Just a Guy

eHealth HIV behavioral interventions are increasingly incorporating digital media, ranging from brief, untailored video interventions to complex computer-tailored multimedia interventions that target individual behaviors. Online video-based interventions are an appealing and effective way to deliver HIV prevention content to gay and bisexual men who have sex with men (GBMSM). Furthermore, video has greater potential to engage learners than conventional text or graphics in web-based or print materials. Storytelling is more effective than exposition and stories effective for learning are characterized by realism.

The Sex Positive!^[+] study is a 2-arm, 12-month, online video-based randomized controlled trial designed to reduce serodiscordant condomless anal sex (CAS) and increase HIV disclosure to sex partners among 1,500 U.S. GBMSM living with HIV who were virally unsuppressed in the past year and report serodiscordant CAS. Men in the intervention arm receive 10 video vignettes - 6 of which are from the new series, described below - grounded in Social Learning and Social Cognitive theories. Participants in the attention control arm receive 10 healthy living videos.

Through our prior work, we have identified a risk reduction intervention approach for GBMSM living with HIV. Sex Positive!^[+] encompasses many characteristics found to reduce risk among HIV-positive populations, in that it is theory-driven, has intervention content focused on HIV transmission behaviors, uses videos that demonstrate risk reduction and health behaviors through modeling (e.g., HIV disclosure, taking HIV medication), is delivered in an intensive manner (i.e., 10 videos and 5 assessments), and is delivered over 12 months. The primary objectives of Sex Positive!^[+] are to reduce CAS with serodiscordant partners and to increase HIV disclosure to sex partners.

Our Community Advisory Group recommended that the video series feature an HIV-positive main character who overcomes a “victim” status and develops a sense of empowerment that positively impacts his personal relationships and physical health. The new dramatic video series will engage learners through storytelling and promote critical thinking on issues of HIV disclosure to sex partners, HIV medication adherence and viral suppression, and serodiscordant CAS. In collaboration with a local production team, including a script writer, producer, and director, we produced a new dramatic video series, combined into one video short, that follows the story of “Guy”, an openly gay man living with HIV in Brooklyn, NY. The video series is based, in part, on the HIV Big Deal project launched online in 2008.