+CLICK: Usability study of a web-based, self-management program for HIV+ youth

Background: Adolescents and young adults account for over 10 million HIV infections worldwide. With advances in antiretroviral therapy, HIV-related mortality and morbidity have dramatically declined and HIV infection has become a chronic disease requiring lifetime management. This study assessed the usability of +CLICK, a tailored, web-based application to enhance self-management skills among HIV-positive youth.

Methods: HIV+ youth ages 13-24 from a pediatric clinic and community-based organization pilot-tested +CLICK's sexual risk reduction module which contained FLASH and video-based activities to enhance self-efficacy, knowledge, attitudes, and perceived norms related to sexual behavior. Participants completed questions regarding usability (ease of use, credibility, understandability, acceptability, and motivation), and short-term psychosocial impact. Descriptive statistics and Wilcoxon Signed Ranks Test were used to assess usability and psychosocial change.

Results: Participants (n=21) were 71.4% female, 71.4% black, and 23.8% Hispanic. Mean age was 18.6 (SD=2.44) years; 62% were behaviorally infected, 38% perinatally infected. Usability parameters were highly rated: 81% of participants rated the program very easy to use; a minimum of 90.5% perceived content as correct and trustworthy; 90.5% agreed most words were understandable; 81% liked the program a lot; 85.7% would use the program again, and 81% would tell their friends about +CLICK. Results indicate participants' confidence to wait to have sex was significantly increased (p=.014) while confidence or importance regarding condom use was unaffected, a finding consistent with differential participant exposure to tailored program content.

Conclusion: The usability, impact, and feasibility of +CLICK for clinic application suggest further module development and efficacy testing is indicated.