HIV/AIDS prevention without borders: An internet-delivered safer sex intervention for young MSM

Background: Although HIV diagnoses in MSM in the US decreased through the 1990s, recent surveillance data suggest resurgence, especially among youth and minorities. Such findings suggest an ongoing need for behavioral interventions to reduce sexual risk. To the extent that MSM increasingly use the internet, it serves as a promising medium for behavioral intervention. The present project sought to leverage the capabilities of the internet to develop an effective, interactive, web-based skills-training and motivational intervention to reduce sexual risk among MSM.

Methods: After a detailed pretest assessment of sexual practices, MSM (N=143) were randomly assigned to the safer sex intervention or to a control condition. The 90-minute intervention consisted of risk assessment and feedback, motivational exercises, skills training and education. The control condition invoked a relaxation-skills website. Follow-up data were collected three months later and analyzed with repeated-measures MANOVA.

Results: From pretest to followup, numbers of unprotected acts decreased significantly in both groups. However, focusing specifically on unprotected acts with partners of positive or unknown serostatus, significantly greater reductions were observed in the intervention group as opposed to the control group.

Conclusions: Although both groups evidenced across-the-board reductions in unprotected sex, perhaps emanating from heightened risk-consciousness as a consequence of completing the detailed assessment, the intervention group showed greater reductions with the riskiest partners, those of positive or unknown serostatus. Thus, this study gives preliminary evidence that a brief web-based intervention offering cognitive behavioral skills training and motivational enhancement can effectively reduce sexual risk in MSM.