, bisexual, and other men who have sex with men (BMSM) to a communication campaign, Testing Makes Us Stronger (TMUS), and its association with HIV testing to determine campaign effectiveness. Data from an online survey (N = 3,105) were analyzed using propensity score weight-adjusted logistic regression to examine the effect of exposure on HIV testing. Among BMSM aged 18-44 (n = 702), 43.2% reported TMUS exposure. The majority of those exposed were aged 25-34 (54%), HIV-negative (65%), and had some college education (87%). TMUS exposure was associated with reported increased HIV testing behaviors at 6- and 12-month frequencies. Communication campaigns with clear implementation strategies, focused objectives, and online and event presence can be associated with longer-term outcomes such as HIV testing.

Change in women's knowledge of general and personal preconception health risks following targeted brief counseling in publicly funded primary care settings.

PURPOSE: To explore knowledge of general and personal preconception health risks among women in publicly funded clinics and whether brief counseling can improve knowledge. DESIGN: Interventional cohort study. SETTING: Five publicly funded primary care clinics. SUBJECTS: Two cohorts of low-income, nonpregnant African-American and Hispanic women of reproductive age (300 in each cohort). INTERVENTION: Targeted brief counseling based upon risks identified via preconception health risk assessment. MEASURES: Correct responses on test of women's knowledge of general and personal preconception health risks pre-encounter vs. 3 to 6 months post-encounter. ANALYSIS: McNemar's test to compare proportion of women in each cohort who correctly answer questions of preconception health knowledge pre-encounter vs. 3 to 6 months post-encounter. RESULTS: Women in the intervention cohort experienced a significant increase in knowledge related to preconception health from baseline to 3 to 6 months post-encounter, including recognition of the importance of folic acid supplementation, seeking medical care for chronic conditions, and review of medication in the preconception period that was not observed for the comparison cohort. Among women with chronic medical conditions, those in the intervention cohort significantly increased their knowledge that the condition could lead to problems in pregnancy (+43%) relative to the lesser improvement in knowledge observed for those in the comparison cohort (+4%) (p < .05). CONCLUSIONS: Women's knowledge of general and personal preconception health risks improved following screening and brief counseling in publicly funded primary care clinics.

Acceptability and potential impact of brief preconception health risk assessment and counseling in the WIC setting.

PURPOSE: To determine the reproductive risks of women using the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the acceptability of delivering preconception screening and counseling with the WIC encounter. DESIGN: A mixed methods approach to include quantitative analysis of reproductive risks and qualitative analysis of post-counseling interviews. SETTING: A WIC clinic in Clayton County, Georgia. PARTICIPANTS: A quota sample of 150 African-American women 18 to 44 years of age recruited from the attendees of WIC nutrition classes for postpartum and breastfeeding women and mothers of children under 5. Intervention. A brief individual counseling based upon identified risks. METHOD: Participants were administered a risk assessment questionnaire by a member of the study team to determine topics for brief counseling. Following standardized brief counseling, participants completed an individual semistructured interview. The risk assessment questionnaire was analyzed quantitatively; transcripts from the post-counseling interviews were analyzed thematically. RESULTS: Reproductive risks were prevalent among women of reproductive age seeking WIC services: unintended pregnancy (27%), history of sexually transmitted infection (49%), inadequate folic acid supplementation (66%), intimate partner violence (47%), tobacco use (21%), binge drinking (10%), and illicit drug use (5%). The vast majority of WIC clients found the preconception risk assessment and brief counseling to be acceptable and important. CONCLUSION: WIC constitutes a suitable location for identifying low-income African-American women in need of preconception and reproductive health services and at risk for poor reproductive health outcomes.