JMIR Publications

ABSTRACT

Background:

Men who have sex with men (MSM) are disproportionally affected by HIV and drug and alcohol use, but few effective HIV prevention interventions for MSM who use substances exist. SBIRT (Screening, Brief Intervention, and Referral to Treatment) is an early intervention for non-treatment-seeking individuals with problem substance use (PSU) and for timely referral to treatment for those with substance use disorders. Electronic SBIs (e-SBIs) reduce implementation challenges such as extensive training, demands on staff time, and inconsistency in the delivery of the BI while remaining as effective as in-person SBIs. An e-SBI tailored for MSM at the time of HIV testing might be particularly opportune to strengthen his motivation to reduce his substance use and HIV risk behavior.

Objective:

The study seeks to develop a tailored e-SBI program to reduce substance use and HIV risk behavior among MSM seeking HIV testing at Nexo Asociacion Civil, our community partners in Argentina (Primary); assess the feasibility and acceptability of integrating e-SBI into the Nexo HIV testing program (Primary); and assess the feasibility and acceptability of implementing an adapted Men’s Health Project (MHP) at Nexo (Secondary). Lastly, we will explore preliminary findings on substance use and sexual risk reduction outcomes (Exploratory).

Methods:

This mixed-methods study has two stages. During Stage 1 (Development), we will develop the e-SBI, adapt MHP, train counselors to deliver MHP, and pilot the e-SBI with 50 MSM coming to Nexo for HIV testing. At each step of the development process, participants will complete quantitative assessments of acceptability and qualitative feedback interviews that will inform revisions to the e-SBI to maximize the acceptability and impact of the intervention. During Stage 2 (RCT Pilot), we will randomize 200 MSM coming to Nexo for HIV testing. They will complete a baseline assessment then their assigned intervention (e-SBI vs. screening only) and followed for 6 months. We will also conduct in-depth interviews with up to 45 participants, 15 with participants from either study condition who entered or completed MHP and/or other substance abuse treatment and 15 from each arm who met criteria for MHP but did not request it.

Results:

The study began recruitment in October 2022 and we are nearing completion of the Stage 1 pilot study. The Stage 2 pilot RCT will launch in March 2024 with all data collection completed by May 2025.

Conclusions:

Completion of this study will allow us to assess the acceptability and feasibility of implementing the e-SBI during HIV testing encounters. We will build the necessary research infrastructure for a subsequent RCT to assess the efficacy of the e-SBI to reduce substance use and HIV sexual risk behavior among MSM in this setting. Clinical Trial: The study was registered at clinicaltrials.gov on September 16, 2022. The identifier number is NCT05542914.