JMIR Publications

ABSTRACT

Background:

The syndemic intersection of HIV risk and substance misuse among young men who have sex with men (YMSM) and young transgender women (YTW) has been well established and well documented, and requires novel scalable interventions.

Objective:

The purpose of the study was to test the efficacy of a fully automated electronic screening and brief intervention, called Step Up, Test Up, to reduce alcohol misuse among adolescents and young adults presenting for HIV testing. Secondary objectives were reduction in sexual risk and uptake of pre-exposure prophylaxis (PrEP) for HIV prevention.

Methods:

Youth ages 16-25 who presented for HIV testing at community-based locations were recruited for study participation. Those who screened at moderate to high risk on the Alcohol Use Disorders Identification Test were randomized (1:1) to either an electronic brief intervention or a time-attention control. The primary outcome was change in alcohol use at 1, 3, 6 and 12-month follow-up. Negative binomial and log binomial regression with generalized estimating equations were conducted to evaluate the intervention efficacy.

Results:

Among a sample of 329 youth, there were no significant differences in alcohol use outcomes between conditions over time or at 1, 3, 6 or 12-month timepoints. In terms of secondary outcomes, there was evidence of reduction in insertive anal sex under the influence of alcohol and drugs at 12 months compared to 3 months in the intervention versus the attention control condition, however there were no other significant differences in sexual risk and no difference in PrEP engagement.

Conclusions:

We found no effect of electronic brief intervention to reduce alcohol use, and some effect on sexual risk among youth ages 16-25 who present for HIV testing. Clinical Trial: ClinicalTrials.gov number, NCT02703116, registered March 9, 2016, https://clinicaltrials.gov/