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Udi Davidovich

Using the Internet to reduce risk of HIV-Infection in steady relationships: A randomized controlled trial of an online tailored intervention

Udi Davidovich
Amsterdam Health Services, Department of Research, Online Re

John de Wit
Utrecht University, social and organizational psychology

Wolfgang Stroebe
Utrecht University, social and organizational psychology

Topic: Internet for disease prevention
Track: Research
Type: Oral presentation

     Full text: Not available
     Slides: available to participants
     Last modified: March 15, 2006
     Presentation date: 10/17/2006 4:30 PM in RYH Tudor 7
     (View Schedule)

Abstract
OBJECTIVES
Relationships are a high-risk setting for HIV-infection. This paper describes the development and efficacy-testing of an online theory-based tailored intervention which prepared single gay men to practice safe sex with future steady partners-labeling it the 'cognitive vaccine approach'.

METHODS
The target was the promotion of negotiated safety (NS): steady partners testing for HIV and reaching agreements to either be monogamous or to only have safe sex outside the relationship in order to have safe unprotected anal intercourse with each other. The intervention content was based on the information, motivation, behavioral-skills model and the intervention was tailored according to knowledge, motivation, and skill-related deficiencies of each participant. Condom use was promoted as the default alternative for NS. Using an online randomized controlled trial we examined the effects of a tailored versus non-tailored version of the intervention. The cognitive effect (i.e. response efficacy, intentions, and perceived behavioral control (PBC) was measured directly after the intervention and, after 6-months, the behavioral effect (i.e. NS and condom use) via e-mail follow-up.

RESULTS
Online recruitment produced 1013 single gay or bisexual men. The median age was 33 (SD=11.1). Analyses revealed that both tailored and non-tailored interventions increased response efficacy (p<.001), but only the tailored intervention increased intentions to practice negotiated safety and to use condoms with future partners (p<.05). No effect was found for PBC. Follow-up on behavior indicated that the men in the tailored intervention were more likely to practice NS with their new partner (OR=10.50, 95%CI 1.19-92.72). Intentions to practice NS at time 1 mediated the intervention effect on behavior.

CONCLUSIONS
The online tailored intervention significantly increased NS behaviors at a six months follow-up and rendered the cognitive vaccine approach effective. The motivational component of the intervention seems to have been the most effective one in inducing behavioral change.


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